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The nurse has instructed a client with panic disorder about how to use the technique of positive self-talk. The nurse determines that the client has understood the instructions when the client verbalizes which statement to use during an impending panic attack?
- A. I am feeling very nervous right now.
- B. I can handle this anxiety; it will be over shortly.
- C. I am taking medication to eliminate these symptoms.
- D. Relax your muscles, relax your muscles.
Correct Answer: B
Rationale: Positive self-talk (B) involves reassuring statements that empower the client to manage anxiety, such as affirming control and the transient nature of the attack. Stating nervousness (A) reinforces anxiety, medication reliance (C) is not self-talk, and muscle relaxation (D) is a different technique.
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A client comes to the emergency department because he thinks he is having a heart attack. Further assessment determines that the client is not having a heart attack but is having a panic attack. When beginning to interview the client, which question would be most appropriate for the nurse to use?
- A. Are you feeling much better now that you are lying down?
- B. What did you experience just before and during the attack?
- C. Do you think you will be able to drive home?
- D. What do you think caused you to feel this way?
Correct Answer: B
Rationale: Asking about the client?s experiences before and during the attack (B) gathers critical information about triggers and symptoms, aiding in confirming the panic attack diagnosis and planning care. Asking about feeling better (A) is premature, driving ability (C) is irrelevant during acute assessment, and causes (D) are less urgent than symptom details.
After teaching a class about the biochemical theories associated with panic disorder, the instructor determines a need for additional teaching when the students identify which neurotransmitter as being implicated?
- A. Dopamine
- B. Serotonin
- C. Norepinephrine
- D. Gamma-aminobutyric acid (GABA)
Correct Answer: A
Rationale: Serotonin (B), norepinephrine (C), and GABA (D) are implicated in panic disorder due to their roles in anxiety regulation. Dopamine (A) is primarily linked to psychosis and reward, not panic, indicating a misunderstanding.
A client with a panic disorder has been prescribed a benzodiazepine medication. Which of the following would the nurse emphasize as a risk associated with using this medication?
- A. Dietary restrictions
- B. Withdrawal symptoms
- C. Agitation
- D. Fecal impaction
Correct Answer: B
Rationale: Benzodiazepines (B) carry a significant risk of withdrawal symptoms, including anxiety and seizures, if stopped abruptly, necessitating careful tapering. Dietary restrictions (A) apply to MAOIs, agitation (C) is a symptom not a risk, and fecal impaction (D) is unrelated.
A nurse is developing the plan of care for a client with panic disorder that will include pharmacologic therapy. Which of the following would the nurse most likely expect to administer?
- A. Benzodiazepine
- B. Selective serotonin reuptake inhibitor (SSRI)
- C. Monoamine oxidase inhibitor (MAOI)
- D. Tricyclic antidepressant (TCA)
Correct Answer: B
Rationale: SSRIs (B) are the first-line treatment for panic disorder due to their efficacy and safety profile for long-term management. Benzodiazepines (A) are used short-term, MAOIs (C) and TCAs (D) are less preferred due to side effects and dietary restrictions.
The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which of the following would the nurse include when describing panic disorder?
- A. Individuals may believe they are having a heart attack when a panic attack occurs.
- B. People with panic attacks often have fewer attacks if they also have agoraphobia.
- C. Typically, individuals experience this disorder after the age of 30 years.
- D. Persons rarely have an underlying comorbid condition of depression.
Correct Answer: A
Rationale: Panic disorder (A) is characterized by sudden, intense fear often mistaken for a heart attack due to symptoms like chest pain and palpitations. Agoraphobia (B) typically increases attack frequency due to fear of public spaces, onset is often earlier than 30 (C), and depression is a common comorbidity (D), making these options incorrect.