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Which is the primary effect of central-acting sympatholytics in a client who exhibits hypertension and anxiety?
- A. Vasoconstriction and reduction of blood pressure and heart rate
- B. Central-acting sympatholytics induce sedation and fatigue
- C. Affects kidneys and reduces activity of renin
- D. Block receptors for norepinephrine in the brain
Correct Answer: D
Rationale: Central-acting sympatholytics block alpha-2 receptors for norepinephrine in the brain stem. Consequently, heart rate and blood pressure are reduced, which adds to the beneficial effects in anxious clients with hypertension. Vasoconstriction will result in higher blood pressure. Central-acting sympatholytics may induce sedation and reduce renin activity in the kidneys but this is not the primary effect.
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A client is scheduled for magnetic resonance imaging (MRI) of the head and neck. Which action by the nurse would be most helpful in calming the anxious client?
- A. Administer antianxiety medication.
- B. Allow the client to express fears and concerns.
- C. Discuss how others have survived the procedure.
- D. Explain how the client can notify staff if anxiety increases.
Correct Answer: B
Rationale: Building trust and restoring comfort can be accomplished when the nurse allows the client to verbalize anxiety. Identifying the problem and exploring possible solutions may be helpful in decreasing anxiety. The physician may prescribe an antianxiety medication to the client prior to testing. Antianxiety drugs work but conversation is more immediate and safer. Knowing the client can call for assistance during the testing may be helpful in decreasing anxiety. But calling for assistance does not help the client in the moment. Discussion of other clients is not helpful in this situation.
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.
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.
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.
What is a side effect of beta-adrenergic blockers?
- A. Sedation
- B. Hyperglycemia
- C. Bradycardia
- D. Addiction
Correct Answer: C
Rationale: Major side effects of beta-adrenergic blocking agents include bradycardia and elevated blood glucose levels. They do not cause sedation, hyperglycemia, or addiction.