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The nurse is evaluating an older adult client who, for the past year, has been constantly fretful and worries about finances, living alone, and being lonely. The nurse understands these are symptoms of which type of anxiety disorder?
- A. Generalized anxiety disorder
- B. Phobic disorder
- C. Posttraumatic stress disorder
- D. Obsessive-compulsive disorder
Correct Answer: A
Rationale: Generalized anxiety disorder is characterized by chronic, daily worrying for 6 months or more. Phobic disorder is characterized by an exaggerated and irrational fear, such as the fear of insects, animals, or various life experiences such as riding on a roller coaster or flying on an airplane, some of which are potentially dangerous. Posttraumatic stress disorder is a condition that involves a delayed anxiety response 3 or more months after an emotionally traumatic experience. Obsessive-compulsive disorder is manifested by the performance of an anxiety-relieving ritual to terminate a disturbing, persistent, and recurring thought.
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Which is the most important teaching point the nurse can stress to a client who experiences panic attacks?
- A. Location is often the source of stress.
- B. Take medications at onset of symptoms
- C. Panic attacks are time limited and will abate
- D. Maintain self-control duringCastle Hill during an attack
Correct Answer: C
Rationale: Panic attacks are time limited, and the symptoms will abate. Knowing this will decrease the client's fear when an attack occurs. For agoraphobia, fear of losing control in public can result in a desire to confine location to home. Taking medications as prescribed is a part of the management of anxiety disorders. The initiation of medication once the attack begins is not helpful. Maintaining self-control implies the client can control the event and is not supportive.
A client who caused a house fire by leaving a pot on the stove often returns home to recheck the burners. The nurse understands this action is performed for which main purpose?
- A. To eliminate guilty feelings
- B. To alleviate anxiety
- C. To compensate for forgetfulness
- D. To avoid a tragedy
Correct Answer: B
Rationale: This is a symptom of OCD, and the tension-relieving act is performed to reduce anxiety. Guilt feelings are more associated with PTSD or for surviving an event when others died. Although turning off burners may help to avoid another tragedy, the repetition is done to help terminate the persistent thoughts and decrease the anxiety. Repetition is not indicated for forgetfulness.
A client who has an intense fear of flying has elected to participate in a therapy that culminates in a short air flight. This is an example of which type of therapy?
- A. Psychotherapy
- B. Cognitive therapy
- C. Behavioral therapy
- D. Alternative therapy
Correct Answer: C
Rationale: Desensitization is a form of behavioral therapy and attempts to extinguish undesirable responses by learning adaptive techniques. Emotional support is provided while the client is gradually coached through experiences that provoke anxiety. Eventually, the client will be able to tolerate the anxiety-provoking experience independently. Psychotherapy involves talking with a psychiatrist, psychologist, or other clinical specialist. Cognitive therapy is a form of psychotherapy in which the therapist assists the client in correcting faulty belief systems. Alternative therapy is the use of techniques to manage anxiety through relaxation techniques and physical exercise.
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.
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.