Nokea
Which level of anxiety is constructive and prepares a person to take action in appropriate situations?
- A. Moderate
- B. Severe
- C. Mild
- D. Panic
Correct Answer: C
Rationale: Mild anxiety is constructive and prepares a person to take action in appropriate situations. In moderate anxiety, the person is more easily distracted. The attention span decreases in severe anxiety. In panic anxiety, the person exaggerates details.
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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.
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.
While caring for an older adult client, the nurse notices the client is exhibiting increased episodes of forgetfulness, restlessness, and anxiety. Which assessment data is most significant for this client?
- A. Age at retirement
- B. Hobbies and activities
- C. Recent loss of spouse
- D. Ability to care for own ADLs
Correct Answer: C
Rationale: Determining the client has suffered the recent loss of spouse may be the cause of increased anxiety.Anxiety may manifest in the older adult as confusion or change in behavior. Loss in functioning and ability to care for own ADLs can also bring about added anxiety and concern. Age at time of retirement is not significant. Involvement in activities and hobbies can help determine the coping used to deal with stress.
The client is brought to the emergency department with complaint of chest pain, rapid breathing, and palpitations. Cardiovascular event is ruled out, and the client is diagnosed with acute panic attack. The client seems embarrassed and states, 'I thought I was going to die.' Which is the best response from the nurse?
- A. It must have been frightening for you.
- B. Chest pain should always be evaluated.
- C. We would not let you die.
- D. But you are okay now.
Correct Answer: A
Rationale: It must have been frightening' is an empathetic statement that validates the feelings of the client and acknowledges the symptoms experienced. This is a therapeutic response and conveys respect, self-worth, and caring. Chest pain should always be evaluated, but this comment is factual not emotionally supportive. Other statements are not indicated as therapeutic or caring.
One week ago, the client was prescribed Buspirone (Buspar) for anxiety. The client phones the office and reports the medication has not eliminated the symptoms. Which is the best response by the nurse?
- A. It may take up to 4 weeks for full therapeutic response.
- B. There are many other medications that can be offered.
- C. Buspar will not eliminate all symptoms associated with anxiety.
- D. Call back in one week if the symptoms continue.
Correct Answer: A
Rationale: Buspirone (Buspar) may take 2 to 4 weeks to produce desired effects. Clients should be provided this information at the time of initial administration. Changing to another medication would not be indicated at this time. Suggesting that the symptoms may not be eliminated is not indicated and should be avoided. Listening to and validating the client's concerns is a therapeutic measure.