THE CLIENT WITH ANXIETY DISORDER
A Client is brought to the hospital emergency room by his brother. The client is perspiring profusely, breathing rapidly, and complaining of dizziness and palpitations.Problem of a cardiovascular nature are ruled out. The client's diagnosis is tentatively listed as Panic Attack.
1.The emergency room nurse observe that the client is hyperventilating.Which of the following measures would be best to try first to ease the symptoms caused by hyperventilation;
a.Have the client breathe into a paper bag.
b.Instruct the client to put his head between his knee.
c.Give the client a low concentration of oxygen by nasal cannula.
d.Tell the client to take several deep, slow breaths and exhale normally.
2.Which of the following nursing actions would be inappropriate on the client's admission to the unit;
a.Support the client's attempts to discuss feelings.
b.Respect the client's personal space.
c.Reassure the client of his safety.
d.Control the client's dysfunctional coping behavior.
3.The client often jumps when spoken to and complain of feeling uneasy. He says "Its as though something bad is going to happen". Which of the following nursing actions would be of least benefit to the client;
a.Being physically present.
b.Being technically competent.
c.Conveying optimistic verbalizations.
d.Communicating a respectful attitude.
4.During a conversation with the client, the nurse observes the client shaking his leg and tapping his fingers on the table next to him. The nurse best statement is;
a."I see that you are anxious. I'll be back later when you are calmer"
b.I noticed that your leg is shaking and you are tapping your fingers on the table. How are you feeling now"
c."I'll get you something to help you feel less anxious"
d."I know that you fee anxious.Let's discuss something more pleasant"
5.The nursing diagnosis for the client is Social Isolation related to severe anxiety, as evidence by withdrawal into his room. An appropriate long-term goal related to this nursing diagnosis is that the client will;
a.attend group meetings with s staff member by discharge.
b.initiate interactions with the nurse when feeling anxious.
c.express tow adaptive methods of coping with anxiety.
d.participate in milieu activities by discharge.
6.In working wit the client with an anxiety disorder,the ultimate nursing goal is to
a.reduce the client's anxiety to a manageable level.
b.help the client decrease denial and avoidance about his feelings and link feelings with behaviors.
c.assist the client with problem solving and developing adaptive coping behaviors.
d.use supportive confrontation when the client avoids painful issues.
7.The client seldom experiences feeling of panic and has been participating in groups. He tell the nurse,"I still have problems falling asleep with out tossing and turning". Of the following nursing actions, which would be most helpful to the client;
a.Teach him relaxation exercise.
b.Tell him to ask his physician fro medication.
c.Recommend that he watch television until he gets sleepy.
d.Advice him to ride the exercise bicycle fro 10 minutes before retiring for the night.
8.The client is taking alprazolam(xanax) to threat moderate to serve anxiety. Xanax will help the client to.
a.focus less on somatic symptoms of anxiety.
b.deny problems with symptoms of anxiety.
c.avoid feeling of anxiety.
d.maintain hypersensitivity to stimuli.
9.While the client is taking alprazolam (Xanax), he should be thought to avoid ingesting;
a.chocolate..
b.cheese.
c.alcohol.
d.shellfish.
The Nurse Work at a Community Mental Health Center.
10.The client with the Axis I diagnosis of Post Traumatic Stress Disorder tells the nurse he wishes that he had been on the air plan that crashed and killed his wife and children a month ago. The nurse assesses the client's statement to be;
a.suicidal ideation.
b.survivor guilt.
c.dysfunctional grieving.
d.numbing of responsiveness.
11.The client states, "You don't know what I've been through. \what can you do" The nurse's best response is;
a."I need ti refer you to a survivor's group where you'll feel more comfortable"
b."Perhaps you'll feel better if you can become interested in a hobby once again"
c."I'd like to help you if you'll let me"
d."I haven't been through what you have,but I'll be better able to understand if you tell me more about it"
12.The client has been taking buspirone(BuSpar) for 2 days as prescribed. Which client statement indicates a need for further teaching;
a."I can take BuSpar as I need it when I'm anxious"
b."I may not feel better for 7-10 days"
c."I can't become physically dependent on BuSpar".
d."I need to take BuSpar with food".
A week ago,a tornado destroyed the client's home and seriously injured her husband. The client has been walking around the hospital in a daze without any outward display of emotions.
13.The client is being admitted to the stress unit with the diagnosis of Acute Stress Disorder. The client tell the nurse in a matter-of-fact manner that her husband is paraplegic,"but that's better than total paralysis". Which protective mechanism is the client exhibiting".
a.Suppression.
b.Rationalization.
c.Denial.
d.Intellectualization.
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