Primary Care Art and Science of Advanced Practice Nursing Test Bank, Chapter 68.

Primary Care Art and Science of Advanced Practice Nursing Test Bank, Chapter 68. Anxiety, Stress, and Trauma-Related Disorders Answer Key on last Page

• The nurse is planning a presentation to a group of nursing students on the topic of anxiety

disorders. Which of the following would the nurse include when describing panic disorder?

• Individuals may believe they are having a heart attack when a panic attack occurs.
• People with panic attacks often have fewer attacks if they also have agoraphobia.
• Typically, individuals experience this disorder after the age of 30 years.
• Persons rarely have an underlying comorbid condition of depression.

• A client comes to the emergency department because he thinks he is having a heart

attack. Further assessment determines that the client is not having a heart attack but is having a panic attack. When beginning to interview the client, which question would be most appropriate for the nurse to use?

• Are you feeling much better now that you are lying down?
• What did you experience just before and during the attack?
• Do you think you will be able to drive home?
• What do you think caused you to feel this way?
• A client with a panic disorder has been prescribed a benzodiazepine medication. Which

of the following would the nurse emphasize as a risk associated with using this medication?

• Dietary restrictions
• Withdrawal symptoms
• Agitation
• Fecal impaction

• A female client is diagnosed with panic disorder. The client tells the nurse that she hasnt

left her house in more than a month because she was afraid of another attack. She visited the mental health clinic today only because her son brought her. Which nursing diagnosis would be a priority for this client?

• Powerlessness related to symptoms of anxiety
• Decisional Conflict related to fear of leaving the house

• Ineffective Family Coping related to symptoms of anxiety
• Social Isolation related to fear of recurrence of anxiety symptoms
• The nurse has instructed a client with panic disorder about how to use the technique of

positive self-talk. The nurse determines that the client has understood the instructions when the client verbalizes which statement to use during an impending panic attack?

• I am feeling very nervous right now.
• I can handle this anxiety; it will be over shortly.
• I am taking medication to eliminate these symptoms.
• Relax your muscles, relax your muscles.

• A client who has been diagnosed with panic disorder visits the clinic and experiences a

panic attack. The client tells the nurse, Im so nervous. My hands are shaking, and Im sweating. I feel as if Im having a stroke right now. Which of the following would the nurse do first?

• Stay with the client while remaining calm.
• Move the client to a safe environment.
• Tell the client that the attack will soon pass.
• Teach the client deep breathing techniques to calm her.
• A client with obsessive-compulsive disorder has been taking fluoxetine for 1 month. The

client tells the nurse, These pills are making me sick. I think Im getting a brain tumor because of the headaches. Which response by the nurse would be most appropriate?

• Lets talk about how often you have been performing the rituals lately.
• Tell me how many times you have washed your hands today.
• Have you been practicing your deep breathing and relaxation exercises?
• These medications have side effects that can cause increased headaches.
• A nurse who has worked with a client diagnosed with generalized anxiety disorder (GAD)

when he was an inpatient on the psychiatric unit sees the client in the waiting room of the outpatient psychiatric clinic. The client motions to the nurse to come over so he can tell the nurse how things have been going since he was discharged. While talking with the client, the nurse determines that the clients therapy has been effective when the client states which of the following?

• I am still experiencing quite a bit of stress at home and at work; things are different at

home than they were in the hospital.

• When my mother-in-law comes over now, I go out to my workshop and work on one

of my projects.

• I’m still drinking coffee; I can’t quit after drinking it all these years.
• I’ve learned having a beer after I get home from work helps me relax.
• The nurse is caring for a client who is being treated in the emergency department for a

panic attack. Which of the following nursing interventions would be most appropriate?

• Demonstrate empathy for the client by trying to mimic the clients state of anxiety.
• Tell the client that you must leave to go report his symptoms to the psychiatrist on

duty.

• Tell the client this is an acute exacerbation with a positive prognosis and low

morbidity.

• Stay with the client, emphasizing that he is safe and that you will remain with him.

• A nurse determines that a client who is experiencing anxiety is using relief behaviors. The

nurse determines that the client is experiencing which degree of anxiety?

• Mild
• Moderate
• Severe
• Panic
• A group of students is reviewing information about anxiety disorders in preparation for a

class examination. The students demonstrate understanding of the material when they state which of the following?

• Anxiety disorders rank second to depression in psychiatric illnesses being treated.
• Women experience anxiety disorders more often than do men.
• Most anxiety disorders tend to be short term with individuals achieving full recovery.
• Anxiety disorders are more common in children than in adolescents.
• While interviewing a client, the client reports an intense fear of spiders, stating, I cant be

near them. I get so upset. I start to sweat and hyperventilate if I see one. The nurse documents this finding as which of the following?

• Algophobia
• Entomophobia
• Arachnophobia
• Cynophobia

• After teaching a class about the biochemical theories associated with panic disorder,

the instructor determines a need for additional teaching when the students identify which neurotransmitter as being implicated?

• Dopamine
• Serotonin
• Norepinephrine
• Gamma-aminobutyric acid (GABA)
• A nurse is preparing an in-service presentation about panic disorders and associated

theories related to the cause. When describing the cognitivebehavioral concepts associated with panic disorders, which of the following would the nurse expect to address?

• Personal losses
• Conditioned response
• Early separation
• Dysfunctional family communication

• A nurse is developing the plan of care for a client with panic disorder that will include

pharmacologic therapy. Which of the following would the nurse most likely expect to administer?

• Benzodiazepine
• Selective serotonin reuptake inhibitor (SSRI)
• Monoamine oxidase inhibitor (MAOI)
• Tricyclic antidepressant (TCA)
• A client with panic disorder who has been prescribed sertraline in conjunction with

alprazolam comes to the clinic for a follow-up. The client states, I stopped taking the alprazolam about 2 days ago. I was feeling really sleepy and tired. Which of the following would alert the nurse to suspect possible withdrawal? Select all that apply.

• Metallic taste
• Irritability
• Dry, flushed skin
• Tremor
• Muscle flaccidity