Psych Stress and Coping

What symptoms should the nurse recognize that differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder?a.) GAD is acute in nature, and panic disorder is chronicb.) Chest pain is a common GAD symptom, whereas this symptom is absent in panic disorderc.) Hyperventilation is a common symptom in GAD and rare in panic disorderd.) Depersonalization is commonly seen in panic disorder and absent in GAD

d.) Depersonalization is commonly seen in panic disorder and absent in GAD

A client with AD has been assigned the nursing diagnosis of anxiety R/T divorce. Which correctly written outcome addresses this client's problem?a.) Rates anxiety as 4 out of 10 by dischargeb.) States anxiety level has decreased by day onec.) Accomplishes activities of daily living independentlyd.) Demonstrates ability for adequate social functioning by day three

a.) Rates anxiety as 4 out of 10 by discharge

As the sole survivor of a roadside bombing, a veteran is experiencing extreme guilt. Which nursing diagnosis would address this client's symptom?a.) Anxietyb.) Altered thought processes c.) Complicated grievingd.) Altered sensory perception

c.) Complicated grieving

A nursing instructor is explaining the etiology of trauma- related disorders from a learning theory perspective. Which student statement indicates that teaching has been effective?a.) "How clients perceive events and view the world affect their response to trauma."b.) "The psychic numbing in PTSD is a result of negative reinforcement." c.). "The individual becomes addicted to the trauma owing to an endogenous opioid response.d.) "Believing that the world is meaningful and controllable can protect an individual from PTSD.

b.) "The psychic numbing in PTSD is a result of negative reinforcement." They do not want to think about it

A nursing instructor is teaching about trauma and stress-related disorders. Which statement by one of the students indicates that further instructions is needed?a.) "The trauma that women experience is more likely to be sexual assault and child sexual abuse."b.) "The trauma that men experience is more likely to be accidents, physical assaults, combat, or viewing death or injury."c.) "After exposure ti a traumatic event, only 10 percent of victims develop PTSD"d.) "Research shows that PTSD is more common in men that in women.

d.) "Research shows that PTSD is more common in men that in women.

A nursing student questions an instructor regarding the order for fluvoxamine (Luvox) 300mg daily for a client diagnosed with OCD. Which instructor response is most accurate?a.) High doses of tricyclic medications will be required for effective treatment of OCDb.) 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 effects of daytime drowsinessd.) The dose of this SSRI is outside the therapeutic range and needs to be questioned

b.) Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treating depression, may be required for OCD.

A college student is unable to take a final exam due to severe test anxiety. Instead of studying, the student relieves stress by attending a movie. Which priority nursing diagnosis should the campus nurse assign for this client?a.) Non-adherence R/T test takingb.) Ineffective role performance R/T helplessnessc.) Altered coping R/T anxietyd.) Powerlessness R/T fear

c.) Altered coping R/T anxiety

Which symptoms should the nurse recognize that differentiate a client diagnosed with 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 experience obsessions, and clients diagnosed with obsessive compulsive personality disorder only experience compulsions.

a.) Clients diagnosed with OCD experience both obsessions and compulsions, and clients diagnosed with obsessive compulsive personality disorder do not.

A cab driver, stuck in traffic, becomes lightheaded, tremulous, diaphoretic, tachycardia, and dyspneic. A work-up in an ED reveals no pathology. Which medical diagnosis should the nurse suspect, and what nursing diagnosis should be the nurse's first priority?a.) GAD and a nursing diagnosis of fearb.) Mild anxiety disorder and a nursing diagnosis of anxietyc.) Panic disorder and a nursing diagnosis of altered role performanced.) Panic disorder and a nursing diagnosis of anxiety

d.) Panic disorder and a nursing diagnosis of anxiety

A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need?a.) Teach deep breathing relaxation exercisesb.) Place the client in a Trendelenburg positionc.) Have the client breathe into a paper bagd.) Administer the ordered prn buspirone (BuSpar)

c.) Have the client breathe into a paper bag

The nurse has been caring for a client diagnosed with GAD. Which of the following nursing interventions address this client's symptoms? Select all that apply.a.) Encourage the client to recognize the signs of escalating anxietyb.) 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 reframe cognitively thoughts about situations that generate anxiety. e.) Encourage the client to avoid caffeinated products.

a.) Encourage the client to recognize the signs of escalating anxietyc.) Encourage the client to employ newly learned relaxation techniques.d.) Encourage the client to reframe cognitively thoughts about situations that generate anxiety. e.) Encourage the client to avoid caffeinated products.

A client is taking chlordiazepoxide (Librium) for generalized anxiety disorder symptoms. In which situation should a nurse recognize that this client is at greatest risk for drug overdose?A. When the client has a knowledge deficit related to the effects of the drugB. When the client combines the drug with alcoholC. When the client takes the drug on an empty stomachD. When the client fails to follow dietary restrictions

B. When the client combines the drug with alcohol

A client diagnosed with generalized anxiety states, "I know the best thing for me to do now is to just forget my worries." How should the nurse evaluate this statement?a.) The client is developing insight.b.) The client's coping skills are improving.c.) The client has a distorted perception of problem resolution. d.) The client is meeting outcomes and moving toward discharge.

c.) The client has a distorted perception of problem resolution.

How would the nurse best describe the major maladaptive client response to panic disorder?a.) Clients overuse medical care because of physical symptomsb.) Clients use illegal drugs to ease symptomsc.) Clients perceive having no control over life situationd.) Clients develop compulsion to deal with anxiety

c.) Clients perceive having no control over life situationWe want to know why they are using maladaptive coping skills

A client diagnosed with Panic Disorder states, "When an attack happens, I feel like I am going to die." Which is the nurse's most appropriate reply?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.

a.) I know it's frightening, but try to remind yourself that this will only last a short time." C is generalizing the patient and D is asking why You want to validate their feelings

A client diagnosed with OCD 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.) Sublimationb.) Dissociationc.) Rationalizationd.) Intellectualization

d.) IntellectualizationHe is acknowledging, but not feeling.

Arthur, who is diagnosed with obsessive-compulsive disorder, reports to the nurse that he can't stop thinking about all the potentially life threatening germs in the environment. What is the most accurate way for the nurse to document this symptom?A. Patient is expressing an obsession with germs.B. Patient is manifesting compulsive thinking.C. Patient is expressing delusional thinking about germs.D. Patient is manifesting arachnophobia of germs.

A. Patient is expressing an obsession with germs.

A nursing instruct is teaching about specific phobias. Which students statement indicated that learning has occurred?a.) "These clients do not recognize that their fear is excessive, and they rarely seek treatment."b.) "These clients have overwhelming symptoms of panic when exposed to the phobic stimulus."c.) "The clients experience symptoms that mirror a CVA."d.) "These clients experience the symptom of tachycardia, dysphagia, and diaphoresis.

b.) "These clients have overwhelming symptoms of panic when exposed to the phobic stimulus.

A client diagnosed with post traumatic stress disorder (PTSD) states, "Why did my doctor prescribe an antidepressant rather than an anti anxiety drug for me?" Which of the following are the most appropriate nursing response? (Select all that apply.)a.) "I'm not sure, because anti anxiety drugs have been approved by the FDA for PTSD." b.) "Antidepressants are not considered first-line treatment choice for PTSD." c.) Many people have adverse reactions to anti-anxiety drugs."d.) "Because of their addictive properties, anti-anxiety drugs are less desirable."e.) "There have been no controlled studies on the effect of anti-anxiety drugs on PTSD.

b.) "Antidepressants are not considered first-line treatment choice for PTSD." d.) "Because of their addictive properties, anti-anxiety drugs are less desirable."e.) "There have been no controlled studies on the effect of anti-anxiety drugs on PTSD.

A family asks the nurse why their son was diagnosed with PTSD and others in the accident were not. Which of the following information should the nurse offer? (Select all that apply.) a.) An individual's religion affiliation can affect response to trauma. b.) Responses are affected by how an individual handled previous trauma.c.) Protectiveness of family and friends can help an individual deal with trauma.d.) Control over the possibility of recurrence can affect the response to trauma.e.) The time in which the trauma occurred can affect the individual's response.

b.) Responses are affected by how an individual handled previous trauma.c.) Protectiveness of family and friends can help an individual deal with trauma.d.) Control over the possibility of recurrence can affect the response to trauma.e.) The time in which the trauma occurred can affect the individual's response.

A client receiving EMDR therapy says, "After only two sessions of my therapy, I am feeling great. Now I can stop and get on with my life." Which of the following nursing responses is most appropriate?a.) "I am thrilled that you have responded so rapidly to EMDR."b.) "To achieve lasting results, all eight phases of EMDR must be completed."c.) If I were you, I would complete the EMDR and comply with the doctor's orders."d.) "How do you feel about continuing the therapy.

b.) "To achieve lasting results, all eight phases of EMDR must be completed.

By which biological mechanism does EMDR achieve its therapeutic effect?a.) EMDR achieves its therapeutic effect, but the exact biological mechanism is unknown.b.) EMDR achieves its therapeutic effect by causing a decrease in imagery vividness.c.) EMDR achieves its therapeutic effect by causing an increase in memory access.d.) EMDR achieves its therapeutic effect by decreasing trauma associated anxiety.

a.) EMDR achieves its therapeutic effect, but the exact biological mechanism is unknown.

A patient is admitted to the hospital with PTSD is ordered the following medications. Which of these medications has a direct use in treating symptoms that are common in PTSD? Select all the apply.a.) Alprazolam (Xanax)b.) Propamolol (Inderal)c.)Docusate sodium (Colace)d.) Docusate (Dulcolax)

a.) Alprazolam (Xanax)- used for anxietyb.) Propamolol (Inderal)- used for tachycardia

The nurse who works on an inpatient psychiatric using is working on developing a treatment plan for a patient admitted with PTSD. The patient a military veteran, reports that sometimes he thinks he sees bombs exploding and the enemy rushing toward him. He has had aggressive outbursts and was hospitalized after assaulting a coworker during one of these episodes. Which one of these nursing interventions are evidence-based responses? Select all that apply. a.) Collaborate with the patient about how he would like staff to respond when he has episodes of re---experiencing traumatic events.b.) Tell the patient it is not appropriate to hit other patients or staff and if that occurs, he will have to be discharged from the hospital. c.) Contact the doctor and recommend that the patient be ordered an antipsychotic medication.d.) Refer to a support group with other military veterans.

a.) Collaborate with the patient about how he would like staff to respond when he has episodes of re-experiencing traumatic events.d.) Refer to a support group with other military veterans.

A military veteran is assessed for outpatient therapy after he reports having problems home and at work. Which of the symptoms that he describes are commonly associated with PTSD? Select all that apply.a.) "I've been drinking and smoking pot daily."b.) "I've been having trouble sleeping and I think I've been having nightmares but I cannot remember them. c.) "I slapped my wife when she was trying to hug me."d.) "I've been having intense pain in the leg where I sustained a combat wound.

a.) "I've been drinking and smoking pot daily."b.) "I've been having trouble sleeping and I think I've been having nightmares but I cannot remember them. c.) "I slapped my wife when she was trying to hug me."D is not related because it is a physical problem

A mother brings her some to the ED and tells the nurse that her son must have PTSD because 2 days ago, he witnessed a car accident in which there were fatalities. She is convinced her son has PTSD because he has been crying when he talks about the incident. She believes that boys are at greater risk for PTSD because they don't typically cry. She read on the internet that PTSD can have dangerous consequences, so she wants her son to get some medication "to cure the PTSD before it gets too bad." Which of these statements by the nurse would accurately correct this mother's misunderstanding about PTSD? Select all that apply. a.) "There are no long-term or dangerous consequences from PTSD"b.) "Women appear to be at greater risk of this disorder that are men."c.) "Medications have been found to be effective in treating symptoms of depression or anxiety but do not represent a cure for this disorder."d.) "Fewer that 10 percent of trauma victims develop PTSD.

b.) "Women appear to be at greater risk of this disorder that are men."c.) "Medications have been found to be effective in treating symptoms of depression or anxiety but do not represent a cure for this disorder."d.) "Fewer that 10 percent of trauma victims develop PTSD."For PTSD: need to have S&S for 1 month; since this happened 2 days ago, would be acute stress disorder

Sammy is diagnosed with a trauma disorder and is being treated at an inpatient psychiatric unit. Which nursing short-term goal is most appropriate for Sammy?a.) Sammy resolves all feelings of survivor's guilt within 1 week.b.) Sammy demonstrates three relaxation techniques upon discharge.c.) Sammy moves through all stages of grief within 1 month.d.) Sammy agrees to seek community resources upon admission.

b.) Sammy demonstrates three relaxation techniques upon discharge.

A military veteran who recently returned from active duty in a Middle Eastern country and suffers from PTSD states he will not allow the laboratory technician, who is Iranian, to draw his blood. The patient states, "He'll probably use a contaminated need on me." Which of these is the most appropriate nursing response by the nurse.a.) "Let me see if I can arrange for a different technician to draw your blood." b.) "Let me help you overcome your cultural bias by letting him draw your blood."c.) "There is no other technician, so you're just going to have to let him draw your blood."d.) "I don't think the technician is really Middle Eastern.

a.) "Let me see if I can arrange for a different technician to draw your blood.

Sandy, a rape survivor, is being treated for PTSD. Which of these statements are good indications that Sally is beginning to recover from PTSD?a.) "I still have nightmares every night, but I don't always remember them anymore."b.) "I'm not drinking as much alcohol as I had been over the last several months."c.) "This traumatic event immobilized me for awhile, but I have found imagery helpful in reducing my anxiety."d.) All of the above.

d.) All of the above.PTSD will always have nightmares

Nursing care of a client with a diagnosis of substance-induces anxiety disorder must take into consideration the nature of the substance and if the symptoms are in the context of: Select all that apply. a.) Intoxicationb.) Psychosocial needsc.) Previous exposured.) Withdrawal

a.) Intoxicationd.) Withdrawal

A patient who is being seen in the community mental health center for PTSD is being considered for EMDR (eye movement desensitized and reprocessing) therapy. The nurse is asked to conduct an assessment to validate the patient's appropriateness for this treatment. Which of the following data, collected by the nurse, are most important to document when determining appropriateness for treatment with EDMR? Select all that apply. a.) The patient has a hx of a seizure disorder. b.) the patient has a hx of electroconvulsive therapy (ECT).c.) The patient reports suicidal ideation with a plan. d.) The patient has been using alcohol in increasing quantities over the last 3 months.

a.) The patient has a hx of a seizure disorder. c.) The patient reports suicidal ideation with a plan. d.) The patient has been using alcohol in increasing quantities over the last 3 months.The question boils down to what are contraindications?

Joe, a patient being treated for PTSD, tells the nurse that his therapist is recommending cognitive therapy. He asks the nurse how that's suppose to help his nightmares. Which of these responses by the nurse provides accurate information about the benefits of this type of therapy. Select all that apply. a.) "The nightmares may be related to troubling thoughts and feelings; cognitive therapy will help you explore and modify those thoughts and feelings. b.) "It is designed to help you cope with anxiety, anger, and other feelings that may be related to your symptoms."c.) "It is designed to repeatedly expose you to the trauma you experienced so you can regain to your symptoms."d.) "Once you learn to repress these troubling feelings, the nightmares should cease.

a.) "The nightmares may be related to troubling thoughts and feelings; cognitive therapy will help you explore and modify those thoughts and feelings. b.) "It is designed to help you cope with anxiety, anger, and other feelings that may be related to your symptoms.

Louisa recently experienced surviving a plan crash and is assessed by the nurse. Which statement made by Louisa indicates that she may be experiencing PTSD? Select all that apply. a.) "I keep having these thoughts about the crash that just pop into my mind at random times." b.) "I am so afraid that I will never be able to fly again. I worry about it constantly."c.) "I have nightmares every night about the crash where I picture myself dying."d.) "I believe that I was meant to survive this accident so that I can focus on the important things in life.

a.) "I keep having these thoughts about the crash that just pop into my mind at random times." b.) "I am so afraid that I will never be able to fly again. I worry about it constantly."c.) "I have nightmares every night about the crash where I picture myself dying.

Natalia is a 38-year-old Army sergeant who has been admitted to the psychiatric unit with a diagnosis of PTSD. Natalia witnessed her combat partner step on an explosive device that caused the combat partner's body to explode. Natalia tells the nurse that she has a headache and is going to stay in her room instead of going to the dining room for dinner. When the nurse later checks on Natalia, is not conscious. Prioritize each of the following nursing interventions from 1 to 5, with 1 being the highest priority. Begin cardiopulmonary resuscitation (CPR). Assess airway, breathing, and circulation.Notify the patient's familyCut down the patient. Call for help

1. Call for help2. Assess airway, breathing, and circulation.3.Begin cardiopulmonary resuscitation (CPR). 4. Notify the patient's familyCut down the patient- she is not hanging

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 agin 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 medication.

b.) "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning.