Chapter 18 Anxiety, Obsessive-Compulsive, and Related Disorders

Chapter 18  Anxiety, Obsessive-Compulsive, and Related Disorders

Complete Chapter Questions And Answers
 

Sample Questions

____ 1. A nursing instructor is teaching about specific phobias. Which student statement indicates to the instructor that 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 experience the symptoms of tachycardia, dysphagia, and diaphoresis.”

____ 2. Which nursing statement to a client about social anxiety disorder versus schizoid personality disorder (SPD) is most accurate?
1.
“Clients diagnosed with social anxiety disorder can manage anxiety without medications, whereas clients diagnosed with SPD can only manage anxiety with medications.”
2.
“Clients diagnosed with SPD are distressed by the symptoms experienced in social settings, whereas clients diagnosed with social anxiety disorder are not.”
3.
“Clients diagnosed with social anxiety disorder avoid interactions only in social settings, whereas clients diagnosed with SPD avoid interactions in all areas of life.”
4.
“Clients diagnosed with SPD avoid interactions only in social settings, whereas clients diagnosed with social anxiety disorder tend to avoid interactions in all areas of life.”

____ 3. What symptoms should the nurse recognize that 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.
Hyperventilation is a common symptom in GAD and rare in panic disorder.
4.
Depersonalization is commonly seen in panic disorder and absent in GAD.

____ 4. Which treatment should the nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder?
1.
Long-term treatment with diazepam (Valium)
2.
Acute symptom control with citalopram (Celexa)
3.
Long-term treatment with buspirone (BuSpar)
4.
Acute symptom control with ziprasidone (Geodon)

Answer Section

MULTIPLE CHOICE

1. ANS: 2
Chapter: Chapter 18, Anxiety, Obsessive-Compulsive, and Related Disorders
Objective: Differentiate among the terms stress, anxiety and fear.
Page: 449
Heading: Core Concept > Panic
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Evaluating
Concept: Patient-Centered Care
Difficulty: Moderate

Feedback
1
This statement does not indicate understanding.
2
The nursing instructor should evaluate that learning has occurred when the student knows that clients with phobias have a panic level of fear that is overwhelming and unreasonable. Phobia is fear cued by a specific object or situation in which exposure to the stimuli produces an immediate anxiety response. Even though the disorder is relatively common among the general population, people seldom seek treatment unless the phobia interferes with ability to function.
3
This statement indicates that further teaching is necessary.
4
This statement indicates that teaching has not been effective.

PTS: 1 CON: Patient-Centered Care

2. ANS: 3
Chapter: Chapter 18, Anxiety, Obsessive-Compulsive, and Related Disorders
Objective: Differentiate among the terms stress, anxiety and fear.
Page: 451–453
Heading: Application of the Nursing Process—Assessment > Phobias
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Evaluating
Concept: Patient-Centered Care
Difficulty: Moderate

Feedback
1
Clients with social anxiety disorder may need medication to manage symptoms.
2
Clients with SPD are distressed by symptoms experienced in all settings.
3
Clients diagnosed with social anxiety disorder avoid interactions only in social settings, whereas clients diagnosed with SPD avoid interactions in all areas of life. Social anxiety disorder is an excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others.
4
This statement in not accurate regarding SPD.

PTS: 1 CON: Patient-Centered Care

3. ANS: 4
Chapter: Chapter 18, Anxiety, Obsessive-Compulsive, and Related Disorders
Objective: Differentiate among the terms stress, anxiety and fear.
Page: 449–451
Heading: Application of the Nursing Process—Assessment
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Evaluating
Concept: Patient-Centered Care
Difficulty: Moderate

Feedback
1
Generalized anxiety disorder is chronic in nature.
2
Clients do not often experience chest pain or hyperventilation with GAD, but do with panic disorder.
3
Hyperventilation occurs with panic disorder.
4
The nurse should recognize that a client diagnosed with panic disorder experiences depersonalization, whereas a client diagnosed with GAD would not. Depersonalization refers to being detached from oneself when experiencing extreme anxiety.

PTS: 1 CON: Patient-Centered Care

4. ANS: 3
The other options are not appropriate treatment for clients diagnosed with generalized anxiety disorder.
Chapter: Chapter 18, Anxiety, Obsessive-Compulsive, and Related Disorders
Objective: Discuss various modalities relevant to treatment of anxiety, obsessive-compulsive, and related disorders.
Page: 470
Heading: Psychopharmacology
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate

Feedback
1
Long-term treatment with diazepam (Valium) is not appropriate treatment for clients diagnosed with generalized anxiety disorder.
2
Acute symptom control with citalopram (Celexa) is not appropriate treatment for clients diagnosed with generalized anxiety disorder.
3
The nurse should identify that an appropriate treatment for clients diagnosed with GAD is long-term treatment with buspirone. Buspirone is an anxiolytic medication that is effective in 60% to 80% of clients diagnosed with GAD. Buspirone takes 10 to 14 days for alleviation of symptoms but does not have the dependency concerns of other anxiolytics.
4
Acute symptom control with ziprasidone (Geodon) is not appropriate treatment for clients diagnosed with generalized anxiety disorder.

PTS: 1 CON: Patient-Centered Care