Deck 18: Anxiety,obsessive-Compulsive,and Related Disorders

Question 1

A nursing instructor is teaching about the symptoms of agoraphobia.Which student statement indicates that learning has occurred?

A)Onset of symptoms most commonly occurs in early adolescence and persists until midlife.
B)Onset of symptoms most commonly occurs in the 20s and 30s and persists for many years.
C)Onset of symptoms most commonly occurs in the 40s and 50s and persists until death.
D)Onset of symptoms most commonly occurs after the age of 60 and persists for at least 6 years.

Answer 1

Onset of symptoms most commonly occurs in the 20s and 30s and persists for many years.

Question 2

A nursing instructor is teaching about the medications used to treat panic disorder.Which student statement indicates that learning has occurred?

A)"Clonazepam (Klonopin)is particularly effective in the treatment of panic disorder."
B)"Clozapine (Clozaril)is used off-label in long-term treatment of panic disorder."
C)"Doxepin (Sinequan)can be used in low doses to relieve symptoms of panic attacks."
D)"Buspirone (BuSpar)is used for its immediate effect to lower anxiety during panic attacks."

Answer 2

"Clonazepam (Klonopin)is particularly effective in the treatment of panic disorder."

Question 3

A nursing instructor is teaching about specific phobias.Which student statement indicates to the instructor that learning has occurred?

A)"These clients recognize their fear as excessive and frequently seek treatment."
B)"These clients have a panic level of fear that is overwhelming and unreasonable."
C)"These clients experience symptoms that mirror a cerebrovascular accident (CVA)."
D)"These clients experience the symptoms of tachycardia,dysphagia,and diaphoresis."

Answer 3

"These clients have a panic level of fear that is overwhelming and unreasonable."

Question 4

A nurse has been caring for a client diagnosed with generalized anxiety disorder (GAD).Which of the following nursing interventions would address this client's symptoms? (Select all that apply.)

A)Encourage the client to recognize the signs of escalating anxiety.
B)Encourage the client to avoid any situation that causes stress.
C)Encourage the client to employ newly learned relaxation techniques.
D)Encourage the client to cognitively reframe thoughts about situations that generate anxiety.
E)Encourage the client to avoid caffeinated products.

Question 5

A college student has been diagnosed with generalized anxiety disorder (GAD).Which of the following symptoms should a campus nurse expect this client to exhibit? (Select all that apply.)

A)Fatigue
B)Anorexia
C)Hyperventilation
D)Insomnia
E)Irritability

Question 6

A client living in a beachfront community is seeking help with an extreme fear of bridges,which is interfering with daily functioning.A psychiatric nurse practitioner decides to try systematic desensitization.Which explanation of this treatment should the nurse provide?

A)"Using your imagination,we will attempt to achieve a state of relaxation."
B)"Because anxiety and relaxation are mutually exclusive states,we can attempt to substitute a relaxation response for the anxiety response."
C)"Through a series of increasingly anxiety-provoking steps,we will gradually increase your tolerance to anxiety."
D)"In one intense session,you will be exposed to a maximum level of anxiety that you will learn to tolerate."

Question 7

What symptoms should a nurse recognize that differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)?

A)GAD is acute in nature,and panic disorder is chronic.
B)Chest pain is a common GAD symptom,whereas this symptom is absent in panic disorders.
C)Hyperventilation is a common symptom in GAD and rare in panic disorder.
D)Depersonalization is commonly seen in panic disorder and absent in GAD.

Question 8

A client diagnosed with an obsessive-compulsive disorder spends hours bathing and grooming.During a one-on-one interaction,the client discusses the rituals in detail but avoids any feelings that the rituals generate.Which defense mechanism should the nurse identify?

A)Sublimation
B)Dissociation
C)Rationalization
D)Intellectualization

Question 9

A family member is seeking advice about an older parent who seems to worry unnecessarily about everything.The family member states,"Should I seek psychiatric help for my mother?" Which is an appropriate nursing response?

A)"My mother also worries unnecessarily.I think it is part of the aging process."
B)"Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning."
C)"From what you have told me,you should get her to a psychiatrist as soon as possible."
D)"Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications."

Question 10

Which symptoms should a nurse recognize that differentiate a client diagnosed with obsessive-compulsive disorder (OCD)from a client diagnosed with obsessive-compulsive personality disorder?

A)Clients diagnosed with OCD experience both obsessions and compulsions,and clients diagnosed with obsessive-compulsive personality disorder do not.
B)Clients diagnosed with obsessive-compulsive personality disorder experience both obsessions and compulsions,and clients diagnosed with OCD do not.
C)Clients diagnosed with obsessive-compulsive personality disorder experience only obsessions,and clients diagnosed with OCD experience only compulsions.
D)Clients diagnosed with OCD experience only obsessions,and clients diagnosed with obsessive-compulsive personality disorder experience only compulsions.

Question 11

A client is newly diagnosed with obsessive-compulsive disorder and spends 45 minutes folding clothes and rearranging them in drawers.Which nursing intervention would best address this client's problem?

A)Distract the client with other activities whenever ritual behaviors begin.
B)Report the behavior to the psychiatrist to obtain an order for medication dosage increase.
C)Lock the room to discourage ritualistic behavior.
D)Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors.

Question 12

A nurse is discussing treatment options with a client whose life has been negatively impacted by claustrophobia.Which of the following commonly used behavioral therapies for phobias should the nurse explain to the client? (Select all that apply.)

A)Benzodiazepine therapy
B)Systematic desensitization
C)Imploding (flooding)
D)Assertiveness training
E)Aversion therapy

Question 13

A client is experiencing a severe panic attack.Which nursing intervention would meet this client's physiological need?

A)Teach deep breathing relaxation exercises.
B)Place the client in a Trendelenburg position.
C)Have the client breathe into a paper bag.
D)Administer the ordered prn buspirone (BuSpar).

Question 14

Which nursing statement to a client about social anxiety disorder versus schizoid personality disorder (SPD)is most accurate?

A)"Clients diagnosed with social anxiety disorder can manage anxiety without medications,whereas clients diagnosed with SPD can only manage anxiety with medications."
B)"Clients diagnosed with SPD are distressed by the symptoms experienced in social settings,whereas clients diagnosed with social anxiety disorder are not."
C)"Clients diagnosed with social anxiety disorder avoid interactions only in social settings,whereas clients diagnosed with SPD avoid interactions in all areas of life."
D)"Clients diagnosed with SPD avoid interactions only in social settings,whereas clients diagnosed with social anxiety disorder tend to avoid interactions in all areas of life."

Question 15

A nursing student questions an instructor regarding the order for fluvoxamine (Luvox)300 mg daily for a client diagnosed with obsessive-compulsive disorder (OCD).Which instructor response is most accurate?

A)High doses of tricyclic medications will be required for effective treatment of OCD.
B)Selective serotonin reuptake inhibitor (SSRI)doses,in excess of what is effective for treating depression,may be required for OCD.
C)The dose of Luvox is low because of the side effect of daytime drowsiness.
D)The dose of this selective serotonin reuptake inhibitor (SSRI)is outside the therapeutic range and needs to be questioned.

Question 16

A cab driver,stuck in traffic,becomes lightheaded,tremulous,diaphoretic,tachycardic and dyspneic.A workup in an emergency department reveals no pathology.Which medical diagnosis should a nurse suspect,and what nursing diagnosis should be the nurse's first priority?

A)Generalized anxiety disorder and a nursing diagnosis of fear
B)Altered sensory perception and a nursing diagnosis of panic disorder
C)Pain disorder and a nursing diagnosis of altered role performance
D)Panic disorder and a nursing diagnosis of anxiety

Question 17

Which treatment should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)?

A)Long-term treatment with diazepam (Valium)
B)Acute symptom control with citalopram (Celexa)
C)Long-term treatment with buspirone (BuSpar)
D)Acute symptom control with ziprasidone (Geodon)

Question 18

A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit.The client has an elaborate routine for toileting activities.Which would be an appropriate initial client outcome during the first week of hospitalization?

A)The client will refrain from ritualistic behaviors during daylight hours.
B)The client will wake early enough to complete rituals prior to breakfast.
C)The client will participate in three unit activities by day three.
D)The client will substitute a productive activity for rituals by day one.

Question 19

A client diagnosed with panic disorder states,"When an attack happens,I feel like I am going to die." Which is the most appropriate nursing response?

A)"I know it's frightening,but try to remind yourself that this will only last a short time."
B)"Death from a panic attack happens so infrequently that there is no need to worry."
C)"Most people who experience panic attacks have feelings of impending doom."
D)"Tell me why you think you are going to die every time you have a panic attack."

Question 20

A nurse is providing discharge teaching to a client taking a benzodiazepine.Which client statement would indicate a need for further follow-up instructions?

A)"I will need scheduled blood work in order to monitor for toxic levels of this drug."
B)"I won't stop taking this medication abruptly because there could be serious complications."
C)"I will not drink alcohol while taking this medication."
D)"I won't take extra doses of this drug because I can become addicted."

Question 21

Traits associated with schizoid,obsessive-compulsive,and _____________________ personality disorders are commonly seen in clients with the diagnosis of body dysmorphic disorder.

Question 22

An attractive female client presents with high anxiety levels because of her belief that her facial features are large and grotesque.Body dysmorphic disorder (BDD)is suspected.Which of the following additional symptoms would support this diagnosis? (Select all that apply.)

A)Mirror checking
B)Excessive grooming
C)History of an eating disorder
D)History of delusional thinking
E)Skin picking

Question 23

Antianxiety drugs are also called ______________________ and minor tranquilizers.