Chapter 12: Anxiety and Related Disorders Flashcards
Since learning that he will have a trial pass to a new group home tomorrow, Bill’s behaviour has changed. He has started to pace rapidly, has become very distracted, and is breathing rapidly. He has trouble focusing on anything other than the group home issue and complains that he suddenly feels very nauseated. Which initial nursing response is most appropriate for Bill’s level of anxiety?
a. “You seem anxious. Would you like to talk about how you are feeling?”
b. “If you do not calm down, I will have to give you medicine to calm you.”
c. “Bill, slow down. Listen to me. You are safe. Take a nice, deep breath.”
d. “We can delay the visit to the group home if that would help you calm down.”
c. “Bill, slow down. Listen to me. You are safe. Take a nice, deep breath.”
A patient who seems to be angry when his family again fails to visit as promised tells the nurse that he is fine and that the visit was not important to him anyway. When the nurse suggests that perhaps he might be disappointed or even a little angry that the family has again let him down, the patient responds that it is his family who is angry, not him, or else they would have visited. Which of the following defence mechanisms is this patient using to deal with his feelings?
a. Rationalization
b. Introjection
c. Regression
d. Dissociation
a. Rationalization
John, a construction worker, is on duty when a wall under construction suddenly falls, crushing a number of co-workers. Shaken initially, he seems to be coping well with the tragedy but later begins to experience tremors, nightmares, and periods during which he feels numb or detached from his environment. He finds himself frequently thinking about the tragedy and feeling guilty that he was spared while many others died. Which statement about this situation is most accurate?
a. John is experiencing post-traumatic stress disorder (PTSD) and requires therapy.
b. John has acute stress disorder and should be treated with antianxiety medications.
c. John is experiencing anxiety and grief and should be monitored for PTSD symptoms.
d. John is experiencing mild anxiety and a normal grief reaction; no intervention is needed.
c. John is experiencing anxiety and grief and should be monitored for PTSD symptoms.
A patient states that she has been ill for several months with stomach pain, headache, and dizziness. A review of her records shows that she has been tested repeatedly for various conditions, She has been diagnosed with dyspepsia and vertigo. She states that her pain is “10 out of 10” on a scale of 1 to 10. She has been treated in the past for anxiety and depression. Which condition should the nurse anticipate?
a. Illness anxiety disorder
b. Somatic symptom disorder
c. Dissociation disorder
d. Generalized anxiety disorder
a. Illness anxiety disorder
An older adult in the outpatient internal medicine clinic complains of feeling a sense of dread and fearfulness without apparent cause. It has been growing steadily worse and is to the point that it is interfering with the patient’s sleep and volunteer work. After a brief interview and cursory physical exam, the nurse diagnoses the patient with generalized anxiety disorder and suggests a referral to the mental health clinic. Which responses by the medical clinic nurse would be the priority response?
a. Complete the referral to the mental health clinic.
b. Meet with the patient’s family to discuss treatment options for generalized anxiety disorder.
c. Instruct the client in deep-breathing and basic cognitive behavioural techniques for coping with worry.
d. Suggest that a battery of blood tests, including a complete blood count (CBC), be ordered and reviewed.
d. Suggest that a battery of blood tests, including a complete blood count (CBC), be ordered and reviewed.
