Chapter 18 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 18

Question 1

Type: MCSA

The nurse is explaining biophysicalsocial theory to a group of students. Which biopsychosocial theory would most support tracing anxiety back to birth trauma?

1. Behavioral

2. Humanistic

3. Psychosocial

4. Genetic

Correct Answer: 3

Rationale 1: Psychosocial theorists believe that anxiety can be traced back to birth trauma. Genetic theorists believe that there is a familial predisposition for anxiety disorders. Behavioral theorists believe anxiety is a learned response. Humanistic theorists believe that one is unable to deal with all of the other theories without looking at how they interact with each other.

Rationale 2: Psychosocial theorists believe that anxiety can be traced back to birth trauma. Genetic theorists believe that there is a familial predisposition for anxiety disorders. Behavioral theorists believe anxiety is a learned response. Humanistic theorists believe that one is unable to deal with all of the other theories without looking at how they interact with each other.

Rationale 3: Psychosocial theorists believe that anxiety can be traced back to birth trauma. Genetic theorists believe that there is a familial predisposition for anxiety disorders. Behavioral theorists believe anxiety is a learned response. Humanistic theorists believe that one is unable to deal with all of the other theories without looking at how they interact with each other.

Rationale 4: Psychosocial theorists believe that anxiety can be traced back to birth trauma. Genetic theorists believe that there is a familial predisposition for anxiety disorders. Behavioral theorists believe anxiety is a learned response. Humanistic theorists believe that one is unable to deal with all of the other theories without looking at how they interact with each other.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the theories that are helpful in understanding anxiety disorders.

Question 2

Type: MCSA

A parent asks the school nurse, How did my child get OCD? Which theory supports the hypothesis that there is an alteration in serotonin synthesis in the brain of a child with OCD?

1. Genetic

2. Humanistic

3. Psychosocial

4. Behavioral

Correct Answer: 1

Rationale 1: Genetic theory has strong evidence that the transmission of certain genes contributes to the development of OCD. Behavioral theorists believe compulsive behavior is an attempt to relieve anxiety. Humanistic theorists believe that one is unable to deal with the theories without looking at how they interact with each other. Psychosocial theorists believe that anxiety can be transmitted from the mother to the child.

Rationale 2: Genetic theory has strong evidence that the transmission of certain genes contributes to the development of OCD. Behavioral theorists believe compulsive behavior is an attempt to relieve anxiety. Humanistic theorists believe that one is unable to deal with the theories without looking at how they interact with each other. Psychosocial theorists believe that anxiety can be transmitted from the mother to the child.

Rationale 3: Genetic theory has strong evidence that the transmission of certain genes contributes to the development of OCD. Behavioral theorists believe compulsive behavior is an attempt to relieve anxiety. Humanistic theorists believe that one is unable to deal with the theories without looking at how they interact with each other. Psychosocial theorists believe that anxiety can be transmitted from the mother to the child.

Rationale 4: Genetic theory has strong evidence that the transmission of certain genes contributes to the development of OCD. Behavioral theorists believe compulsive behavior is an attempt to relieve anxiety. Humanistic theorists believe that one is unable to deal with the theories without looking at how they interact with each other. Psychosocial theorists believe that anxiety can be transmitted from the mother to the child.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Discuss the theories that are helpful in understanding anxiety disorders.

Question 3

Type: MCSA

Your client states, I havent left my house for six years. The nurse knows that the most helpful theory for dealing with this problem would come from the:

1. Behavioral theorists.

2. Humanistic theorists.

3. Genetic theorists.

4. Psychosocial theorists.

Correct Answer: 1

Rationale 1: Behavioral theorists would most likely use behavior modification for this clients agoraphobia. Genetic theorists believe in a familial predisposition toward anxiety disorders. Humanistic theorists believe one must look at how all theories interact with each other. Psychosocial theorists believe that anxiety is a repression of a fear of expressing forbidden impulses.

Rationale 2: Behavioral theorists would most likely use behavior modification for this clients agoraphobia. Genetic theorists believe in a familial predisposition toward anxiety disorders. Humanistic theorists believe one must look at how all theories interact with each other. Psychosocial theorists believe that anxiety is a repression of a fear of expressing forbidden impulses.

Rationale 3: Behavioral theorists would most likely use behavior modification for this clients agoraphobia. Genetic theorists believe in a familial predisposition toward anxiety disorders. Humanistic theorists believe one must look at how all theories interact with each other. Psychosocial theorists believe that anxiety is a repression of a fear of expressing forbidden impulses.

Rationale 4: Behavioral theorists would most likely use behavior modification for this clients agoraphobia. Genetic theorists believe in a familial predisposition toward anxiety disorders. Humanistic theorists believe one must look at how all theories interact with each other. Psychosocial theorists believe that anxiety is a repression of a fear of expressing forbidden impulses.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Discuss the theories that are helpful in understanding anxiety disorders.

Question 4

Type: MCMA

The client is experiencing an episode of anxiety. The nurse will expect to observe which common coping behaviors?

Standard Text: Select all that apply.

1. Problem solving

2. Indulgence

3. Somatization

4. Acting out

5. Withdrawal

Correct Answer: 3,4,5

Rationale 1: Problem solving. Problem solving is a common method of coping with the subjective feeling of anxiety in response to stressors by trying new methods to deal with issues at hand.

Rationale 2: Indulgence. Avoidance, not indulgence, is a common method of coping with the subjective feeling of anxiety in response to stressors; simply put, the individual avoids dealing with or looking at feelings/stressors.

Rationale 3: Somatization. Somatization is a common method of coping with the subjective feeling of anxiety in response to stressors through the development and identification of physical symptoms.

Rationale 4: Acting out. Acting out is a common method of coping with the subjective feeling of anxiety in response to stressors.

Rationale 5: Withdrawal. Withdrawal is a common method of coping with the subjective feeling of anxiety in response to stressors by avoiding dealing with the feeling/situation.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain how the concept of anxiety relates to anxiety disorders.

Question 5

Type: MCSA

The nurse would expect clients with dissociative disorders to have what in common with clients with anxiety disorders? Anxiety that is:

1. So disabling that they are totally nonfunctional.

2. So disabling that their functioning is adversely affected.

3. Objective.

4. Nonthreatening.

Correct Answer: 2

Rationale 1: The anxiety is so disabling that these clients functioning is adversely affected, but they may not be totally dysfunctional. The anxiety is a subjective feeling that is threatening and not objective.

Rationale 2: The anxiety is so disabling that these clients functioning is adversely affected, but they may not be totally dysfunctional. The anxiety is a subjective feeling that is threatening and not objective.

Rationale 3: The anxiety is so disabling that these clients functioning is adversely affected, but they may not be totally dysfunctional. The anxiety is a subjective feeling that is threatening and not objective.

Rationale 4: The anxiety is so disabling that these clients functioning is adversely affected, but they may not be totally dysfunctional. The anxiety is a subjective feeling that is threatening and not objective.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain how the concept of anxiety relates to anxiety disorders.

Question 6

Type: MCSA

Freud identified a number of defense mechanisms. It is evident that the nurse recognizes one of these common defense mechanisms for a client with dissociative identity disorder when the nurse charts that the client has used:

1. Denial.

2. Fixation.

3. Repression.

4. Rationalization.

Correct Answer: 3

Rationale 1: Repression explains the loss of conscious awareness in dissociation. Fixation is not completing developmental tasks in earlier stages of development. Rationalization is making excuses. Denial is lack of acknowledging.

Rationale 2: Repression explains the loss of conscious awareness in dissociation. Fixation is not completing developmental tasks in earlier stages of development. Rationalization is making excuses. Denial is lack of acknowledging.

Rationale 3: Repression explains the loss of conscious awareness in dissociation. Fixation is not completing developmental tasks in earlier stages of development. Rationalization is making excuses. Denial is lack of acknowledging.

Rationale 4: Repression explains the loss of conscious awareness in dissociation. Fixation is not completing developmental tasks in earlier stages of development. Rationalization is making excuses. Denial is lack of acknowledging.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Incorporate a knowledge of the common themes and distinctive characteristics of anxiety disorders into the care of clients with anxiety disorders.

Question 7

Type: MCSA

A client stays to the nurse, Everything makes me anxious now. The nurse knows that this free-floating anxiety is a common theme in:

1. OCDs.

2. Generalized anxiety disorders.

3. Phobias.

4. Dissociative identity disorders.

Correct Answer: 2

Rationale 1: Usually, clients with generalized anxiety disorders have anxiety that is not related to a specific stimulus. Clients with phobias, dissociative identity disorders, and OCDs have anxiety related to a stimulus.

Rationale 2: Usually, clients with generalized anxiety disorders have anxiety that is not related to a specific stimulus. Clients with phobias, dissociative identity disorders, and OCDs have anxiety related to a stimulus.

Rationale 3: Usually, clients with generalized anxiety disorders have anxiety that is not related to a specific stimulus. Clients with phobias, dissociative identity disorders, and OCDs have anxiety related to a stimulus.

Rationale 4: Usually, clients with generalized anxiety disorders have anxiety that is not related to a specific stimulus. Clients with phobias, dissociative identity disorders, and OCDs have anxiety related to a stimulus.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Incorporate a knowledge of the common themes and distinctive characteristics of anxiety disorders into the care of clients with anxiety disorders.

Question 8

Type: MCSA

The nurse is preparing an in-service regarding the commonalties of anxiety disorders. The nurse should plan to include that all anxiety disorders have which one thing in common?

1. All anxiety disorders can be so disabling that functioning may be adversely affected.

2. All anxiety disorders require treatment with medication.

3. All anxiety disorders first occur during adolescents.

4. All anxiety disorders cause depression.

Correct Answer: 1

Rationale 1: People with these disorders have one thing in common: anxiety so disabling that their functioning is adversely affected. The functional disabilities they have may affect all dimensions of life, including physical, emotional, cognitive, sociocultural, and spiritual, as well as social, work, and family relationships. There is no evidence to support the other answers.

Rationale 2: People with these disorders have one thing in common: anxiety so disabling that their functioning is adversely affected. The functional disabilities they have may affect all dimensions of life, including physical, emotional, cognitive, sociocultural, and spiritual, as well as social, work, and family relationships. There is no evidence to support the other answers.

Rationale 3: People with these disorders have one thing in common: anxiety so disabling that their functioning is adversely affected. The functional disabilities they have may affect all dimensions of life, including physical, emotional, cognitive, sociocultural, and spiritual, as well as social, work, and family relationships. There is no evidence to support the other answers.

Rationale 4: People with these disorders have one thing in common: anxiety so disabling that their functioning is adversely affected. The functional disabilities they have may affect all dimensions of life, including physical, emotional, cognitive, sociocultural, and spiritual, as well as social, work, and family relationships. There is no evidence to support the other answers.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast both the common themes and distinctive characteristics of anxiety disorders.

Question 9

Type: MCMA

The nurse is caring for a client who is complaining of a number of somatic discomforts associated with chronic anxiety. The nurse knows that somatic discomforts associated with anxiety include:

Standard Text: Select all that apply.

1. Heartburn

2. Diarrhea

3. Epigastric pain

4. Constipation

5. Muscular tension

Correct Answer: 1,2,3,4

Rationale 1: Heartburn, epigastric pain, diarrhea, and constipation are all somatic discomforts that are associated with chronic anxiety. Muscular tension is often associated with acute anxiety and is not considered a somatic discomfort.

Rationale 2: Heartburn, epigastric pain, diarrhea, and constipation are all somatic discomforts that are associated with chronic anxiety. Muscular tension is often associated with acute anxiety and is not considered a somatic discomfort.

Rationale 3: Heartburn, epigastric pain, diarrhea, and constipation are all somatic discomforts that are associated with chronic anxiety. Muscular tension is often associated with acute anxiety and is not considered a somatic discomfort.

Rationale 4: Heartburn, epigastric pain, diarrhea, and constipation are all somatic discomforts that are associated with chronic anxiety. Muscular tension is often associated with acute anxiety and is not considered a somatic discomfort.

Rationale 5: Heartburn, epigastric pain, diarrhea, and constipation are all somatic discomforts that are associated with chronic anxiety. Muscular tension is often associated with acute anxiety and is not considered a somatic discomfort.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Incorporate a knowledge of the common themes and distinctive characteristics of anxiety disorders into the care of clients with anxiety disorders.

Question 10

Type: MCMA

The nurse assesses a client during a panic attack and determines the clients level of anxiety to be acute. What physical changes did the nurse likely observe?

Standard Text: Select all that apply.

1. Sweating

2. Breathing difficulty

3. Trembling

4. Impaired cognition

5. Vomiting

Correct Answer: 1,2,3

Rationale 1: Sweating. Sweating is a physical change that might occur during a panic attack.

Rationale 2: Breathing difficulty. Breathing difficulties are a physical change that might occur during a panic attack.

Rationale 3: Trembling. Trembling is a physical change that might occur during a panic attack.

Rationale 4: Impaired cognition. Impaired cognition is not an acute physical change; it is a cognitive change.

Rationale 5: Vomiting. Vomiting is a physical change that might occur during a panic attack.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Conduct a thorough and comprehensive assessment in the care of clients with anxiety disorders.

Question 11

Type: MCSA

A client is admitted to the hospital after being found in a car on the side of a bridge with complaints of having a heart attack. Following extensive tests, it was found the client did not have a heart attack. The client most likely was having:

1. PTSD.

2. Transitory cardiac symptoms.

3. A panic attack.

4. Suicidal feelings.

Correct Answer: 3

Rationale 1: Heart attack symptoms are a defining feature of a panic attack. PTSD and suicidal feelings do not manifest as a heart attack. The scenario indicates that transitory cardiac symptoms were ruled out by extensive cardiac tests.

Rationale 2: Heart attack symptoms are a defining feature of a panic attack. PTSD and suicidal feelings do not manifest as a heart attack. The scenario indicates that transitory cardiac symptoms were ruled out by extensive cardiac tests.

Rationale 3: Heart attack symptoms are a defining feature of a panic attack. PTSD and suicidal feelings do not manifest as a heart attack. The scenario indicates that transitory cardiac symptoms were ruled out by extensive cardiac tests.

Rationale 4: Heart attack symptoms are a defining feature of a panic attack. PTSD and suicidal feelings do not manifest as a heart attack. The scenario indicates that transitory cardiac symptoms were ruled out by extensive cardiac tests.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Conduct a thorough and comprehensive assessment in the care of clients with anxiety disorders.

Question 12

Type: MCSA

Some clients are at increased risk of being dually diagnosed with a mental health disorder and a substance abuse disorder. The client with a mental health disorder that is more likely to exhibit substance abuse in an attempt to avoid traumatic memories is the client with:

1. PTSD.

2. Dissociative fugue.

3. OCD.

4. Generalized anxiety disorder.

Correct Answer: 1

Rationale 1: Substance abuse is found in many clients with PTSD as they try to suppress traumatic memories. OCD, generalized anxiety disorders, and dissociative fugue disorders do not have a high level of traumatic memories.

Rationale 2: Substance abuse is found in many clients with PTSD as they try to suppress traumatic memories. OCD, generalized anxiety disorders, and dissociative fugue disorders do not have a high level of traumatic memories.

Rationale 3: Substance abuse is found in many clients with PTSD as they try to suppress traumatic memories. OCD, generalized anxiety disorders, and dissociative fugue disorders do not have a high level of traumatic memories.

Rationale 4: Substance abuse is found in many clients with PTSD as they try to suppress traumatic memories. OCD, generalized anxiety disorders, and dissociative fugue disorders do not have a high level of traumatic memories.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Conduct a thorough and comprehensive assessment in the care of clients with anxiety disorders.

Question 13

Type: MCSA

A client has compulsive cleaning behaviors, scrubbing areas throughout the house over and over, especially areas where the family gathers. It is most important for the nurse to assess:

1. For vomiting during cleaning.

2. The impact of symptoms on the family system.

3. How frequently the client cleans the house.

4. For forgetfulness.

Correct Answer: 2

Rationale 1: OCD impacts the family system especially with impaired role function. How frequently the client cleans the house and vomiting during cleaning may be important to assess, but they are not the most important. Forgetfulness is not a component of OCD.

Rationale 2: OCD impacts the family system especially with impaired role function. How frequently the client cleans the house and vomiting during cleaning may be important to assess, but they are not the most important. Forgetfulness is not a component of OCD.

Rationale 3: OCD impacts the family system especially with impaired role function. How frequently the client cleans the house and vomiting during cleaning may be important to assess, but they are not the most important. Forgetfulness is not a component of OCD.

Rationale 4: OCD impacts the family system especially with impaired role function. How frequently the client cleans the house and vomiting during cleaning may be important to assess, but they are not the most important. Forgetfulness is not a component of OCD.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Conduct a thorough and comprehensive assessment in the care of clients with anxiety disorders.

Question 14

Type: MCMA

The client, a combat veteran, was recently diagnosed with PTSD. Which symptoms, if present, would be characteristic of PTSD?

Standard Text: Select all that apply.

1. Fear of returning to sleep

2. Fitful sleep

3. Excessive sleeping

4. Hair pulling

5. Terrifying nightmares

Correct Answer: 1,2,5

Rationale 1: Fear of returning to sleep. Fear of returning to sleep is a physical symptom characteristic of PTSD.

Rationale 2: Fitful sleep. Fitful sleep is a physical symptom characteristic of PTSD.

Rationale 3: Excessive sleeping. Sleep loss, not excessive sleeping, is a physical symptom characteristic of PTSD.

Rationale 4: Hair pulling. Hair pulling is an anxiety symptom, but not a symptom of PTSD.

Rationale 5: Terrifying nightmares. Having terrifying nightmares is a physical symptom characteristic of PTSD.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Conduct a thorough and comprehensive assessment in the care of clients with anxiety disorders.

Question 15

Type: MCSA

The nurse caring for a client with an anxiety disorder knows to be most attentive to the nurses:

1. Inability to assess the situation accurately.

2. Anxiety causing forgetfulness.

3. Inability to identify personal somatic problems.

4. Own overall feelings.

Correct Answer: 4

Rationale 1: The nurse must be aware of his/her own feelings because anxiety may be transferred from the client to others. The inability to assess the situation accurately, inability to identify personal somatic problems, and anxiety causing forgetfulness may be part of the overall feelings.

Rationale 2: The nurse must be aware of his/her own feelings because anxiety may be transferred from the client to others. The inability to assess the situation accurately, inability to identify personal somatic problems, and anxiety causing forgetfulness may be part of the overall feelings.

Rationale 3: The nurse must be aware of his/her own feelings because anxiety may be transferred from the client to others. The inability to assess the situation accurately, inability to identify personal somatic problems, and anxiety causing forgetfulness may be part of the overall feelings.

Rationale 4: The nurse must be aware of his/her own feelings because anxiety may be transferred from the client to others. The inability to assess the situation accurately, inability to identify personal somatic problems, and anxiety causing forgetfulness may be part of the overall feelings.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Conduct a thorough and comprehensive assessment the care of clients with anxiety disorders.

Question 16

Type: MCSA

During the assessment of a client with an anxiety disorder, the client becomes very anxious. The nurse should:

1. Suspend data gathering and wait until the next day to resume the assessment.

2. Suspend data gathering and take action to reduce anxiety.

3. Continue data gathering and ask what the precipitating factor for the anxiety is.

4. Continue data gathering and ask clarifying questions.

Correct Answer: 2

Rationale 1: As anxiety increases, the perceptual field for a client decreases. The nurse should suspend data gathering and take action to reduce anxiety. Suspending data gathering until the next day is incorrect because the nurse needs to gather the assessment information as soon as possible. Continuing to gather data and asking for clarification, or asking about the precipitating factor for the anxiety, may not result in accurate information because the client may not be able to focus on the questions or answers.

Rationale 2: As anxiety increases, the perceptual field for a client decreases. The nurse should suspend data gathering and take action to reduce anxiety. Suspending data gathering until the next day is incorrect because the nurse needs to gather the assessment information as soon as possible. Continuing to gather data and asking for clarification, or asking about the precipitating factor for the anxiety, may not result in accurate information because the client may not be able to focus on the questions or answers.

Rationale 3: As anxiety increases, the perceptual field for a client decreases. The nurse should suspend data gathering and take action to reduce anxiety. Suspending data gathering until the next day is incorrect because the nurse needs to gather the assessment information as soon as possible. Continuing to gather data and asking for clarification, or asking about the precipitating factor for the anxiety, may not result in accurate information because the client may not be able to focus on the questions or answers.

Rationale 4: As anxiety increases, the perceptual field for a client decreases. The nurse should suspend data gathering and take action to reduce anxiety. Suspending data gathering until the next day is incorrect because the nurse needs to gather the assessment information as soon as possible. Continuing to gather data and asking for clarification, or asking about the precipitating factor for the anxiety, may not result in accurate information because the client may not be able to focus on the questions or answers.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Design a plan of care for intervening into mild, moderate, severe, and panic levels of client anxiety.

Question 17

Type: MCSA

A client having a severe panic attack may require the nurse to provide:

1. Teaching about anxiety.

2. Firm reassurance and protection until the episode subsides.

3. A physical activity for the client to focus on.

4. Teaching about ways to decrease anxiety.

Correct Answer: 2

Rationale 1: Offering firm reassurance and protection until the episode subsides provides safety for the client. Teaching about anxiety and ways to decrease anxiety are not appropriate because a client having a severe panic attack cannot learn at this level of anxiety. The client is unable to focus on a physical activity at this level of anxiety.

Rationale 2: Offering firm reassurance and protection until the episode subsides provides safety for the client. Teaching about anxiety and ways to decrease anxiety are not appropriate because a client having a severe panic attack cannot learn at this level of anxiety. The client is unable to focus on a physical activity at this level of anxiety.

Rationale 3: Offering firm reassurance and protection until the episode subsides provides safety for the client. Teaching about anxiety and ways to decrease anxiety are not appropriate because a client having a severe panic attack cannot learn at this level of anxiety. The client is unable to focus on a physical activity at this level of anxiety.

Rationale 4: Offering firm reassurance and protection until the episode subsides provides safety for the client. Teaching about anxiety and ways to decrease anxiety are not appropriate because a client having a severe panic attack cannot learn at this level of anxiety. The client is unable to focus on a physical activity at this level of anxiety.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Design a plan of care for intervening into mild, moderate, severe, and panic levels of client anxiety.

Question 18

Type: MCSA

When caring for a new client with OCD, it is most important for the nurse to:

1. Not interrupt the ritual.

2. Teach ritual interruption skills.

3. Interrupt the ritual.

4. Teach about anti-anxiety foods.

Correct Answer: 1

Rationale 1: Do not interrupt the ritual because the client may have to start from the beginning. For a new client, teaching ritual interruption skills and teaching about anti-anxiety foods would not be the priority.

Rationale 2: Do not interrupt the ritual because the client may have to start from the beginning. For a new client, teaching ritual interruption skills and teaching about anti-anxiety foods would not be the priority.

Rationale 3: Do not interrupt the ritual because the client may have to start from the beginning. For a new client, teaching ritual interruption skills and teaching about anti-anxiety foods would not be the priority.

Rationale 4: Do not interrupt the ritual because the client may have to start from the beginning. For a new client, teaching ritual interruption skills and teaching about anti-anxiety foods would not be the priority.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design a plan of care for intervening into mild, moderate, severe, and panic levels of client anxiety.

Question 19

Type: MCSA

In developing a plan of care for a client with extreme panic, the nurse knows that:

1. Anxiety may be communicated through behavioral responses.

2. Behaviors are mobilized.

3. Social skills are intact.

4. Anxiety may be communicated through verbalizations.

Correct Answer: 1

Rationale 1: Anxiety may be communicated through behavioral responses and not through verbalizations. The high level of anxiety does not allow behaviors to be mobilized or social skills to remain intact.

Rationale 2: Anxiety may be communicated through behavioral responses and not through verbalizations. The high level of anxiety does not allow behaviors to be mobilized or social skills to remain intact.

Rationale 3: Anxiety may be communicated through behavioral responses and not through verbalizations. The high level of anxiety does not allow behaviors to be mobilized or social skills to remain intact.

Rationale 4: Anxiety may be communicated through behavioral responses and not through verbalizations. The high level of anxiety does not allow behaviors to be mobilized or social skills to remain intact.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design a plan of care for intervening into mild, moderate, severe, and panic levels of client anxiety.

Question 20

Type: MCSA

A client in the inpatient mental health unit is experiencing severe anxiety. The nurse knows that the client:

1. Is able to focus.

2. May be easily distracted.

3. Will be able to communicate in writing.

4. Retains information.

Correct Answer: 2

Rationale 1: The client with severe anxiety is easily distracted and unable to focus. The client with severe anxiety will not be able to communicate in writing or retain information.

Rationale 2: The client with severe anxiety is easily distracted and unable to focus. The client with severe anxiety will not be able to communicate in writing or retain information.

Rationale 3: The client with severe anxiety is easily distracted and unable to focus. The client with severe anxiety will not be able to communicate in writing or retain information.

Rationale 4: The client with severe anxiety is easily distracted and unable to focus. The client with severe anxiety will not be able to communicate in writing or retain information.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design a plan of care for intervening into mild, moderate, severe, and panic levels of client anxiety.

Question 21

Type: MCSA

In treating clients with prolonged anxiety, the nurse knows it is most important to:

1. Teach communication skills.

2. Explore old and ineffective coping strategies.

3. Encourage the expression of anger.

4. Help clients use anxiety to increase self-awareness and develop coping strategies.

Correct Answer: 4

Rationale 1: Helping clients use anxiety to learn about themselves and to develop coping strategies is a way to view anxiety from a positive position, whereas exploring old and ineffective coping strategies focus on what has not worked. Although teaching communication skills and encouraging the expression of anger may be important, they are not the most important interventions at this time.

Rationale 2: Helping clients use anxiety to learn about themselves and to develop coping strategies is a way to view anxiety from a positive position, whereas exploring old and ineffective coping strategies focus on what has not worked. Although teaching communication skills and encouraging the expression of anger may be important, they are not the most important interventions at this time.

Rationale 3: Helping clients use anxiety to learn about themselves and to develop coping strategies is a way to view anxiety from a positive position, whereas exploring old and ineffective coping strategies focus on what has not worked. Although teaching communication skills and encouraging the expression of anger may be important, they are not the most important interventions at this time.

Rationale 4: Helping clients use anxiety to learn about themselves and to develop coping strategies is a way to view anxiety from a positive position, whereas exploring old and ineffective coping strategies focus on what has not worked. Although teaching communication skills and encouraging the expression of anger may be important, they are not the most important interventions at this time.

Global Rationale:

Cognitive Level: Creating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Design a plan of care for intervening into mild, moderate, severe, and panic levels of client anxiety.

Question 22

Type: MCSA

After administering medication for an anxiety disorder, it is important for the nurse to record whether the client:

1. Uses caffeine.

2. Takes other medications.

3. Exhibits drowsiness.

4. Uses alcohol.

Correct Answer: 3

Rationale 1: Drowsiness is a common side effect of anti-anxiety medications. The nurse should determine whether the client uses alcohol, caffeine, or other medications prior to administering an anti-anxiety medication.

Rationale 2: Drowsiness is a common side effect of anti-anxiety medications. The nurse should determine whether the client uses alcohol, caffeine, or other medications prior to administering an anti-anxiety medication.

Rationale 3: Drowsiness is a common side effect of anti-anxiety medications. The nurse should determine whether the client uses alcohol, caffeine, or other medications prior to administering an anti-anxiety medication.

Rationale 4: Drowsiness is a common side effect of anti-anxiety medications. The nurse should determine whether the client uses alcohol, caffeine, or other medications prior to administering an anti-anxiety medication.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Educate clients and their families about pharmacologic and nonpharmacologic measures for anxiety disorders.

Question 23

Type: MCSA

The nurse knows that medication teaching has been ineffective when the client with an anxiety disorder states, My SSRI isnt working. Ive been on it for:

1. One week.

2. Four weeks.

3. 12 weeks.

4. Eight weeks.

Correct Answer: 1

Rationale 1: Typically, an SSRI takes four weeks for a therapeutic response and up to 812 weeks to see a full response to the drug.

Rationale 2: Typically, an SSRI takes four weeks for a therapeutic response and up to 812 weeks to see a full response to the drug.

Rationale 3: Typically, an SSRI takes four weeks for a therapeutic response and up to 812 weeks to see a full response to the drug.

Rationale 4: Typically, an SSRI takes four weeks for a therapeutic response and up to 812 weeks to see a full response to the drug.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Educate clients and their families about pharmacologic and nonpharmacologic measures for anxiety disorders.

Question 24

Type: MCSA

The nurse is teaching a client with social phobia about anxiety medications. The nurse knows the teaching has been effective when the client states, I know I:

1. Can use other medications.

2. Cant consume alcohol.

3. Can stop the medication any time.

4. Cant drink decaffeinated beverages.

Correct Answer: 2

Rationale 1: Clients should not consume alcohol with most anti-anxiety medications. They should not drink caffeinated beverages, use other medications without physician approval, or stop taking the medication unless directed to do so.

Rationale 2: Clients should not consume alcohol with most anti-anxiety medications. They should not drink caffeinated beverages, use other medications without physician approval, or stop taking the medication unless directed to do so.

Rationale 3: Clients should not consume alcohol with most anti-anxiety medications. They should not drink caffeinated beverages, use other medications without physician approval, or stop taking the medication unless directed to do so.

Rationale 4: Clients should not consume alcohol with most anti-anxiety medications. They should not drink caffeinated beverages, use other medications without physician approval, or stop taking the medication unless directed to do so.

Global Rationale:

Cognitive Level: Creating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Educate clients and their families about pharmacologic and nonpharmacologic measures for anxiety disorders.

Question 25

Type: MCSA

The nurse is working with a client who has a fear of driving a car. An intervention strategy planned to help this client face the fear is to teach:

1. Goal-oriented contracting.

2. Meditation.

3. Cognitive behavioral therapy.

4. Physical exercise.

Correct Answer: 3

Rationale 1: Cognitive behavioral therapy helps clients think differently about their fears and test reality. Meditation helps with relaxation. Goal-oriented contracting increases a sense of control. Physical exercise does not directly deal with cognition.

Rationale 2: Cognitive behavioral therapy helps clients think differently about their fears and test reality. Meditation helps with relaxation. Goal-oriented contracting increases a sense of control. Physical exercise does not directly deal with cognition.

Rationale 3: Cognitive behavioral therapy helps clients think differently about their fears and test reality. Meditation helps with relaxation. Goal-oriented contracting increases a sense of control. Physical exercise does not directly deal with cognition.

Rationale 4: Cognitive behavioral therapy helps clients think differently about their fears and test reality. Meditation helps with relaxation. Goal-oriented contracting increases a sense of control. Physical exercise does not directly deal with cognition.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Educate clients and their families about pharmacologic and nonpharmacologic measures for anxiety disorders.

Question 26

Type: MCSA

The mental health nurse is training primary care providers about treatment options for anxiety disorders, including pharmacologic options. The nurse knows that SSRIs are the choice class of medications for treating anxiety disorders because they:

1. Have fewer side effects than other anti-anxiety medications.

2. Have a short half-life.

3. Are metabolized in the liver.

4. Are adrenergic blocking agents.

Correct Answer: 1

Rationale 1: Because SSRIs have fewer side effects than other anti-anxiety medications, this makes them the medications of choice. SSRIs are not adrenergic blocking agents and are not metabolized in the liver. SSRIs do not have a short half-life.

Rationale 2: Because SSRIs have fewer side effects than other anti-anxiety medications, this makes them the medications of choice. SSRIs are not adrenergic blocking agents and are not metabolized in the liver. SSRIs do not have a short half-life.

Rationale 3: Because SSRIs have fewer side effects than other anti-anxiety medications, this makes them the medications of choice. SSRIs are not adrenergic blocking agents and are not metabolized in the liver. SSRIs do not have a short half-life.

Rationale 4: Because SSRIs have fewer side effects than other anti-anxiety medications, this makes them the medications of choice. SSRIs are not adrenergic blocking agents and are not metabolized in the liver. SSRIs do not have a short half-life.

Global Rationale:

Cognitive Level: Creating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Educate clients and their families about pharmacologic and nonpharmacologic measures for anxiety disorders.

Question 27

Type: MCSA

Teaching clients and family members about the physical cues that indicate increasing anxiety would include information on:

1. Short attention span.

2. Forgetfulness.

3. Urinary retention.

4. Urinary frequency.

Correct Answer: 4

Rationale 1: Urinary frequency is a physical cue, but urinary retention is not. A short attention span and forgetfulness are behavioral cues, not physical cues.

Rationale 2: Urinary frequency is a physical cue, but urinary retention is not. A short attention span and forgetfulness are behavioral cues, not physical cues.

Rationale 3: Urinary frequency is a physical cue, but urinary retention is not. A short attention span and forgetfulness are behavioral cues, not physical cues.

Rationale 4: Urinary frequency is a physical cue, but urinary retention is not. A short attention span and forgetfulness are behavioral cues, not physical cues.

Global Rationale:

Cognitive Level: Creating

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Educate clients and their families about pharmacologic and nonpharmacologic measures for anxiety disorders.

Question 28

Type: MCSA

A client is newly diagnosed with an anxiety disorder. To support this client, who is struggling to accept the diagnosis, the nurse would:

1. Actively listen to the client and provide support.

2. Discourage the use of psychometric tests.

3. Flood the client with stressful stimuli.

4. Assess for secondary gain to confront the client.

Correct Answer: 1

Rationale 1: The most effective intervention would be to actively listen to the client and provide support. Discouraging the use of psychometric tests that might support the diagnosis, confronting with secondary gain issues, and flooding the client with stressful stimuli are not helpful interventions for this client.

Rationale 2: The most effective intervention would be to actively listen to the client and provide support. Discouraging the use of psychometric tests that might support the diagnosis, confronting with secondary gain issues, and flooding the client with stressful stimuli are not helpful interventions for this client.

Rationale 3: The most effective intervention would be to actively listen to the client and provide support. Discouraging the use of psychometric tests that might support the diagnosis, confronting with secondary gain issues, and flooding the client with stressful stimuli are not helpful interventions for this client.

Rationale 4: The most effective intervention would be to actively listen to the client and provide support. Discouraging the use of psychometric tests that might support the diagnosis, confronting with secondary gain issues, and flooding the client with stressful stimuli are not helpful interventions for this client.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Analyze personal feelings and possible challenges in caring for clients with anxiety disorders.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

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