Chapter 15: Anxiety and Obsessive-Compulsive Disorders Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition MULTIPLE CHOICE 1. A nurse wants to teach alternative coping strategies to a patient experiencing severe anxiety.
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Which action should the nurse perform first? a. Verify the patient’s learning style. b. Lower the patient’s current anxiety. c. Create outcomes and a teaching plan. d. Assess how the patient uses defense mechanisms. ANS: B
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A patient experiencing severe anxiety has a markedly 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. Use of defense mechanisms does not apply.
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PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 15-4, 5, 64 (Table 15-1) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
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2. A woman is 5'7", 160 lbs. and wears a size 8 shoe. She says, “My feet are huge. I’ve asked
ANS: B
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three orthopedists to surgically reduce my feet.” This person tries to buy shoes to make her feet look smaller and, in social settings, conceals both feet under a table or chair. Which health problem is likely? a. Social anxiety disorder b. Body dysmorphic disorder c. Separation anxiety disorder d. Obsessive-compulsive disorder due to a medical condition
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Body dysmorphic disorder refers to a preoccupation with an imagined defect in appearance in a normal-appearing person. The patient’s feet are proportional to the rest of the body. In obsessive-compulsive or related disorder due to a medical condition, the individual’s symptoms of obsessions and compulsions are a direct physiological result of a medical condition. Social anxiety disorder, also called social phobia, is characterized by severe anxiety or fear provoked by exposure to a social or a performance situation that will be evaluated negatively by others. People with separation anxiety disorder exhibit developmentally inappropriate levels of concern over being away from a significant other.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 15-28, 29 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
3. A patient experiencing moderate anxiety says, “I feel undone.” An appropriate response for
the nurse would be: a. “What would you like me to do to help you?”
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