Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders My Nursing Test Banks

Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Which of the following is a priority in dealing with a highly anxious patient?

A.

Provide support to reinforce a sense of security.

B.

Implement strict limit setting to control behavior.

C.

Increase environmental stimuli to distract the patient.

D.

Provide more freedom to promote self-expression.

____ 2. Your new patient is admitted to the ER after a car accident. She is extremely anxious. Which intervention is most helpful?

A.

Ask her to describe her feelings to you.

B.

Stay with her in the exam room.

C.

Set her up in a quiet exam room away from activity and give her privacy.

D.

Encourage her to remember what happened in the accident.

____ 3. Your patient has been taking Buspar for 1 month. On returning to the clinic for a follow-up visit, which statement would describe medication effectiveness?

A.

Reduction in number of delusions

B.

Less depressed

C.

Sleeping better

D.

Reduced desire for alcohol

____ 4. To establish an open and trusting relationship with a male patient who is in the hospital with severe anxiety, which response by the charge nurse is best?

A.

Urge the staff to have frequent interaction with the patient.

B.

Share an activity with the patient.

C.

Discipline the patient about his behavior.

D.

Encourage enjoyable activities.

____ 5. When working with a female client experiencing a phobia about spiders, Nurse Toni should anticipate that a problem for this client would be:

A.

Anxiety when speaking of the feared item.

B.

Depression toward the feared object.

C.

Denying the existence of a phobia.

D.

Distortion of reality.

____ 6. Nurse Janet is aware that the symptoms that distinguish post-traumatic stress disorder (PTSD) from anxiety disorders include:

A.

Avoiding situations and certain activities that resemble any type of stress.

B.

Demonstrating a blunted affect when discussing the traumatic situations.

C.

Having a minimum interest in family and others.

D.

Re-experiencing the trauma in dreams or flashback.

____ 7. Nurse Aubyn is aware that patients suffering from anxiety seem to do best in environments where they have:

A.

Competition.

B.

Routine and enjoyable activities.

C.

Complex thought processes.

D.

A lot of alone time.

____ 8. When planning care for a female patient diagnosed with obsessive and compulsive behavior, Nurse Barbara and case manager Marc must recognize that the ritual:

A.

Assists the patient to understand their inability to deal with reality.

B.

Helps the patient to be in control of their anxiety.

C.

Helps the patient control the obsessive and compulsive behavior.

D.

Is used to manipulate others.

____ 9. When preparing the discharge plans for a patient with chronic anxiety, Nurse Barbara evaluates the goals that were set for the patient. Nurse Barbara also evaluates if the patient has achieved the discharge long-term goals. Which goal would be most appropriate to be include in the plan of care requiring evaluation?

A.

The patient is completely stress free.

B.

The patient ignores their feelings of anxiety.

C.

The patient is able to identify triggers that produce anxiety.

D.

The patient maintains contact with a crisis counselor.

____ 10. Helenann, a long-term care nurse educator, noted that one of the staff members was complaining of stress and anxiety. A common physiological response to stress and anxiety is:

A.

Urticaria.

B.

Light-headiness.

C.

Sedation.

D.

Palpitations.

____ 11. According to Hans Seyle, if a person does not adapt to the stress in his or her surroundings, eventually the person will experience:

A.

Fright or flight.

B.

Exhaustion.

C.

Resistance.

D.

Adaptation.

____ 12. Which of the following is TRUE in the stage of fight or flight of the general adaptation syndrome?

A.

Heart rate is decreased.

B.

The blood vessels constrict.

C.

The blood vessels dilate.

D.

Exhaustion occurs.

____ 13. What type of behavior modification is being used when the patient transforms into a relaxed state? (Documented by checking their heart rate and blood pressure.)

A.

Biofeedback.

B.

Massage.

C.

Hypnosis.

D.

Imagery.

____ 14. A client is unwilling to go out of the house for fear of having to get on a elevator or be in small room. Because of this fear, the client remains home except when accompanied outside by the spouse. The nurse suspects that the client has:

A.

Agoraphobia.

B.

Hematophobia.

C.

Claustrophobia.

D.

Hypochondriasis.

____ 15. An elderly patient explains to the nurse that while weeding his garden, he was suddenly startled by a 6-foot non-poisonous snake. He immediately displayed extreme fear and suddenly had a burst of energy and ran from the snake. The nurse realizes that this client is describing which of the following stages identified in GAS?

A.

Exhaustion

B.

Problem solving

C.

Crisis

D.

Delirium

Completion

Complete each statement.

16. An irrational fear is known as a _____________.

17. The positive form of stress is called _________________

18. The most common anxiety disorder is ______________.

19. The uncomfortable feeling of dread that is a response to periods of stress is known as __________________.

20. When you know the cause of the tension, that is an example of ______________ anxiety.

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 21. Which of the following may be seen in a patient experiencing panic attacks? (Select all that apply)

A.

Feels faint

B.

Thinks he or she is having a heart attack

C.

Gains a sense of serenity

D.

Able to focus on minute details

E.

Dry mouth and trembling hands

____ 22. Which of the following medications would generally NOT used to treat anxiety? (Select all that apply)

A.

Haloperidol

B.

Carbamazepine

C.

Buspirone

D.

Alprazolam

E.

Clonidine

F.

Lorazepam

____ 23. Daria is admitted to the medical-surgical unit experiencing an anxiety episode. Nurses on the unit are aware of several nursing interventions that can reduce the anxiety that Daria is experiencing (select all that apply):

A.

Attempt to calm the patient by placing an arm around the person.

B.

Maintain a calm environment.

C.

Promote open communication.

D.

Provide the client with a safe, quiet, and private place.

E.

Document the patients behavior.

____ 24. While observing a female patient on the oncology unit who has a secondary diagnosis of panic attacks, the nurse would expect to observe which of the following symptoms (select all that apply):

A.

Nausea.

B.

Diaphoresis.

C.

Ritualistic behavior.

D.

Increased pulse.

E.

Reliving the experience.

____ 25. The following are levels of anxiety (select all that apply):

A.

Mild. 

B.

Moderate. 

C.

Severe. 

D.

Panic.

____ 26. Commonly used medications for anxiety disorders include (select all that apply):

A.

Xanax.

B.

Valium.

C.

Zoloft.

D.

Ambien.

E.

Altivan.

____ 27. The following conditions can be stress related (select all that apply):

A.

Asthma.

B.

Cancer.

C.

Burnout.

D.

Hunger.

E.

Immunity impairment.

Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders

Answer Section

MULTIPLE CHOICE

1. ANS: A

Support and safety are key interventions in anxiety. Responses B, C, and D may all add to anxiety.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; General Interventions; page 168-169

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

2. ANS: B

This patient is most likely overwhelmed and may feel abandoned, so staying with her will be most reassuring. Encouraging her to talk about feelings or memories of the accident will probably increase anxiety, and leaving her alone will increase her sense of abandonment.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; General Interventions; page 169

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

3. ANS: C

Buspar is used for anxiety disorders. Sleeping better would be an indication of reduction in anxiety.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Table 10-2, Commonly Used Anti-Anxiety Medications; page 168

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration

4. ANS: D

Activities can provide a diversion from intense feelings that can be lead to the patient being more receptive in beginning a relationship

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Nursing Care for People with Anxiety and Anxiety-Related Disorders; page 161

KEY: Integrated Processes: Caring | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need: Psychosocial Integrity: Stress Management

5. ANS: A

Phobia is an irrational fear that creates intense anxiety with even thinking about the feared item.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Types of Anxiety and Anxiety-Related Disorders-Phobias; page 163

KEY: Integrated Processes: Caring | Content Area: Mental Health: Phobias | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Stress Management

6. ANS: D

In the DSM-5, PTSD symptoms are described as re-experiencing a traumatic event, avoidance, negative cognitions and mood, and arousal. Experiencing the actual trauma in dreams or flashbacks is one of the major symptoms that separate post-traumatic stress disorder from other anxiety disorders.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Post-Traumatic Stress Disorder; page 165-166

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concepts

7. ANS: B

Diversion is an effective intervention. An activity that is enjoyable and nonstressful provides a diversion. The other choices would increase anxiety.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Nursing Care for People with Anxiety and Anxiety-Related Disorders; page 169

KEY: Integrated Processes: Caring | Content Area: Mental Health: Anxiety | Cognitive Level: Evaluation | Client Need: Psychosocial Integrity: Therapeutic Environment

8. ANS: B

The rituals performed by the patient with obsessive-compulsive disorder are a substitute for the cause of the anxiety.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Obsessive-Compulsive Disorder; page 164-165

KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concept

9. ANS: C

Recognizing triggers that produce anxiety will permit the patient to cope with anxiety or avoid specific triggers. Response C is the most realistic and measurable goal.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Nursing Care for People with Anxiety and Anxiety-Related Disorders; page 169

KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health | Cognitive Level: Evaluation | Client Need: Psychosocial Integrity: Stress Management

10. ANS: D

Palpitations are a common physiological response to stress and anxiety.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety-Differential Diagnosis; page 162

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Stress Management

11. ANS: B

Hans Selye is the theorist who developed the general adaptation syndrome (GAS) theory, which explains that if a person continues to resist change, he or she will eventually decrease the immune system, which could result in complete exhaustion or death.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Etiology of Anxiety and Stress; page 161

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Synthesis | Client Need: Health Promotion and Maintenance: Health Promotion/Disease Prevention

12. ANS: B

During fight or flight, the blood vessels constrict because norepinephrine and epinephrine have been released.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Differential Diagnosis; page 161

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Synthesis | Client Need: Health Promotion and Maintenance: Health Promotion and Disease Prevention

13. ANS: A

Biofeedback is a form of behavior modification that patients learn to control physical responses to stress. Biofeedback is done without the use of medication.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Alternative Interventions for People with Anxiety Disorder; page 168

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need: Psychosocial Integrity: Stress Management

14. ANS: A

A patient suffering with agoraphobia is afraid of open spaces; therefore this patient will hesitate about being outside.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Phobias; page 164

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Synthesis | Client Need: Psychosocial Integrity: Mental Health Concepts

15. ANS: C

General adaptation syndrome (GAS) disorder consists of three different stages: fright/crisis; resistance or adaptation; and exhaustion.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; page 161

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Reduction of Risk Potential: Potential for Alternations in Body Systems

COMPLETION

16. ANS: phobia

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Phobias; page 163

KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Anxiety | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

17. ANS:

eustress

Eustress comes from positive experiences, like weddings and job promotions. The anxiety produced by positive stress can be just as distressing as negative stress due to the changing expectations and unknowns.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety Disorders; page 160

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Stress Management

18. ANS:

phobia

The person is aware of the fear and is aware that it is an irrational fear.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Phobias; page 163

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concepts

19. ANS:

anxiety

Stress produces anxiety. The feeling of dread is a classic symptom of anxiety.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety Disorders; page 160

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanism

20. ANS:

signal

Signal anxiety is an uncomfortable feeling in response to a known stressor.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety Disorders; page 160

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental Health Concepts

MULTIPLE RESPONSE

21. ANS: A, B, E

Panic attacks are an anxiety disorder that creates symptoms of fight or flight.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Panic Disorder; page 163

KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Anxiety | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

22. ANS: A, B

Haloperidol is an antipsychotic and carbamazepine is a mood stabilizer used to treat bipolar disorder. All of the others are anti-anxiety medications.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Table 10-2, Commonly Used Anti-Anxiety Medications; page 168

KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration

23. ANS: B, C, D, E

The nurse must establish trust with the anxious patient before using therapeutic touch. A calm, safe environment is useful when someone is anxious.

PTS: 1

REF: Chapter 10 Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Nursing Care for Patients with Anxiety and Related Disorders; page 169

KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Environment

24. ANS: A, B, D

With a panic attack, the patient will experience common symptoms of the fight or flight response. The person has an episode of fear that is classified as intense. This intense episode can go from being calm to being anxious very quickly.

PTS: 1

REF: Chapter 10 Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Panic Disorders; Nursing Care for Patients with Anxiety and Related Disorders; page 169

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Coping Mechanisms

25. ANS: A, B, C, D

Panic is the only level of anxiety that leads to personality disorganization.

PTS: 1

REF: Chapter 10 Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety Disorders; page 160

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Stress Management

26. ANS: A, B, D, E

All these medications can be used for different symptoms and types of anxiety disorders.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Table 10-1, Adaptation Responses to Stress and the Outcome of Stress on the Body; page 162

KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Analysis | Client Need: Health Promotion and Maintenance: Health Promotion/Disease Prevention

27. ANS: A, B, C, E

All of these disorders may have stress as a contributor.

PTS: 1

REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Table 10-1, Adaptation Responses to Stress and the Outcome of Stress on the Body; page 162

KEY: Integrated Processes: Teaching/Learning

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