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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.
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A nurse stops at the scene of an accident and attempts to assist a client who is lying in an overturned vehicle. When the nurse crawls into the vehicle, the client starts screaming 'incoming, incoming' and is violently thrashing and attempting to kick the nurse. Which is the best interpretation by the nurse?
- A. The client is diagnosed with post-traumatic stress disorder.
- B. The accident has triggered a flashback.
- C. The accident is a result from psychic numbing.
- D. Alcohol use disorder caused the accident.
Correct Answer: B
Rationale: The crash situation has brought about a flashback to a previous trauma in the experience of this client. The client is probably dealing with PTSD but this cannot be assumed as a diagnosis by the nurse. Psychic numbing is not indicated. Although it is not unusual for clients who suffer from PTSD to use alcohol or other substances to suppress symptoms, it cannot be assumed that any alcohol was used in this instance or is the root of the accident.
Clients with obsessive-compulsive disorder (OCD) may exhibit what sign or symptom?
- A. Fear of situations in which they may capture the attention of others
- B. Delayed anxiety response
- C. Psychic numbing
- D. Performing ritualistic behaviors
Correct Answer: D
Rationale: Clients with OCD may feel compelled to perform the same act repeatedly for a specific number of times or in a prescribed sequence and acknowledge performing ritualistic behaviors. Persons with social phobia experience fear of situations in which they may capture the attention of others. Post-traumatic stress disorder (PTSD) is a condition that involves a delayed anxiety response. Initially, the affected person avoids dealing with the tragedy and detaches from others using a technique that is referred to as psychic numbing.
Avoiding places or situations in which panic attacks occur is how the client with agoraphobia manages fears. Which is a common symptom of agoraphobia?
- A. Surrounding self with family and friends
- B. Avoiding strangers
- C. Avoiding feelings of anxiety
- D. Feeling safer at home
Correct Answer: D
Rationale: People with agoraphobia confine themselves to home where they feel safe. The greatest fear for a person with this disorder is having a panic attack and losing control in public. Peopleâ??family, friends, or strangersâ??are less of an issue than being able to control the location (home). Anxiety disorders such as agoraphobia do not have a logical explanation and cannot be controlled through avoiding feelings of anxiety.
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 reports moderate to severe anxiety requires intervention. What technique(s) suggested by the nurse would be helpful in assisting this client in the management of anxiety? Select all that apply.
- A. Use rapid respirations
- B. Take a cool shower or bath
- C. Visualize a relaxing place
- D. Listen to music
- E. Smoke a cigarette
- F. Progressively tighten muscles
Correct Answer: C,D
Rationale: Visualizing a relaxing place is using imagery to relax the client. Listening to music can be a distraction and help to lessen anxiety-provoking stimuli. Slow breathing, taking a warm shower, avoiding alcohol and nicotine, and progressively relaxing muscle groups are additional techniques that are helpful to decrease anxiety.