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The nurse is caring for a client who is being treated in the emergency department for a panic attack. Which of the following nursing interventions would be most appropriate?
- A. Demonstrate empathy for the client by trying to mimic the client?s state of anxiety.
- B. Tell the client that you must leave to go report his symptoms to the psychiatrist on duty.
- C. Tell the client this is an acute exacerbation with a positive prognosis and low morbidity.
- D. Stay with the client, emphasizing that he is safe and that you will remain with him.
Correct Answer: D
Rationale: Staying with the client and emphasizing safety (D) provides reassurance and reduces fear during a panic attack. Mimicking anxiety (A) is inappropriate, leaving the client (B) increases distress, and discussing prognosis (C) is less urgent than providing immediate support.
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A nurse determines that a client who is experiencing anxiety is using relief behaviors. The nurse determines that the client is experiencing which degree of anxiety?
- A. Mild
- B. Moderate
- C. Severe
- D. Panic
Correct Answer: C
Rationale: Relief behaviors, such as avoidance or rituals, are typically used in severe anxiety (C) to reduce overwhelming distress. Mild anxiety (A) enhances alertness, moderate (B) involves manageable distress, and panic (D) involves disorganized behavior, not specific relief behaviors.
A nurse who has worked with a client diagnosed with generalized anxiety disorder (GAD) when he was an inpatient on the psychiatric unit sees the client in the waiting room of the outpatient psychiatric clinic. The client motions to the nurse to come over so he can tell the nurse how things have been going since he was discharged. While talking with the client, the nurse determines that the client?s therapy has been effective when the client states which of the following?
- A. I am still experiencing quite a bit of stress at home and at work; things are different at home than they were in the hospital.
- B. When my mother-in-law comes over now, I go out to my workshop and work on one of my projects.
- C. I?m still drinking coffee; I can?t quit after drinking it all these years.
- D. I?ve learned having a beer after I get home from work helps me relax.
Correct Answer: B
Rationale: Going to the workshop (B) indicates effective coping by using a constructive activity to manage stress from a trigger (mother-in-law?s visits). Persistent stress (A) suggests ineffective therapy, coffee (C) can worsen anxiety, and alcohol use (D) is an unhealthy coping mechanism.
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.
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.
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.