Chapter 13: Understanding Anxiety and Anxiety Defenses

Chapter 13: Understanding Anxiety and Anxiety Defenses

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1)   The nurse wishes to teach an alternative coping strategy to a client who is currently experiencing severe anxiety. The nurse will first need to

ANS:   A

A client experiencing severe anxiety has a markedly narrowed perceptual field and difficulty attending to events in the environment. Thus a client experiencing severe anxiety will not learn readily. Options B and C are relevant to the task but are not the priority measure. Option D: The nurse has already assessed the client’s anxiety level.

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 214, Text Page: 215

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

2)   A client approaches the nurse and blurts out “You’ve got to help me! Something terrible is happening. I’m falling apart. I can’t think. My heart is pounding and my head is throbbing.” The nurse responds “It’s almost time for visiting hours. Let’s get your hair combed.” This interaction can be evaluated as

ANS:   B

The nurse has closed off client-centered communication and introduced an irrelevant topic, a ploy designed to make the nurse, who is uncomfortable dealing with the client’s severe anxiety, feel better.

DIF:    Cognitive Level: Evaluation              REF:    Text Page: 215

TOP:    Nursing Process: Evaluation              MSC:   NCLEX: Physiologic Integrity

3)   A client has been assessed as having moderate anxiety. He 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. Clarifying helps the client identify thoughts and feelings. Option A is a nontherapeutic question for which the client likely does not have an answer. Option B: The client may be unable to determine this. Option D is a directive the client is probably unable to accomplish.

DIF:    Cognitive Level: Application             REF:    Text Page: 215

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

4)   A client is noted to have a high level of non-goal-directed motor activity, running from chair to chair in the solarium. He is wide eyed and seems terror stricken. He cries “They’re coming! They’re coming!” He neither follows staff direction nor responds to verbal efforts to calm him. The initial nursing intervention of highest priority is to

ANS:   A

Safety is of highest priority because the client experiencing panic is at high risk for self-injury related to increased non-goal-directed motor activity, distorted perceptions, and disordered thoughts. Option B: The goal should be to decrease environmental stimuli. Option C is a lower priority than safety. Option D: Clarification of feelings cannot take place until the level of anxiety is lowered.

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 216, Text Page: 217

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Safe, Effective Care Environment;