Chapter 11: Anxiety, Anxiety Disorders, and Obsessive-Compulsive Disorders

Chapter 11: Anxiety, Anxiety Disorders, and Obsessive-Compulsive Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse wishes to teach alternative coping strategies to a patient who is experiencing severe anxiety. The nurse will first need to:

ANS:  A

A patient experiencing severe anxiety has a significantly narrowed perceptual field and difficulty attending to events in the environment. A patient experiencing severe anxiety will not learn readily. Determining preferred modes of learning, devising outcomes, and constructing teaching plans are relevant to the task but are not the priority measure. The nurse has already assessed the patient’s anxiety level. Using defense mechanisms does not apply.

DIF:    Cognitive Level: Analysis                REF:   Pages: 167-168

TOP:   Nursing Process: Planning               MSC:  NCLEX: Physiological Integrity

2. A patient approaches the nurse and impatiently blurts out, “You’ve got to help me! Something terrible is happening. My heart is pounding.” The nurse responds, “It’s almost time for visiting hours. Let’s get your hair combed.” Which approach has the nurse used?

ANS:  B

The nurse has closed off patient-centered communication. The introduction of an irrelevant topic makes the nurse feel better. The nurse is uncomfortable dealing with the patient’s severe anxiety.

DIF:    Cognitive Level: Application           REF:   Page: 167

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

3. A patient who is experiencing moderate anxiety says, “I feel undone.” An appropriate response for the nurse would be:

ANS:  C

Increased anxiety results in scattered thoughts and an inability to articulate clearly. Clarification helps the patient identify his or her thoughts and feelings. Asking the patient why he or she feels anxious is nontherapeutic, and the patient will not likely have an answer. The patient may be unable to determine what he or she would like the nurse to do to help. Telling the patient to get his or her feelings under control is a directive the patient is probably unable to accomplish.

DIF:    Cognitive Level: Application           REF:   Page: 167

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

4. A patient with a high level of motor activity runs from chair to chair and cries, “They’re coming! They’re coming!” The patient does not follow the staff’s directions or respond to verbal interventions. The initial nursing intervention of highest priority is to:

ANS:  A

Safety is of highest priority; the patient who is experiencing panic is at high risk for self-injury related to an increase in non–goal-directed motor activity, distorted perceptions, and disordered thoughts. The goal should be to decrease the environmental stimuli. Respecting the patient’s personal space is a lower priority than safety. The clarification of feelings cannot take place until the level of anxiety is lowered.

DIF:    Cognitive Level: Analysis                REF:   Pages: 167-168

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment