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Test Bank For Davis Advantage for Townsend’s Essentials of Psychiatric Mental Health Nursing 9th Edition Karyn Morgan(CHAPTER 18 AND 19)

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Test Bank For Davis Advantage for Townsend’s Essentials of Psychiatric Mental Health Nursing 9th Edition Karyn Morgan(CHAPTER 18 AND 19)

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EXAMINER001
Chapter 18: Anxiety, Obsessive-Compulsive, and Related Disorders



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

1. The nurse is teaching the staff about specific phobias. Which statement from a staff member
indicates teaching has been effective?
1. “These clients recognize their fear as excessive and frequently seek treatment.”
2. “These clients have a panic level of fear that is overwhelming and unreasonable.”
3. “These clients experience symptoms that mirror a cerebrovascular accident.”
4. “These clients exhibit symptoms of tachycardia, dysphagia, and diaphoresis.”
2.
Which information would a nurse include in client teaching about social anxiety disorder?
1. Obsessions are the underlying reason for clients to avoid social situations.
2. These people avoid social interactions because of a perceived physical flaw.
3. Individuals with social anxiety disorder avoid performing in front of others.
4. People with this disorder avoid social gatherings because of fear of separation.
3.
Which guideline should the nurse use to help differentiate a client diagnosed with panic
disorder from a client diagnosed with generalized anxiety disorder (GAD)?
1. GAD is acute in nature, and panic disorder is chronic.
2. Chest pain is a common GAD symptom, whereas this symptom is absent in
panic disorders.
3. Depression is a commNoUn
RsEySmxIapNtmoGminTieBnr.G0CA0OD1M@andstruarveiain panic disorder.
4. 4. Depersonalization is absent in GAD but is commonly seen in panic disorder.

Which medication treatment should the nurse administer to clients diagnosed with generalized
anxiety disorder (GAD)?
1. Long-term treatment with diazepam (Valium)
2. Acute symptom control with propranolol (Inderal)
3. Long-term treatment with buspirone (BuSpar)
5. 4. Acute symptom control with ziprasidone (Geodon)

The nurse is assessing a client diagnosed with hoarding disorder. Which statement would the
nurse expect to hear from the client?
1. “I am a perfectionist.”
2. “I get obsessive about cleaning my counter tops.”
3. “I donate my clothing to charities.”
6. 4. “I prefer to have wide walkways in my home.”

A cab driver, stuck in traffic, becomes lightheaded, tremulous, diaphoretic, tachycardic, and
dyspneic. A work-up in an emergency department reveals no pathology. Which nursing diagnosis
should be the nurse’s first priority?
1. Fear
2. Powerlessness
3. Altered role performance
4. Anxiety

, 7. The client with panic disorder says, “When an attack happens, I feel like I am going to die.”
Which response should the nurse make?
1. “I know it’s frightening, but try to remind yourself that this will only last a short
time.”
2. “Death from a panic attack happens so infrequently that there is no need to worry.”
3. “Most people who experience panic attacks have feelings of impending doom.”
4. “Tell me why you think you are going to die every time you have a panic attack.”
8.
The nursing instructor is teaching about medications used to treat clients diagnosed with panic
disorder. Which student statement indicates teaching has been effective?
1. “Clonazepam (Klonopin) is particularly effective in the treatment of panic
disorder.”
2. “Clonidine (Catapres) is used off-label in long-term treatment of panic disorder.”
3. “Atenolol (Tenormin) can be used in low doses to relieve symptoms of panic
attacks.”
4. “Buspirone (BuSpar) is used for its immediate effect to lower anxiety during
panic attacks.”
9.
A son is seeking advice about his mother who seems to worry unnecessarily about everything.
The son states, “Should I seek psychiatric help for my mother?” Which is an appropriate nursing
response?
1. “My mother also worries unnecessarily. I think it is part of the aging process.”
2. “Anxiety is considered abnormal when it is out of proportion to the
stimulus causing it and when it impairs functioning.”
3. “From what you
haveNtoUldRESmxIea,NmyGoinuTesBhr.o0uC0lOd1Mg@et shteur vtoiaa
psychiatrist as soon as
possible.”
4. “Worry and anxiety are complex phenomena and are effectively treated only
with psychotropic medications.”

10. The client is experiencing a severe panic attack. Which nursing intervention would meet
this client’s physiological need?
1. Teach deep breathing relaxation exercises.
2. Place the client in a brightly lit room.
3. Have the client breathe into a paper bag.
4. Administer the ordered prn buspirone (BuSpar).

11. The college student has severe test anxiety. Instead of studying for finals, the student relieves
stress by attending a movie. Which priority nursing diagnosis should the campus nurse assign
for this student?
1. Non-adherence R/T test taking
2. Ineffective role performance R/T helplessness
3. Ineffective coping R/T anxiety
4. Powerlessness R/T fear

12. The client living in a riverfront community is seeking help with an extreme fear of bridges,
which is interfering with daily functioning. The psychiatric nurse practitioner decides to try
systematic desensitization. Which best explanation of this treatment should the nurse provide?
1. “Using your imagination, we will attempt to achieve a state of relaxation.”

, 2. “Because anxiety and relaxation are mutually exclusive states, we can attempt
to substitute a relaxation response for the anxiety response.”
3. “Through a series of increasingly anxiety-provoking steps, we will gradually
increase your tolerance to anxiety while in a relaxed state.”
4. “In one intense session, you will be exposed to a maximum level of anxiety
that you will learn to tolerate.”

13. The client diagnosed with obsessive-compulsive disorder has an elaborate routine for toileting
activities. Which would be an appropriate initial client outcome during the first week of
hospitalization?
1. The client will refrain from ritualistic behaviors during daylight hours.
2. The client will wake early enough to complete rituals prior to breakfast.
3. The client will participate in three unit activities by day three.
4. The client will substitute a productive activity for rituals by day one.

14. The nurse is providing discharge teaching to a client about benzodiazepines. Which
client statement would indicate a need for further follow-up instructions?
1. “I will need scheduled blood work in order to monitor for toxic levels of
this drug.”
2. “I won’t stop taking this medication abruptly because there could be
serious complications.”
3. “I will not drink alcohol while taking this medication.”
4. “I won’t take extra doses of this drug because I can become addicted.”
15. The nurse is teaching a
cliNenUtREdSixaIganNmoGsienTdeBwr.0itCh0O1aMn@xiesttyuavbioaut treatment
options. Which statement by the client indicates effective teaching?
1. “There is nothing that I can do to that will reduce anxiety.”
2. “Medication is available, but only for those who have had anxiety for a year
or more.”
3. “If I ignore the symptoms of anxiety, it will go away.”
4. “Practicing yoga or meditation may help reduce my anxiety.”

16. The client is newly diagnosed with obsessive-compulsive disorder and spends 50 minutes
folding clothes and rearranging them in drawers. Which nursing action would best address this
client’s problem?
1. Distract the client with other activities whenever ritual behaviors begin.
2. Report the behavior to the psychiatrist to obtain an order for medication
dosage increase.
3. Lock the room to discourage ritualistic behavior.
4. Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors.

17. A nurse questions the charge nurse about an order for fluvoxamine (Luvox) 300 mg daily in two
divided doses for a client diagnosed with obsessive-compulsive disorder (OCD). Which charge
nurse response is most accurate?
1. “High doses of tricyclic medications will be required for effective treatment
of OCD.”
2. “High doses of selective serotonin reuptake inhibitor (SSRI), above what
is effective for depression, may be required for OCD.”

, 3. “The dose of Luvox is low because of the side effect of daytime drowsiness.”
4. “The dose of this SSRI is outside the therapeutic range and needs to be brought
to the psychiatrist’s attention.”

18. The client is prescribed alprazolam (Xanax) for acute anxiety. Which client finding should cause
a nurse to question this order?
1. History of alcohol use disorder
2. History of personality disorder
3. History of schizophrenia
4. History of hypertension

19. During her uncle’s wake, a 5-year-old girl runs up to the casket before her mother can stop her. An
appointment is made with a nurse practitioner when the child starts twisting and pulling out her
hair, resulting in hair loss. Which nursing diagnosis should the nurse assign to this child?
1. Fear
2. Altered family processes
3. Ineffective impulse control
4. Disturbed body image

20. The nurse is preparing a presentation about the onset of symptoms for agoraphobia.
Which information should the nurse include in the teaching session?
1. Occurs in early adolescence and persists until midlife
2. Occurs in the 20s and 30s and persists for many years
3. Occurs in the 40s and 50s and persists until death
4. Occurs after the age oNf 0REaSxnIdaNpmeGriTnsiseBtr.s0fCo0Or1aM@t lesatsut
6viyaears


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

21. The client has been diagnosed with generalized anxiety disorder (GAD). Which symptoms
would the nurse observe upon assessment? (Select all that apply.)
1. Muscle tension
2. Paresthesia
3. Hyperventilation
4. Restlessness
5. Procrastination

22. The nurse is discussing treatment options with a client who has arachnophobia. Which commonly
used behavioral therapies for phobias should the nurse explain to the client? (Select all that
apply.)
1. Benzodiazepine therapy
2. Systematic desensitization
3. Imploding (flooding)
4. Competing response training
5. Habit reversal training

23. The nurse is caring for a client diagnosed with generalized anxiety disorder. Which
activities would the nurse encourage for this client? (Select all that apply.)
1. Recognize the signs of escalating anxiety.

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