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The nurse is caring for a client with an anxiety disorder who is prescribed an antianxiety drug. Which response by the client indicates a need for more teaching regarding the use of this group of medications?
- A. I can now make decisions.
- B. The stress is more manageable.
- C. The cause of my stress is gone.
- D. My chest tightness is gone.
Correct Answer: C
Rationale: The use of drug therapy in the management of anxiety disorders is intended to eliminate or decrease the symptoms of anxiety. The stress becomes more manageable and allows the client to better deal with issues of daily living. Drug therapy does not eliminate the causative factors.
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To develop a therapeutic relationship with an anxious client, the nurse looks for ways to build trust. What nursing intervention is most likely to help the nurse gain the client's trust?
- A. Leaving the client alone during a new experience.
- B. Giving support in nonverbal ways.
- C. Being available and attentive to the client's requirements.
- D. Giving detailed explanations and do not repeat them frequently.
Correct Answer: C
Rationale: Building trust is especially critical to developing a therapeutic relationship with an anxious client. Being available and attentive to the client's requirements contributes to this trust. The nurse should not leave an anxious client alone, especially during a new or potentially frightening experience. To manage an anxious client's restricted attention and concentration, directions or explanations must be simple, brief, and repeated frequently to implement adjusting teaching.
Which type of therapy assists the clients to alter their irrational thinking?
- A. Psychopharmacology
- B. Desensitization
- C. Behavioral Therapy
- D. Cognitive Therapy
Correct Answer: D
Rationale: Cognitive therapy is a type of psychotherapy in which the therapist helps clients alter their irrational thinking, correct their faulty belief systems, and replace negative self-statements with positive ones. Desensitization involves providing emotional support while gradually exposing a person to whatever it is that provokes anxiety. Behavioral therapy attempts to extinguish undesirable responses by learning other adaptive techniques. Psychopharmacology is the use of medications to treat various disorders.
The client who is waiting to be transported to the operating room tells the nurse of a fear of waking up during the operation. The client is visibly upset with sweaty palms, wringing of the hands, and increased heart rate. Which is the best action to be taken by the nurse?
- A. Postpone the surgery until another day/time.
- B. Allow the family to spend time with the client.
- C. Contact chaplain services and request a visit from clergy.
- D. Stay with the client until anesthesiologist evaluates situation.
Correct Answer: D
Rationale: The primary goal for nursing management of this client is to restore comfort. The nurse should validate the client's feelings, remain present, and share concerns with the anesthesiologist. If the client's fear cannot be calmed, the surgery may need to be postponed. Allowing the client to spend time with the family may be helpful but does not address the fear of anesthesia. The presence of clergy may be calming for a client with spiritual needs. Restoring calm and comfort to the client is important prior to procedures.
A client who is a nursing student reports increased anxiety with test iniziative. Which behavioral technique is most appropriate for this client to put into practice?
- A. Write 'I can do this' on an index card and place in view.
- B. Use breathing techniques to reduce anxiety.
- C. Use meditation prior to exams.
- D. Participate in a study group and prepare well before exams.
Correct Answer: B
Rationale: Behavioral therapy is used to coach a client to engage in some form of distraction or perform relaxation or breathing exercises to overcome symptoms. Teaching the student how to use breathing techniques can be helpful during stress-inducing exams. Writing 'I can do this' on a card is a form of cognitive therapy and provides positive thinking. Use of meditation can be helpful in the management of generalized anxiety but is not practical in a classroom setting. Studying and preparing for exams is expected but is not a behavioral technique that is helpful during test-taking events.
Following the death of a spouse, a client is prescribed a short-term use of lorazepam. Which is the best rationale to support taking this medication at bedtime?
- A. Deters the client from driving under the influence
- B. Prevents nightmares and obsessive thoughts
- C. Induces drowsiness and sleep
- D. Causes dizziness and lightheadedness
Correct Answer: C
Rationale: Antianxiety drugs such as lorazepam can cause drowsiness and induce sleep. Because many clients with anxiety disorders also have insomnia, taking the medication at bedtime will promote sleep. Nightmares and obsessive thoughts may be decreased through the induction of sleep. Using the drug at bedtime is not for the purpose of deterring driving. This drug can cause dizziness and light-headedness in some clients.