Anxiety Management in Healthcare Settings, Exams of Health sciences

Download Anxiety Management in Healthcare Settings and more Exams Health sciences in PDF only on Docsity! Saunders Anxiety Health Exam Questions with Answers Latest Update A client being discharged from the hospital to home with a diagnosis of tuberculosis is worried about the possibility of infecting family members and others. Which information should reassure the client that contaminating family members and others is not likely? 1. The family does not need therapy, and the client will not be contagious after 1 month of medication therapy. 2. The family does not need therapy, and the client will not be contagious after 6 consecutive weeks of medication therapy. 3. The family will receive prophylactic therapy, and the client will not be contagious after 1 continuous week of medication therapy. 4. The family will receive prophylactic therapy, and the client will not be contagious after 2 to 3 consecutive weeks of medication therapy. - Correct Answers 4 The nurse enters a client's room, and the client immediately demands to be released from the hospital. During review of the client's record, the nurse notes that the client was admitted 2 days ago for the treatment of an anxiety disorder and that the admission was a voluntary one. The nurse reports the findings to the registered nurse (RN) and expects that the RN will take which action? 1. Call the client's family. 2. Persuade the client to stay a few more days. 3. Contact the primary health care provider (PHCP). 4. Tell the client that discharge is not possible at this time. - Correct Answers 3 A client is admitted to the in-patient unit and is being considered for electroconvulsive therapy (ECT). The client appears calm, but the family is hypervigilant and anxious. The client's mother begins to cry and states, "My child's brain will be destroyed. How can the doctor do this?" The nurse should make which therapeutic response? 1. "It sounds as though you need to speak to the psychiatrist." 2. "Perhaps you'd like to see the ECT room and speak to the staff." 3. "Your child has decided to have this treatment. You should be supportive of the decision." 4. "It sounds as though you have some concerns about the ECT procedure. Why don't we sit down together and discuss any concerns you may have?" - Correct Answers 4 A mother of a teenage client with an anxiety disorder is concerned about her daughter's progress during discharge. She states that her daughter "stashes food, eats all the wrong things that make her hyperactive," and "hangs out with the wrong crowd." While helping the mother prepare for her daughter's discharge, the nurse should make which suggestion? 1. The mother should restrict the daughter's socializing time with her friends. 2. The mother should restrict the amount of chocolate and caffeine products in the home. 3. The mother should keep her daughter out of school until she can adjust to the school environment. 4. The mother should consider taking time off of work to help her daughter readjust to the home environment. - Correct Answers 2 The nurse is reviewing the health care record of a client admitted to the psychiatric unit. The nurse notes that the admission nurse has documented that the client is experiencing anxiety as a result of a situational crisis. The nurse should determine that this type of crisis could be caused by which event? 1. Witnessing a murder 2. A 13-year-old child is diagnosed with osteogenic sarcoma of the femur. Following a course of chemotherapy, it is decided that leg amputation is necessary. Following the amputation, the child becomes very frightened because of aching and cramping felt in the missing limb. Which statement made by the nurse will best assist in alleviating the child's fear? 1. "The pain medication that I give you will take these feelings away." 2. "This aching and cramping are normal and temporary and will subside." 3. "This pain is not real pain and relaxation exercises will help it go away." 4. "This always occurs after the surgery, and we will teach you ways to deal with it." - Correct Answers 2 A 1-year-old child with hypospadias is scheduled for surgery to correct this condition. The nurse is asked to assist in preparing a plan of care for this child. During this developmental time period, which factor should the nurse take into account? 1. Sibling rivalry will cause regression to occur. 2. Fears of separation and mutilation are present. 3. Embarrassment of voiding irregularities is common. 4. Concern over size and function of the penis is present. - Correct Answers 2 A client is somewhat nervous about having magnetic resonance imaging (MRI). Which statement by the nurse should provide reassurance to the client about the procedure? 1. "You will be able to eat before the procedure unless you get nauseated easily. If so, you should eat lightly." 2. "The MRI machine is a long, hollow narrow tube, and may make you feel somewhat claustrophobic." 3. "Even though you are alone in the scanner, you will be in voice communication with the technologist during the procedure." 4. "It is necessary to remove any metal or metal-containing objects before having the MRI done to avoid the metal being drawn into the magnetic field." - Correct Answers 3 A client is fearful about having an arm cast removed. Which action by the nurse would be the most helpful? 1. Telling the client that the saw makes a frightening noise 2. Reassuring the client that no one has had an arm lacerated yet 3. Stating that the hot cutting blades cause burns only very rarely 4. Showing the client the cast cutter and explaining how it works - Correct Answers 4 The nurse is assessing a client diagnosed with severe anxiety. Which objective data should the nurse expect to find? Select all that apply. 1. Selective inattention 2. Oblivious to surroundings 3. Unable to focus on anything 4. Engaging in purposeless activity (walking around aimlessly) 5. Physical behavior may become erratic, uncoordinated, and impulsive. 6. Showing unproductive relief behavior (stomping, wringing hands, dropping things) - Correct Answers 2,3,4,6 The nurse is reading about the four different levels of anxiety. Which different categories distinguish and describe each level? Select all that apply. 1. Effects on environment 2. Dysfunctional behavior 3. Effects on problem solving 4. Effects on perceptual field 5. Healthy reaction necessary for survival 6. Physical and other defining characteristics - Correct Answers 3,4,6 A client who is taking lithium carbonate is scheduled for surgery. The nurse would reinforce what information in the preoperative teaching about this medication? 1. The medication will be discontinued a week before the surgery and resumed 1 week postoperatively. 2. The medication is to be taken until the day of surgery and resumed by injection immediately postoperatively. 3. The medication will be discontinued 1 to 2 days before the surgery and resumed as soon as full oral intake is allowed. 4. The medication will be discontinued several days before surgery and resumed by injection in the immediate postoperative period. - Correct Answers 3 A client is scheduled to have an elective cesarean delivery. How should the nurse allay the client's feelings of anxiety? 1. Emphasize the technical aspects of this type of delivery. "I don't have time right now, but I'll get someone else to talk to you." - Correct Answers 2 The nurse on the mental health unit is collecting data on a client diagnosed with obsessive-compulsive disorder (OCD). The nurse expects to note which behavioral characteristics of OCD? Select all that apply. 1. Rigidity 2. Hostility 3. Inflexibility 4. Adaptability 5. Repetitive thoughts 6. Ritualistic behavior - Correct Answers 1,3,5,6 The student nurse is studying the cellular composition of the brain composed of approximately 100 billion neurons or nerve cells. Although neurons come in a great variety of shapes and sizes, all carry out the same three types of physiological actions. Which are these types of actions? Select all that apply. 1. Respond to stimuli 2. Conduct electrical impulses 3. Allow inward flow of sodium 4. Change membrane permeability 5. Release chemicals called neurotransmitters 6. Inhibit actions leading to a negative outcome - Correct Answers 1,2,5 The nurse is caring for a client with long-term Alzheimer's disease (AD). Which are some of the behavioral manifestations the nurse should expect to observe? Select all that apply. 1. Apraxia 2. Aphasia 3. Agnosia 4. Hyperorality 5. Somatization 6. Operant conditioning - Correct Answers 1,2,3,4 A client with obsessive-compulsive disorder (OCD) who continually cleans the bathroom becomes enraged with the roommate for using the bar of bathing soap for cleaning the bathroom. The client begins to yell and slaps the roommate. Which action should the nurse take first? 1. Restrain the client. 2. Fill out an incident report. 3. Remove both clients to a separate, safe location. 4. Call the hospital risk management department. - Correct Answers 3 The nurse is assigned to assist in the care of a client with obsessive-compulsive disorder (OCD). The nurse should place priority on which action when planning care for this client? 1. Demand active participation in care. 2. Monitor for obsessive-compulsive behavior. 3. Educate the client about self-care demands. 4. Establish a trusting nurse-client relationship. - Correct Answers 4 The nurse is preparing a care plan for the client with obsessive-compulsive disorder (OCD). The nurse should focus on which as the primary means to accomplish work with this client? 1. Group therapy 2. Medical diagnosis 3. Recreational therapy 4. Goals and objectives - Correct Answers 4 A client is admitted to the mental health unit with a diagnosis of possible somatic symptom disorder. Besides anxiety, the nursing assessment is especially important in identifying which client signs/symptoms are contributing to the somatic symptom disorder? Select all that apply. 1. Depression 2. Substance abuse 3. Potential for violence 4. Adverse childhood events 5. Posttraumatic stress disorder (PTSD) Insomnia 3. Seizure disorders 4. Alcohol withdrawal 5. Postpartum depression 6. Obsessive-compulsive disorder (OCD) - Correct Answers 1,2,3,4 The nurse is caring for a client experiencing a partial placental abruption. The client is uncooperative and is refusing any interventions until her husband arrives at the hospital. The nurse analyzes the client's behavior as likely the result of which situation? 1. Emotional immaturity 2. A stubborn personality 3. An undiagnosed psychiatric disorder 4. Acute anxiety and the need for support - Correct Answers 4 A pregnant woman reports that she has just finished taking the prescribed antibiotics to treat a urinary tract infection. The mother expresses concern that her baby will be born with an infection. Which response should the nurse make to help reduce the maternal fears that the newborn will be born with an infection? 1. "Urinary infections during pregnancy are common. Your baby will be fine." 2. "Your developing baby cannot acquire an infection from you during pregnancy." 3. "You shouldn't worry about this because you received early prenatal care and are taking your prenatal vitamins." 4. "Now that you have taken the medication as prescribed, we will continue to monitor you closely by repeating the urine culture before you leave today." - Correct Answers 4 During an office visit, a prenatal client with mitral stenosis states she has been under a lot of stress lately. During data collection, the client questions everything the nurse does and behaves in an anxious manner. Which is the appropriate nursing response or action at this time? 1. Tell the client not to worry. 2. Refer the client to a counselor. 3. Ignore the client's unfounded concerns and continue. 4. Explain the purpose of the nurse's actions and answer all questions. - Correct Answers 4 A primigravida client comes to the clinic and has been diagnosed with a urinary tract infection. She has repeatedly verbalized concern regarding safety of the fetus. Which client problem does the nurse identify as the priority at this time? 1. Altered tissue integrity 2. Urinary tract infection 3. Pain associated with the infection 4. Fear about the well-being of the fetus - Correct Answers 4 A client arrives in the emergency department in a crisis state. The client demonstrates signs of profound anxiety and is unable to focus on anything but the object of the crisis and the impact on self. The initial data collection would focus on which information? 1. The object of the crisis 2. The client's coping mechanisms 3. The presence of support systems 4. The physical condition of the client - Correct Answers 4 A client comes to the emergency department following an assault and is extremely agitated, trembling, and hyperventilating. Which initial nursing action is appropriate? 1. Begin to teach relaxation techniques. 2. Encourage the client to discuss the assault. 3. Remain with the client until the anxiety decreases. 4. Place the client in a quiet room alone to decrease stimulation. - Correct Answers 3 A client with a history of victim abuse has which signs/symptoms of the physical effects of living with a severe level of anxiety and chronic stress? Select all that apply. 1. Eupnea 2. Irritability 3. Moist skin 4. Bradycardia 5. Hypertension 6. Gastrointestinal disturbances - Correct Answers 2,5,6 A mother experiencing dystocia looks alarmed and asks, "What's going on? Why are you all poking and prodding? Is my baby okay?" Based on the client's questions, the nurse understands that the client is experiencing which problem? 2. Anxiety related to previous parenting issues 3. Anxiety related to the inability to achieve relaxation 4. Anxiety related to physical and emotional maternal exhaustion - Correct Answers 1 A client who has successfully adjusted to a colostomy declines the invitation to speak to a support group on the subject of alteration in body image. The client reports an extreme fear of public speaking. The nurse recognizes that this client is suffering from social phobia. Which are some other manifestations of social phobias? Select all that apply. 1. Performing badly on stage 2. Being afraid of strangers 3. Excessive anxiety when riding in an elevator 4. Looking awkward while eating or drinking in public 5. Not being able to answer questions in a classroom 6. Fear of saying something that sounds foolish in public - Correct Answers 1,4,5,6 A client in pulmonary edema has a prescription to receive morphine sulfate intravenously. The licensed practical nurse assisting in caring for the client determines that the client experienced an intended effect of the medication if which is noted? 1. Increased pulse rate 2. Relief of apprehension 3. Decreased urine output 4. Increased blood pressure - Correct Answers 2 A client is scheduled for an amniocentesis and tells the nurse, "I'm not sure I should have this test done." Which response by the nurse is appropriate? 1. "Tell me what concerns you have." 2. "Don't worry. Everything will be fine." 3. "Why don't you want to have this test done?" 4. "The primary health care provider has scheduled this test for a reason." - Correct Answers 1 A client is admitted to a psychiatric unit for observation following severe anxiety attacks. On admission, the client states, "There's nothing wrong with me. I shouldn't even be here. I am taking up a room, and there is probably someone else who really needs it." Although the nurse interprets this response as denial, which findings support a severe level of anxiety? Select all that apply. 1. Decreased pulse rate 2. Inability to think clearly 3. Inability to problem solve 4. Impulsively reacting to situations 5. Dry skin and mucous membranes - Correct Answers 2,3 A client with an oral endotracheal tube attached to a mechanical ventilator is about to begin the weaning process. The nurse asks the primary health care provider whether this process should be delayed temporarily based on administration of which medication to the client in the last hour? 1. Digoxin 2. Lorazepam 3. Furosemide 4. Metoclopramide - Correct Answers 2 The nurse is preparing a client scheduled for a bone marrow aspiration, and the client asks the nurse whether the procedure will be painful. The nurse should make which response to the client? 1. "No, it is not painful." 2. "You will receive general anesthesia." 3. "You will be heavily medicated before the procedure." 4. "A local anesthetic will be given and will decrease the discomfort." - Correct Answers 4 The nurse is preparing a client for a right below-the-knee amputation. The nurse anticipates that the client is likely to experience which psychosocial problems in the perioperative period? Select all that apply. 1. Pain 2. Anger 3. Grief 4. Anxiety 5. Altered body image - Correct Answers 3,4,5 1. Administer a sedative. 2. Convey empathy, trust, and respect toward the client. 3. Ignore the signs and symptoms of anxiety so that they will soon disappear. 4. Make sure the client knows all the correct medical terms so that he or she can understand what is happening. - Correct Answers 2 An anxious client is experiencing respiratory alkalosis from hyperventilation as a result of anxiety. The nurse should do which action to help the client experiencing this acid- base disorder? 1. Put the client in a supine position. 2. Provide emotional support and reassurance. 3. Withhold all sedative or antianxiety medications. 4. Tell the client to breathe very deeply but more slowly. - Correct Answers 2 A preoperative client expresses anxiety to the nurse about the upcoming surgery. Which response by the nurse is most likely to stimulate further discussion between the client and the nurse? 1. "If it's any help, everyone is nervous before surgery." 2. "I will be happy to explain the entire surgical procedure to you." 3. "Can you share with me what you've been told about your surgery?" 4. "Let me tell you about the care you'll receive after surgery and the amount of pain you can anticipate." - Correct Answers 3 A nursing student is assigned to care for a hospitalized 2-year-old child. The nursing instructor reviews the plan of care with the student and asks the student to identify the expected behavior of the child in regard to separation anxiety. Which statement by the student indicates an understanding of separation anxiety that can occur in a 2-year-old child? 1. "The child will withdraw." 2. "Separation anxiety is not an issue in a 2-year-old." 3. "The child may ignore the parents when they visit." 4. "Two-year-olds usually adjust well to hospitalization." - Correct Answers 3 A 4-year-old child is hospitalized for severe gastroenteritis. The child is crying and clinging to the mother. The mother becomes very upset and is afraid to leave the child. Which nursing intervention would be most appropriate to alleviate the child's fears and the mother's anxiety? 1. Reassure the mother that the child will be fine after she leaves. 2. Ask the mother if she would like to stay overnight with the child. 3. Give the mother the telephone number of the pediatric unit, and tell the mother to call at any time. 4. Tell the mother to bring the child's favorite toys the next time she comes to the hospital to visit. - Correct Answers 2 The nurse is reviewing the record of a client who is hospitalized for treatment of a panic disorder. The nurse notes that the client was admitted by voluntary hospitalization. During the day, the client runs down the hallway and demands release from the hospital. The nurse notes that the client is exhibiting signs/symptoms of anxiety and attempts to assist the client back to the client's hospital room. Which is the next appropriate nursing action at this time? 1. Notify the registered nurse (RN). 2. Call security and persuade the client to stay. 3. Help the client pack his or her personal belongings in preparation for discharge. 4. Inform the client that discharge is not possible because of the type of admission process involved. - Correct Answers 1 The nurse is collecting data on a client in crisis. Which question should the nurse ask to determine the client's perception of the precipitating event that led to the crisis? 1. "With whom do you live?" 2. "Who is available to help you?" 3. "What leads you to seek help now?" 4. "What do you usually do to feel better?" - Correct Answers 3 A client taking buspirone hydrochloride for 1 month is scheduled for a follow-up appointment. The nurse gathers data from the client and interprets that the medication is effective if the client reports an absence of which sign/symptom? 1. Delusions 2. Paranoid thoughts 3. Palpitations and anxiety 4. Alcohol withdrawal signs/symptoms - Correct Answers 3 Which nursing interventions are most helpful when caring for a client who is displaying signs/symptoms of panic level anxiety? Select all that apply. 1.