25. A person who has been unable to leave home for more than a week because of severe anxiety
says, “I know it does not make sense, but I just can’t bring myself to leave my apartment alone.” Which nursing intervention is appropriate? a. Help the person use online video calls to provide interaction with others. b. Advise the person to accept the situation and use a companion. c. Ask the person to explain why the fear is so disabling. d. Teach the person to use positive self-talk techniques. ANS: D
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Positive self-talk, a form of cognitive restructuring, replaces negative thoughts such as “I can’t leave my apartment” with positive thoughts such as “I can control my anxiety.” This technique helps the patient gain mastery over the symptoms. The other options reinforce the sick role.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 15-51, 72 (Table 15-4) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
26. A nurse assesses an individual who commonly experiences anxiety. Which comment by this
_a
nd
person indicates the possibility of obsessive-compulsive disorder? a. “I check where my car keys are eight times.” b. “My legs often feel weak and spastic.” c. “I’m embarrassed to go out in public.” d. “I keep reliving a car accident.” ANS: A
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Recurring doubt (obsessive thinking) and the need to check (compulsive behavior) suggest obsessive-compulsive disorder. The repetitive behavior is designed to decrease anxiety but fails and must be repeated. Stating “My legs feel weak most of the time” is more in keeping with a somatic disorder. Being embarrassed to go out in public is associated with an avoidant personality disorder. Reliving a traumatic event is associated with posttraumatic stress disorder.
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PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 15-25 to 27, 79 (Table 15-7) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 27. When alprazolam is prescribed for a patient who experiences acute anxiety, health teaching
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should include instructions to a. report drowsiness. b. eat a tyramine-free diet. c. avoid alcoholic beverages. d. adjust dose and frequency based on anxiety level. ANS: C
Drinking alcohol or taking other anxiolytics along with the prescribed benzodiazepine should be avoided because depressant effects of both drugs will be potentiated. Tyramine-free diets are necessary only with monoamine oxidase inhibitors (MAOIs). Drowsiness is an expected effect and needs to be reported only if it is excessive. Patients should be taught not to deviate from the prescribed dose and schedule for administration. PTS: 1
DIF: Cognitive Level: Apply (Application)
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