Chapter 18 Flashcards
When a client has a mild level of anxiety, his or her emotional response is:
a. Relaxed and calm
b. Energized
c. Feeling overloaded
d. Helplessness with loss of control
ANS: A
Mild anxiety results in relatively comfortable feelings. An energized emotional response describes feelings of moderate anxiety. Feeling overloaded is characteristic of severe anxiety, and feeling helpless with loss of control refers to the highest level of anxiety, which is panic.
A female college student is seeking help from the counseling center for test anxiety. She reports that during an exam, she “freezes,” and says, “It feels like the time I have to take the exam is racing by, and I can’t answer any of the questions when I know the answers.” Which level of anxiety is the client experiencing?
a. Mild
b. Moderate
c. Severe
d. Panic
ANS: C
These are typical symptoms when someone experiences a severe level of anxiety. During mild anxiety, the perceptual field is broad; moderate anxiety is the best state for problem solving and learning because perception is focused; panic results in totally scattered or closed perception, and problem solving is nearly impossible.
A learned response to an anticipated event, such as when a person who does not like to fly experiences nausea and sweaty palms before boarding an airplane, is best described as:
a. A normal anxiety response
b. Signal anxiety
c. An anxiety state
d. An anxiety trait
ANS: B
This response occurs as the individual anticipates a stress-provoking event. A normal anxiety response does not best meet the description in this situation; an anxiety state refers to when a person’s coping abilities have become overwhelmed and the person has lost emotional control; and an anxiety trait is part of an individual’s personality that occurs as an overreaction to situations.
A client tells the nurse that exercising in the gym helps him keep his stress level reduced.
Which type of coping mechanism best describes this situation?
a. Spiritual
b. Emotional
c. Intellectual
d. Physical
ANS: D
Stress-release activities such as exercise, jogging, and yoga are considered physical coping mechanisms. Spiritual coping mechanisms include prayer, faith, and rituals. Emotional coping mechanisms consist of crying, talking, and defense mechanisms. Intellectual coping mechanisms are observed when an individual changes his or her perceptions of a threat to make it less meaningful.
The charge nurse is angry with another nurse who has arrived one hour after the shift begins.
Rather than expressing her anger, the nurse avoids confrontation by denying approval of the nurse’s requested vacation day. What does this behavior demonstrate?
a. Substitution
b. Restitution
c. Suppression
d. Rationalization
ANS: A
Substitution is defined as disguising motivations by replacing an inappropriate behavior with one that is more acceptable. Restitution is defined as doing something to resolve guilt feelings; suppression is removing anxiety about a conflict from consciousness; and rationalization uses a good, but unreal, reason to make an excuse for an action.
The nurse is aware that several theories have been proposed to explain anxiety. Which theory explains anxiety as a result of interactions with others?
a. Biological model
b. Psychodynamic model
c. Interpersonal model
d. Behavioral model
ANS: C
The basis of this theory is that the anxiety response develops in early childhood as a result of interactions with others. The biological model relates to neurochemicals in the brain. The psychodynamic model is Freud’s theory that anxiety results from conflict between the ego and the id. The behavioral model describes anxiety as a learned response.
Adolescents who ineffectively cope with anxiety often express their anxiety through:
a. Inappropriate behaviors
b. Calm behavior
c. Psychotic behavior
d. Suicide
ANS: A
Behaviors such as defiance, experimenting with drugs, aggressiveness, and manipulation are examples of these behaviors. The other options are responses that are not commonly seen among adolescents with ineffective coping skills.
What is the term for physical expression of anxiety by an individual in ways such as nausea or headaches?
a. Compensation
b. Somatization
c. Denial
d. Fantasy
ANS: B
Often when an individual denies his or her feelings of anxiety, the anxiety is expressed physically. The other options are examples of defense mechanisms.
Which term best describes an individual’s feelings of anxiety that are broad, long-lasting, and excessive?
a. Generalized anxiety disorder
b. Panic attack
c. Phobic disorder
d. Obsessive-compulsive disorder
ANS:A
This diagnosis is given to individuals with these symptoms. Panic attacks last a short time, phobias relate to excessive fear of a specific object or situation, and obsessive-compulsive disorder is a constant thought and behavior.
A client has constant thoughts about locking his front door every time he leaves his house.
This client is experiencing a/an:
a. Compulsion
b. Phobia
c. Obsession
d. Anxiety reaction
ANS: C
Obsession is constantly thinking about something, and compulsion is acting it out. Phobia is irrational fear, and anxiety reaction is not a used term.
Which is a typical symptom of posttraumatic stress disorder?
a. Constant use of defense mechanisms
b. Flashbacks
c. Distressing persistent thoughts
d. Irrational fear
ANS: B
Flashbacks are vivid recollections of the trauma. Constant use of defense mechanisms is simply a maladaptive way of coping. Distressing, persistent thoughts represent obsession, and irrational fear is a phobia
Which is a typical symptom of posttraumatic stress disorder?
a. Constant use of defense mechanisms
b. Flashbacks
c. Distressing persistent thoughts
d. Irrational fear
ANS: B
Flashbacks are vivid recollections of the trauma. Constant use of defense mechanisms is simply a maladaptive way of coping. Distressing, persistent thoughts represent obsession, and irrational fear is a phobia.
The treatment team and a male client in whom obsessive-compulsive disorder associated with hand washing has been diagnosed decide on a treatment plan for the disorder. The nurse begins to implement the plan by having the client gradually extend the time between hand washes. This intervention is an example of which type of therapy?
a. Behavior modification
b. Desensitization
c. Flooding
d. Pharmacological therapy
ANS: B
This method gradually desensitizes the anxiety reaction, replacing it with effective coping skills. Behavior modification replaces maladaptive behavior with positive behavior; flooding is the complete opposite of desensitization; and pharmacological therapy is the use of medications.
A female client is taking a benzodiazepine for her anxiety disorder. She complains of anorexia and nausea since she started taking the medication a few days ago. What is the nurse’s best response?
a. “Be sure to take the medicine on an empty stomach to avoid these symptoms.”
b. “It takes a while to get used to the medicine. Give it a couple of weeks.”
c. “Try taking the medication with food or milk, and see if the symptoms improve.”
d. “Stop taking the medication immediately, and I will notify your doctor.”
ANS: C
Taking the medication with food or milk usually alleviates GI side effects of this class of drugs. An empty stomach will intensify the side effect. It is not true to say that it takes a while to adjust to the medication. Completely stopping the medication is not necessary.
A male client has had agoraphobia for several years. In the past 2 years, he has not left his home, and he only speaks to people on the phone occasionally. Which nursing diagnosis has the highest priority in this situation?
a. Social isolation
b. Thought processes, disturbed
c. Coping, ineffective individual
d. Powerlessness
ANS: A
All of the nursing diagnoses apply, but given the length of time of isolation, “Social isolation” is most appropriate.
