Anxiety and Alterations in Mood

86問 • 1年前

問題一覧

A client’s admitting history indicates signs of akathisia. What clinical finding should the nurse expect when assessing for akathisia?

Motor restlessness

A client is diagnosed with generalized anxiety disorder. For what behavior should the nurse assess a client to determine the effectiveness of therapy?

Identifies when anxiety is developing

A nurse is caring for a client with a generalized anxiety disorder. Which factor should be assessed to determine the client’s present status?

Behavior

A client arrives at the mental health clinic disheveled, agitated, and demanding that the nurse “do something to end this feeling.” What clinical manifestation is evident?

Feelings of panic

A client’s severe anxiety and panic are often considered to be “contagious.” What action should be taken when a nurse’s personal feelings of anxiety are increasing?

Say, “Another staff member is coming in. I will leave and return later.”

In what situation should a nurse anticipate that a client will experience a phobic reaction?

Coming into contact with the feared object

A nurse is interviewing a client with a phobia. Which treatment should the nurse inform the client has the highest success rate?

Systematic desensitization using relaxation techniques

A nurse speaks with a client who just experienced a panic attack. Which statement is most therapeutic when addressing the client’s concerns?

“You are concerned that this might happen again.”

People who are involved in a bioterrorism attack exhibit immediate reactions to the traumatic event. Which responses can a nurse expect in survivors during the immediate period after a traumatic event? Select all that apply.

Denial, Confusion, Helplessness

The parents of an adolescent who is experiencing posttraumatic stress disorder have decided to care for their child at home. What is the priority intervention that the home health nurse must include in the plan of care?

Assist the parents to understand that their child may avoid emotional attachments.

A client with a general anxiety disorder says to the nurse, “What can I do to prevent overreacting to stress?” What is the nurse’s best response?

“Develop a wide variety of coping strategies.”

What clinical findings may be expected when a nurse assesses an individual with an anxiety disorder? Select all that apply.

Worrying about a variety of issues, Regressing to an earlier level of adjustment, Converting the anxiety into a physical symptom, Displacing the anxiety onto a less threatening object

How should a nurse expect a client’s anxiety to be manifested physiologically?

Increased blood glucose level

What is an appropriate way a nurse can help a client to decrease anxiety?

Acquire skills with which to face stressful events.

A client comes to a mental health center with severe anxiety evidenced by crying, wringing the hands, and pacing. What should be the first nursing intervention?

Stay physically close to the client.

A nurse considers that in a conversion disorder pseudoneurologic symptoms such as paralysis or blindness:

are generally necessary for the client to cope with a stressful situation

An anxious client reports experiencing pain in the abdomen and feeling empty and hollow. A diagnostic workup reveals no physical causes of these clinical findings. What term best reflects what the client is experiencing?

Somatization

A client newly diagnosed with a conversion disorder is manifesting paralysis of a leg. The nurse can expect this client to:

recover the use of the affected leg but, under stress, again develop similar symptoms.

A nurse is caring for a client who has a diagnosis of conversion disorder with paralysis of the lower extremities. Which is the most therapeutic nursing intervention?

Avoiding focusing on the client’s physical symptoms

What characteristic of anxiety is associated with a diagnosis of conversion disorder?

Relieved by the symptom

What characteristic uniquely associated with psychophysiologic disorders differentiates them from somatoform disorders?

Underlying pathophysiology

A client believes that doorknobs are contaminated and refuses to touch them, except with a paper tissue. What nursing intervention is most therapeutic for this client?

Supply the client with paper tissues to help functioning until anxiety is reduced.

A nurse is caring for a client diagnosed with an obsessive- compulsive disorder. What is the basis for the obsessions and compulsions?

Unconscious control of unacceptable feelings

A nurse is developing a care plan for a client with an obsessive-compulsive behavior disorder. Which nursing intervention will most likely increase the client’s anxiety?

Limiting the client’s ritualistic acts to three times a day

Hospitalization or day-treatment centers are often indicated for the treatment of a client with an obsessive-compulsive disorder because these settings:

provide the neutral environment the client needs to work through conflicts.

What should a nurse include in the initial plan of care for a client with the long-standing, obsessive-compulsive behavior of hand washing?

Develop a routine schedule of activities to reduce the need for the ritualistic behavior.

A client with a history of obsessive-compulsive behaviors has a marked decrease in symptoms and expresses a wish to obtain a part-time job. On the day of a job interview the client arrives at the mental health center displaying signs of anxiety. What is the nurse’s best response to the client’s behavior?

“Going for your interview triggered some feelings in you. Perhaps you could call a friend to drive you there.”

What should a nurse consider when planning care for a client who is using ritualistic behavior?

Clients do not want to repeat the ritual but feel compelled to do so.

What is the priority discharge criterion for a client who is using ritualistic behaviors?

Intervenes to maintain increasing anxiety at a manageable level

A nurse is caring for a client who uses ritualistic behavior. What common antiobsessional medication does the nurse anticipate will be prescribed?

Fluvoxamine

A client is using ritualistic behaviors. Why should a nurse allow the client ample time for the performance of the ritual?

Denial of this activity may precipitate panic levels of anxiety.

A nurse is caring for a client with an obsessive-compulsive personality disorder that involves rituals. What should the nurse conclude about the ritual?

Seems illogical but is needed by the person

A nurse is preparing to care for a client who engages in ritualistic behavior. What should the plan of care include?

Help the client to understand that the behavior is caused by maladaptive coping to increased anxiety.

Which is the best nursing intervention during the working phase of the therapeutic relationship to meet the needs of individuals who demonstrate obsessive-compulsive behavior?

Supporting rituals while setting realistic limits

A nurse is caring for a client with a somatoform disorder. What should the nurse anticipate that this client will do?

Redirect the conversation with the nurse to physical symptoms.

A client who is being admitted to the mental health unit with bipolar disorder is depressed, avoids eye contact, responds in a very low voice, and is tearful. What is most therapeutic for a nurse to say during the assessment interview?

“I know this is difficult, but as soon as we are finished, I’ll take you to your room.”

A depressed older client has not been eating well since admission to the hospital. The client repeatedly states, “No one cares.” What is the nurse’s most appropriate response?

“I care about you. What are some foods you especially like?”

A client is admitted to the mental health unit because of a progressively increasing depression over the past month. What clinical finding does a nurse expect during the initial assessment of the client?

Diminished verbal expression caused by slowed thought processes

A nurse is planning care for a depressed client. Which approach is most therapeutic?

Allowing the client time to complete activities

What is most appropriate for a nurse to say when interview- ing a newly admitted depressed client whose thoughts focus on feelings of worthlessness and failure?

“Tell me how you feel about yourself.”

A client whose depression is beginning to lift remains aloof from the other clients on the mental health unit. How can a nurse help the client to participate in an activity?

Invite another client to take part in a joint activity with the nurse and the client.

Which activity is most appropriate for a nurse to introduce to a depressed client during the early part of hospitalization?

Project involving drawing

A withdrawn client refuses to get out of bed and becomes upset when asked to do so. What nursing action is most therapeutic?

Stay with the client until the client calms down.

A client with the diagnosis of bipolar disorder, depressive episode, has been hospitalized on a psychiatric unit for 1 week. What is the most appropriate activity for this client?

Talk with the nurse several times during the day.

During a special meeting to discuss the unexpected suicide of a recently discharged client, a nurse overhears another client moan softly, “I’m next. Oh, my God, I’m next. They couldn’t protect that person, and they can’t protect me.” What is the nurse’s most therapeutic response?

“You seem to be afraid you will hurt yourself.”

A depressed client is concerned about many fears that are upsetting and frightening and expresses a feeling of having committed the “unpardonable sin.” What is the nurse’s most therapeutic response?

“Your thoughts are part of your illness and will change as you improve.”

A nurse plans to evaluate a newly admitted depressed client’s potential for suicide. What is the best approach to obtain this information?

Inquire whether the client is now considering suicide.

A client with major depression that includes psychotic features tells the nurse, “All my relatives have been killed because I have been sinful and need to be punished.” What is the primary focus of nursing interventions?

Protect the client against any suicidal impulses.

A client is admitted to the mental health unit after attempting suicide. When a nurse approaches, the client is tearful and silent. What is the nurse’s best initial intervention?

Say, “I see you are tearful. Tell me about what is going on in your life, and we can work on helping you.”

A nurse has been assigned to work with a depressed client on a one-to-one basis. The next morning the client refuses to get out of bed, stating, “I’m too sick to be helped, and I don’t want to be bothered.” What is the nurse’s best response?

“I know you don’t feel like getting up, but you may feel better if you do. Let me help you get started.”

A frail, depressed client frequently paces the halls, becoming physically tired from the activity. What action should the nurse take to help reduce this activity?

Have the client perform simple, repetitive tasks.

A nurse sits with a depressed client twice a day, although there is little verbal communication. One afternoon, the client asks, “Do you think they’ll ever let me out of here?” What is the nurse’s best reply?

“How do you feel about leaving here?”

A nurse is working with a client with a major depressive episode. What is a long-term goal for this client?

Verbalize realistic perceptions of self and others.

A depressed client states, “I am no good. I’m better off dead.” What is the priority nursing intervention?

Alerting the staff to schedule 24-hour observation of the client

What is a therapeutic nursing action when caring for a depressed client?

Sitting down next to the client at frequent intervals

A teenager recently committed suicide, and grief counselors have been working with students. What behaviors indicate to the school nurse that a student may be considering suicide? Select all that apply.

Withdrawing from friends, Giving away prized possessions

A client with a diagnosis of major depression refuses to participate in unit activities because of being “just too tired.” What is the nurse’s best approach?

Accept the client’s feelings about activities calmly, while setting firm limits.

A nurse stops by the room of a tearful, newly admitted depressed client and offers to walk with the client to the evening meal. The client looks intently at the nurse, saying nothing. What is the nurse’s best response?

“It may be very difficult for you to be on a psychiatric unit.”

A client is admitted to the psychiatric hospital after many self-inflicted nonlethal injuries over the last month. Which level of suicidal behavior is reflective of the client’s behavior?

Gestures

A nurse moves into the working phase of a therapeutic relationship with a depressed client who has a history of suicide attempts. What question should the nurse ask the client when exploring alternative coping strategies?

“How will you manage the next time your problems start piling up?”

A nurse is assigned to care for a depressed client on a day when the client seems more withdrawn and depressed than usual. Which nursing intervention is most appropriate?

Spend a few extra minutes with the client throughout the day.

A nurse is discharging a client from the mental health unit who has been treated for major depression. Which statement is most therapeutic at this time?

“Call the contact number you were given if you have an emergency.”

On the second day after admission, a suicidal client asks a nurse, “Why am I being watched around the clock, and why can’t I walk around the entire unit?” Which reply is most appropriate?

“We are concerned that you might try to harm yourself.”

After 4 days on the inpatient psychiatric unit, a client on suicidal precautions tells the nurse, “Hey, look! I was feeling pretty depressed for a while, but I’m certainly not going to kill myself.” What is the nurse’s best response to this statement?

“We should talk some more about this.”

During a group discussion, it is learned that a group member hid suicidal urges and committed suicide several days ago. The nurse leading the group should be prepared to manage the:

fear by some members that their own suicidal urges may go unnoticed and unprotected.

What treatment should a nurse anticipate will be ordered for a client with severe, persistent, intractable depression and suicidal ideation?

Electroconvulsive therapy

A severely depressed client is to have electroconvulsive therapy (ECT). What should a nurse include when discussing this therapy with the client?

Sleep will be induced and treatment will not cause pain

An extremely depressed client signed the consent for electroconvulsive therapy (ECT) but continues to express anxiety about the procedure. What is most important for a nurse to emphasize when discussing ECT with the client?

“You will not be left alone during the procedure.”

A nurse is assisting with the administration of electroconvulsive therapy (ECT) to a severely depressed client. What side effect of the therapy should the nurse anticipate?

Confusion immediately after the treatment

When a nurse sits next to a depressed client and begins to talk, the client states, “I’m stupid and useless. Talk with the other people who are more important.” Which response is most therapeutic?

“I want to talk with you because you are important to me.”

A client is admitted to a mental health facility for depression. What action should a nurse take to help the client develop a positive self-regard?

Involve the client in activities that promote success.

A depressed client tells a nurse, “I want to die.” Which is the nurse’s most therapeutic response?

“You would rather not live.”

A client exhibiting manic behavior is admitted to the psychiatric hospital. In which room should the nurse manager place the client?

One that has basic simple furnishings

During the orientation tour for three new staff members, a young, hyperactive manic client greets them by saying, “Welcome to the funny farm. I’m Jo-Jo, the head yo-yo.” Which meaning can the nurse assign to the client’s statement?

Anxious over the arrival of new staff members

What is the best nursing intervention when the language of a client in the manic phase of a bipolar disorder becomes vulgar and profane?

Recognize that the behavior is part of the illness, but set limits on it.

A client with bipolar disorder, manic episode, has a superior, authoritative manner and constantly instructs other clients about how to dress, what to eat, and where to sit. The nurse should intervene because these behaviors eventually will cause the other clients to feel:

angry

A client with the diagnosis of bipolar disorder, manic episode, is extremely active, talks constantly, and tends to badger the other clients, some of whom are now becoming agitated. What is the best strategy for a nurse to use with this client?

Distraction

What therapeutic nursing intervention may redirect a hyperactive, manic client?

Encouraging the client to tear pictures out of magazines for a scrapbook

A nurse is caring for a hyperactive, manic client who exhibits flight of ideas and is not eating. What may be the reason why the client is not eating?

Is too busy to take the time to eat

A psychologist has been a client on a mental health unit for 3 days. The client has questioned the authority of the treatment team, advised other clients that their treatment plans are wrong, and has been disruptive in group therapy. What is the nurse’s most appropriate intervention?

Accept that the client is unable to control this behavior, and set appropriate limits.

How should the nursing staff provide for the nutritional needs of a client experiencing periods of extreme mania and hyperactivity?

Offer high-calorie snacks frequently that the client can hold.

A client is admitted to a psychiatric hospital after a month of unusual behavior that included eating and sleeping very little, talking and singing constantly, and going on frequent shopping sprees. In the hospital, the client is demanding, bossy, and sarcastic. Which disorder does the nurse associate with these behaviors?

Bipolar disorder, manic phase

What is essential for the nurse to do when approaching a client during a period of overactivity?

Use a firm but caring and consistent approach.

What should the nurse include when developing a plan of care for a client in the manic phase of bipolar disorder?

Redirect the client’s excess energy to constructive channels

The nurse assesses a client with the diagnosis of bipolar disorder, manic episode. Which clinical findings support this diagnosis? Select all that apply

Grandiosity, Talkativeness, Distractibility

A depressed client often sleeps past the expected time of awakening and spends excessive time resting and sleeping. Which nursing intervention is appropriate for this client?

Restrict the client’s access to the bedroom.

Astignars random QS

Kyla Angelique Son · 19問 · 1年前

Astignars random QS