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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.
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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 nurse is developing a teaching plan for a client with generalized anxiety disorder, focusing on nutrition. Which of the following would the nurse encourage the client to avoid? Select all that apply.
- A. Coffee
- B. Ginseng
- C. Milk products
- D. Citrus juices
- E. Aged cheese
Correct Answer: A,B
Rationale: Coffee (A) and ginseng (B) are stimulants that can exacerbate anxiety symptoms in GAD. Milk products (C), citrus juices (D), and aged cheese (E) are not typically contraindicated unless specific sensitivities exist.
A client with panic disorder who has been prescribed sertraline in conjunction with alprazolam comes to the clinic for a follow-up. The client states, I stopped taking the alprazolam about 2 days ago. I was feeling really sleepy and tired. Which of the following would alert the nurse to suspect possible withdrawal? Select all that apply.
- A. Metallic taste
- B. Irritability
- C. Dry, flushed skin
- D. Tremor
- E. Muscle flaccidity
Correct Answer: B,D
Rationale: Abrupt cessation of alprazolam, a benzodiazepine, can cause withdrawal symptoms like irritability (B) and tremor (D) due to central nervous system rebound. Metallic taste (A), dry skin (C), and muscle flaccidity (E) are not typical withdrawal symptoms.
A group of students is reviewing the signs and symptoms associated with anxiety. The students demonstrate an understanding of the information when they identify which of the following as cognitive symptoms? Select all that apply.
- A. Edginess
- B. Feelings of unreality
- C. Difficulty concentrating
- D. Tunnel vision
- E. Apprehensiveness
- F. Speech dysfluency
Correct Answer: B,C,E
Rationale: Cognitive symptoms of anxiety include feelings of unreality (B), difficulty concentrating (C), and apprehensiveness (E), reflecting mental processing disruptions. Edginess (A) is emotional, tunnel vision (D) is perceptual, and speech dysfluency (F) is behavioral.
A female client is diagnosed with panic disorder. The client tells the nurse that she hasn?t left her house in more than a month because she was afraid of another attack. She visited the mental health clinic today only because her son brought her. Which nursing diagnosis would be a priority for this client?
- A. Powerlessness related to symptoms of anxiety
- B. Decisional Conflict related to fear of leaving the house
- C. Ineffective Family Coping related to symptoms of anxiety
- D. Social Isolation related to fear of recurrence of anxiety symptoms
Correct Answer: D
Rationale: Social Isolation (D) is the priority, as the client?s fear of panic attacks has led to avoiding leaving home, significantly impacting social functioning. Powerlessness (A) and decisional conflict (B) are relevant but less immediate, and ineffective family coping (C) is not supported by the scenario.