Chapter 18: Anxiety, Obsessive-Compulsive, and Related Disorders

Chapter 18: Anxiety, Obsessive-Compulsive, and Related Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     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)

 

 

____     5.   Which symptoms should the nurse recognize that differentiate a client diagnosed with obsessive-compulsive disorder (OCD) from a client diagnosed with obsessive-compulsive personality disorder?

1.	Clients diagnosed with OCD experience both obsessions and compulsions, and clients diagnosed with obsessive-compulsive personality disorder do not.
2.	Clients diagnosed with obsessive-compulsive personality disorder experience both obsessions and compulsions, and clients diagnosed with OCD do not.
3.	Clients diagnosed with obsessive-compulsive personality disorder experience only obsessions, and clients diagnosed with OCD experience only compulsions.
4.	Clients diagnosed with OCD experience only obsessions, and clients diagnosed with obsessive-compulsive personality disorder experience only compulsions.

 

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

 

5. ANS:  1

Chapter: Chapter 18, Anxiety, Obsessive-Compulsive, and Related Disorders

Objective: Describe various types of anxiety, obsessive-compulsive, and related disorders and identify symptomatology associated with each.

Page: 455–456

Heading: Obsessive-Compulsive Disorder

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis (Analyzing)

Concept: Patient-Centered Care

Difficulty: Moderate

 

	Feedback
1	A client diagnosed with OCD experiences both obsessions and compulsions. Clients with obsessive-compulsive personality disorder exhibit a pervasive pattern of preoccupation with orderliness, perfectionism, mental and interpersonal control, but do not experience obsessions and compulsions.
2	Clients with OCD experience obsessions and compulsions. Clients with obsessive-compulsive personality disorder do not.
3	The nurse would not recognize these symptoms as differentiating the disorders.
4	This statement is inaccurate regarding these disorders.

 

 

PTS:     1          CON:   Patient-Centered Care