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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.
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Following a severe automobile accident, the client reports insomnia and terrifying nightmares. The symptoms persist for months. Diagnostic testing reveals no physical basis for these recurrent symptoms. These symptoms suggest the client is experiencing which of the following?
- A. Exaggerated fear
- B. Panic attack
- C. Phobic disorder
- D. Post-traumatic stress disorder
Correct Answer: D
Rationale: Post-traumatic stress disorder (PTSD) is a condition of delayed anxiety response that can occur after an emotionally traumatic event. The circumstances of the event can be an actual or threatened injury to self or others. Exaggerated fear, panic attack, and phobic disorder are not indicated with insomnia and/or nightmares following a traumatic event.
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.
Which provides the best data to support the diagnosis of anxiety disorder in clients of any age? Select all that apply.
- A. Magnetic resonance imaging (MRI)
- B. Computed tomography (CT scan)
- C. Presenting symptoms
- D. Client history
- E. Prescription list
- F. Over-the-counter medications
Correct Answer: C,D
Rationale: Diagnosing of most clients with anxiety disorders is based on presenting symptoms and client history. MRI and CT scans can be done to rule out brain pathology and other physiologic causes. Alcohol, prescription drugs, as well as over-the-counter drugs can alter findings or contribute to symptoms presented but are not the best data to base a diagnosis of anxiety disorder.
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.