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NURS 3310 Exam 1- Anxiety & Stress Exam
questions with correct answers
Anxiety |- |VERIFIED |ANSWER✔✔-An |alert |to |the |human |condition |of |impending |doom, |either |real |or | imagined, |accompanied |by |autonomic |responses |that |serve |as |a |protective |mechanism. Anxiety |vs |Fear |vs |Normal |Anxiety |- |VERIFIED |ANSWER✔✔-Anxiety: |Apprehension, |uneasiness, | uncertainty, |or |dread |from |real |or |perceived |threat Fear: |Reaction |to |specific |danger Normal |anxiety: |Necessary |for |survival Mild |to |Moderate |Anxiety |- |VERIFIED |ANSWER✔✔-May |have |a |positive |impact |(depending |on |the | person |or |situation); |if |the |impact |is |not |positive, |increased |anxiety |levels |can |result. Severe |anxiety |to |panic |- |VERIFIED |ANSWER✔✔-Can |lead |to |injury |to |self |or |others |(in |some |cases, | suicide, |primarily |due |to |impulsivity). Panic |- |VERIFIED |ANSWER✔✔-Can |lead |to |death |if |not |managed Risk |Factors |for |Anxiety |- |VERIFIED |ANSWER✔✔-Affect |all |persons |across |the |life |span Lifetime |prevalence |is |higher |among |females Highest |lifetime |prevalence |is |between |the |ages |of | 30 |to | 44 |years Non-Hispanic |whites |have |a |higher |incidence |compared |with |Hispanics |and |non-Hispanic |blacks
Familial |patterns |appear |in |certain |anxiety |disorders What |are |the |diagnostic |tests |to |confirm |anxiety? |- |VERIFIED |ANSWER✔✔-No |specific |tests |to |confirm |anxiety; |some |diagnostic |tests |may |be |useful |to |detect |conditions |that |contribute |to |anxiety. Primary |Prevention |for |Anxiety |- |VERIFIED |ANSWER✔✔-Well |visits |across |the |life |span Fostering |healthy |parent-infant |and |parent-child |relationships Parental |education: |tasks |related |to |stages |of |growth |and |development Crisis |intervention |when |applicable Secondary |Prevention |for |Anxiety |- |VERIFIED |ANSWER✔✔-Drug |screening |when |applicable Revised |Children's |Manifest |Anxiety |Scale Acute |Panic |Inventory Covi |Anxiety |Scale Social |Phobia |and |Anxiety |Inventory State-Trait |Anxiety |Inventory Collaborative |Interventions |for |Anxiety |- |VERIFIED |ANSWER✔✔-Behavioral |therapies |and |counseling | Complementary |and |alternative |medicine Rehabilitation Examples |of |complementary/alternative |medicine |for |anxiety |- |VERIFIED |ANSWER✔✔-Meditating Exercising Breathing |exercises Natural |remedies |(St. |John's |wort, |kava |kava, |valerian |root). Examples |of |rehabilitation |for |anxiety |- |VERIFIED |ANSWER✔✔-Psychosocial | Vocational
SSRI's |- |VERIFIED |ANSWER✔✔-SSRIs |are |generally |well-tolerated |agents |but |demonstrate |an |increased |risk |for |a |life-threatening |condition |(serotonin |syndrome) |when |combined |with |other |agents |that | agonize |serotonin. |Abrupt |discontinuation |of |SSRIs |can |lead |to |discontinuation |syndrome. SNRI's |- |VERIFIED |ANSWER✔✔-The |SNRIs |indicated |for |anxiety |include |venlafaxine |(for |panic |disorder, |social |anxiety |disorder, |and |GAD) |and |duloxetine |(for |GAD). |Like |SSRIs, |abrupt |discontinuation |of | SNRIs |can |lead |to |discontinuation |syndrome. They |block |both |ST |and |NE TCA's |- |VERIFIED |ANSWER✔✔-TCAs |influence |a |number |of |different |neurotransmitter |receptors | potentially |relevant |to |anxiety. |Doxepin |is |the |only |drug |in |this |group |that |has |an |FDA |indication |for | the |treatment |of |anxiety. |Although |effective, |this |is |considered |third- |and |fourth-tier |treatment | choice |due |to |its |significant |side |effects, |potential |for |suicidal |thinking |and |lethality |if |used |as |an | overdose |agent. MAOIs |- |VERIFIED |ANSWER✔✔-Increase |monoamine |availability. Phenelzine |sulfate |is |effective |in |treating |symptoms |associated |with |social |anxiety,37,38 |but |it |is | considered |a |second- |or |third-tier |choice |compared |with |the |newer |agents |that |boast |fewer |side | effects. Dissociating |- |VERIFIED |ANSWER✔✔-a |disconnection |of |thoughts, |emotions, |sensations, |and |behaviors |connected |with |a |memory Projecting |- |VERIFIED |ANSWER✔✔-refers |to |the |unconscious |rejection |of |emotionally |unacceptable | features |and |attributing |them |to |others Minimize |- |VERIFIED |ANSWER✔✔- Rationalize |- |VERIFIED |ANSWER✔✔-consists |of |justifying |illogical |or |unreasonable |ideas, |actions, |or | feelings |by |developing |acceptable |explanations |that |satisfy |the |teller |and |the |listener
Splitting |- |VERIFIED |ANSWER✔✔-is |the |inability |to |integrate |the |positive |and |negative |qualities |of | oneself |or |others |into |a |cohesive |image. Example: |A |26-year-old |woman |initially |values |her |acquaintances |yet |invariably |becomes |disillusioned | when |they |turn |out |to |have |flaws. Regressive |Behavior |- |VERIFIED |ANSWER✔✔-is |reverting |to |an |earlier, |more |primitive |and |childlike | pattern |of |behavior |that |may |or |may |not |have |been |previously |exhibited Stress |- |VERIFIED |ANSWER✔✔-refers |to |an |event |or |demand |made |on |the |individual |or |family |that | causes |the |individual |or |family |to |appraise |the |event |or |demand |for |the |scope |and |meaning |and |to | determine |whether |resources |for |its |management |are |exceeded |and |whether |the |event |or |demand |is |neutral |(no |stress), |challenging, |or |threatening. Cognitive |Appraisal |- |VERIFIED |ANSWER✔✔-Individual's |perception |regarding |how |stressful |an |event | is |or |will |be General |adaptation |syndrome |- |VERIFIED |ANSWER✔✔-Describes |the |body's |short-term |and |long-term |reactions |to |stress Coping |- |VERIFIED |ANSWER✔✔-Cognitive |and |behavioral |efforts |to |manage |stress Equilibrium |- |VERIFIED |ANSWER✔✔-Condition |in |which |all |competing |elements |are |in |balance Categories |of |Stressors |- |VERIFIED |ANSWER✔✔-Emotional |Stressors Behavioral |Stressors Physiologic |Stressors SNS |Response |to |Stress |- |VERIFIED |ANSWER✔✔-Stressor |sends |signals |to: | -Limbic |System -Hypothalamus |
Exhaustion |of |resources |leads |to |loss |of |homeostasis. |Negative |physical, |psychological, |and/or |social | manifestations. Risk |Factors |for |Stress |- |VERIFIED |ANSWER✔✔-}Impaired |cognition }Chronic |health |conditions |including |mental |health |issues }Multiple |significant |life |changes }Socioeconomic |status |(e.g., |poor, |homeless) }Caregiver }Individual |in |a |foreign |country—especially |with |language/cultural |barrier Case |Study: | }John, |a |24-year-old |young |man, |returned |from |the |Iraqi |war |last |month |and |has |become |increasingly |irritable, |isolated, |and |depressed. }His |wife |says |he |does |not |want |to |go |anywhere |and |won't |leave |his |home |for |days |at |a |time. |In |the | interview |with |the |nurse |at |the |clinic, |he |indicates |that |he |feels |helpless, |anxious, |and |jumpy. }Identify |priorities |in |providing |care |for |this |patient |and |develop |a |nursing |care |plan. |- |VERIFIED | ANSWER✔✔-}Anxiety |is |one |of |the |most |important |issues. |A |psychiatric |professional |may |prescribe | medications. }Alpha |agonists |(e.g., |clonidine |or |prazosin) |can |reduce |hyperarousal |and |intrusive |symptoms, |and/or | a |selective |serotonin |reuptake |inhibitor |such |as |paroxetine |(Paxil) |will |also |help |anxiety |and | depressive |symptoms. }Nurse |generalists |can |teach |relaxation |techniques |and |encourage |John |to |talk |about |what |he |is |going |through |to |reduce |his |anxiety. }Isolation |is |a |problem |that |can |be |addressed |by |identifying |support |groups |for |people |who |are | having |the |same |problems. |There |are |likely |to |be |other |Iraq |veterans |in |the |area |who |are |being | treated |at |the |local |veterans' |administration. |Realizing |that |he |is |not |alone |and |learning |that |recovery |is |possible |will |be |strong |therapeutic |factors |for |John.
PTSD |- |VERIFIED |ANSWER✔✔-PTSD |is |characterized |by |persistent |re-experiencing |of |a |highly | traumatic |event |that |involves |actual |or |threatened |death |or |serious |injury |to |self |or |others, |to |which | the |individual |responded |with |intense |fear, |helplessness, |or |horror The |PNS |triggers |a |hypoaroused |state |with |dysregulation |between |the |hypothalamus, |pituitary |gland, | and |adrenal |glands |which |results |in |dissociation The |nurse |is |assessing |a |newly |admitted |client |for |symptoms |of |post-traumatic |stress |disorder |(PTSD). |Which |symptoms |are |typically |seen |with |this |diagnosis? |(Select |all |that |apply). A. |Anger |with |numbing |of |other |emotions B. |Exaggerated |startle |response C. |Feeling |that |one |is |having |a |heart |attack D. |Frequent |thoughts |about |contamination E. |Frequent |nightmares F. |Survivor's |guilt |- |VERIFIED |ANSWER✔✔-Answer: |A, |B, |E, |F Rationale: |These |are |all |common |symptoms |of |PTSD. |C |is |common |in |panic |disorder |and |D |is |common |in |obsessive-compulsive |disorder. A |nurse |at |Regional |Medical |Center |is |developing |a |care |plan |for |a |female |client |with |post-traumatic | stress |disorder. |Which |of |the |following |would |she |do |initially? A. |Instruct |the |client |to |use |distraction |techniques |to |cope |with |flashbacks. B. |Encourage |the |client |to |put |the |past |in |proper |perspective C. |Encourage |the |client |to |verbalize |thoughts |and |feelings |about |the |trauma D. |Avoid |discussing |the |traumatic |event |with |the |client |- |VERIFIED |ANSWER✔✔-Answer: |C Rationale: |Planning |the |care |for |a |patient |with |PTSD |involves |helping |the |patient |verbalize |thoughts | and |feelings |about |the |trauma. |This |helps |the |patient |work |through |the |strong |emotions |connected | with |the |trauma |and |helps |them |foster |belief |that |they |are |able |to |cope. A |group |of |community |nurses |sees, |and |plans |care |for |various |clients |with |different |types |of | problems. |Which |of |the |following |clients |would |they |consider |the |most |vulnerable |to |post-traumatic | stress |disorder? A. |An |8-year-old |boy |with |asthma |who |has |recently |failed |a |grade |in |school
Major |Depressive |Disorder |S&S |- |VERIFIED |ANSWER✔✔-Depressed |or |irritable |mood, |adhedonia, | psychomotor |agitation |or |retardation, |fatigue, |insomnia, |hypersomnia, |decreased |cognitive |function, | feelings |of |worthlessness, |and |in |severe |cases; |suicidal |ideation Psychological |and |Cognitive |variables |of |MDD |- |VERIFIED |ANSWER✔✔-1. |A |negative, |self |deprecating | view |of |self
- |A |pessimistic |view |of |the |world
- |The |belief |that |negative |reinforcement |(or |no |validation |for |the |self) |will |continue |in |the |future. A |nurse |assesses |a |client |suspected |of |having |major |depressive |disorder. |Which |client |symptom | would |eliminate |this |diagnosis? A. |The |client |is |disheveled |and |malodorous. B. |The |client |refuses |to |interact |with |others. C. |The |client |is |unable |to |feel |any |pleasure. D. |The |client |has |maxed-out |charge |cards |and |exhibits |promiscuous |behaviors. |- |VERIFIED | ANSWER✔✔-D Rationale The |nurse |should |assess |that |a |client |who |has |maxed-out |credit |cards |and |exhibits |promiscuous | behavior |would |be |exhibiting |manic |symptoms. |According |to |the |DSM-IV-TR, |these |symptoms |would | rule |out |the |diagnosis |of |major |depressive |disorder.
- |A |30-year-old |patient |diagnosed |with |major |depressive |disorder |has |a |nursing |diagnosis |of | Situational |Low |Self-Esteem |related |to |negative |view |of |self. |Which |of |the |following |are |appropriate | interventions |by |the |nurse? |(Select |all |that |apply.)
- |Encourage |reconnecting |with |high |school |friends.
- |Role-play |to |increase |assertiveness |skills.
- |Focus |on |identifying |strengths |and |accomplishments.
- |Provide |time |for |journaling |to |explore |underlying |thoughts |and |feelings.
- |Explore |new |job |opportunities. |- |VERIFIED |ANSWER✔✔-2, | 4
2: |Increasing |assertiveness |can |help |increase |levels |of |self |confidence |which |is |beneficial |for |a |patient | with |Low-Self-Esteem. 4: |Allowing |the |patient |to |journal |helps |the |patient |identify |what |is |causing |them |to |have |low-self- esteem |and |to |identify |possible |methods |to |mitigate |the |issues. Margaret, |age |68, |is |a |widow |of | 6 |months. |Since |her |husband |dies, |her |sister |reports |that |Margaret | has |become |socially |withdrawn, |has |lost |weight, |and |does |little |more |each |day |than |visit |the | cemetery |where |her |husband |was |buried. |She |told |her |sister |today |that |she |"didn't |have |anything | more |to |live |for." |She |has |been |hospitalized |with |major |depressive |disorder. |The |PRIORITY |nursing | diagnosis |for |Margaret |would |be: A. |Imbalanced |nutrition: |less |than |body |requirements B. |Complicated |grieving C. |Risk |for |suicide D. |social |isolation |- |VERIFIED |ANSWER✔✔-C. Rationale: |This |client |is |indicating |thoughts |of |suicide. |Safety |should |always |be |considered |the |priority |with |the |other |diagnoses |being |addressed |after |the |initial |threat |has |passed. A |client |has |just |been |admitted |to |the |psychiatric |unit |with |a |diagnosis |of |major |depressive |disorder. | Which |of |the |following |behavioral |manifestations |might |the |nurse |expect |to |assess? |(Select |ALL |that | apply) A. |Slumped |posture B. |Delusional |thinking C. |Feelings |of |despair D. |Feels |best |early |in |the |morning |and |worse |as |the |day |progresses E. |Anorexia |- |VERIFIED |ANSWER✔✔-A, |B, |C, |E | Rationale: |Behavioral |symptoms |of |severe |depression |include |slumped |posture, |walking |slowly, | virtually |nonexistent |communication, |delusional |thinking, |no |personal |hygiene. Affective |symptoms |of |depression |include |feelings |of |total |despair, |hopelessness, |and |worthlessness, | flat |unchanging |affect, |sadness, |and |inability |to |feel |pleasure. Physiological |symptoms |of |severe |depression |include |constipation, |urinary |retention, |anorexia, |weight |loss, |difficulty |falling |asleep |and |awakening |very |early |in |the |morning.
3: |A |primary |assumption |in |cognitive |therapy |is |that |changing |the |way |one |thinks |will |change |one's | mood. |Specifically, |developing |patterns |of |more |rational |and |positive |thinking |will |improve |one's | mood. 4: |In |cognitive |theory, |it |is |assumed |that |cognitive |distortions |arise |from |a |defect |in |cognitive | development, |which |culminates |in |an |individual |thinking |that |he |or |she |is |worthless, |inadequate, |and | rejected |by |others. |These |patterns |of |thinking |need |to |be |corrected |to |promote |a |positive |change |in | mood. ED |& |Stress |- |VERIFIED |ANSWER✔✔-Altered |brain |serotonin |function |contributes |to |dysregulation |of | appetite, |mood, |and |impulse |control |in |eating |disorders Genetic |vulnerability ◦Bulimia: |serotonin |levels |remaining |abnormal | Anorexia: |underlying |neurotransmitter |dysfunction; |gene-environmental |interaction A |nurse |is |teaching |a |client |diagnosed |with |an |eating |disorder |about |behavior-modification |programs. | Why |is |this |intervention |the |treatment |of |choice? A. |It |helps |the |client |correct |a |distorted |body |image. B. |It |addresses |the |underlying |client |anger. C. |It |manages |the |client's |uncontrollable |behaviors. D. |It |allows |clients |to |maintain |control. |- |VERIFIED |ANSWER✔✔-D Behavior-modification |programs |are |the |treatment |of |choice |for |clients |diagnosed |with |eating | disorders, |because |these |programs |allow |clients |to |maintain |control. |Issues |of |control |are |central |to | the |etiology |of |these |disorders. |Behavior |modification |techniques |function |to |restore |healthy |weight.
A |nursing |instructor |is |teaching |about |the |DSM-5 |criteria |for |the |diagnosis |of |binge-eating |disorder. | Which |of |the |following |student |statements |indicates |that |further |instruction |is |needed? |(Select |all | that |apply) A. |In |this |disorder, |binge |eating |occurs |exclusively |during |the |course |of |bulimia |nervosa. B. |In |this |disorder, |binge |eating |occurs, |on |average, |at |least |once |a |week |for |three |months. C. |In |this |disorder, |binge |eating |occurs, |on |average, |at |least |two |days |a |week |for |six |months. D. |In |this |disorder, |distress |regarding |binge |eating |is |present. E. |In |this |disorder, |distress |regarding |binge |eating |is |absent. |- |VERIFIED |ANSWER✔✔-A |C |E | According |to |the |DSM-5 |criteria |for |the |diagnosis |of |binge-eating |disorder, |binge |eating |should |not | occur |exclusively |during |the |course |of |anorexia |nervosa |or |bulimia |nervosa. |The |new |time |frame | criteria |in |the |DSM-5 |states |that |binge |eating |must |occur, |on |average, |at |least |once |a |week |for |three | months |not |two |days |a |week |for |six |months. |The |DSM-5 |criteria |states |that |distress |regarding |binge | eating |would |be |present Outpatient |treatment |is |planned |for |a |patient |diagnosed |with |anorexia |nervosa. |Select |the |most | important |outcome |related |to |the |nursing |diagnosis: |Imbalanced |nutrition: |less |than |body | requirements. |Within | 1 |week, |the |patient |will: A. |weigh |self |accurately |using |balanced |scales B. |limit |exercise |to |less |than | 2 |hours |daily C. |select |clothing |that |fits |properly D. |gain | 1 |to | 2 |pounds |- |VERIFIED |ANSWER✔✔-D Only |the |outcome |of |a |gain |of | 1 |to | 2 |pounds |can |be |accomplished |within | 1 |week |when |the |patient |is |an |outpatient. |The |focus |of |an |outcome |is |not |on |the |patient |weighing |self. |Limiting |exercise |and | selecting |proper |clothing |are |important, |but |weight |gain |takes |priority The |nurse |is |preparing |to |perform |an |admission |assessment |on |a |client |with |a |diagnosis |of |bulimia | nervosa. |Which |assessment |findings |should |the |nurse |expect |to |note? |(Select |all |that |apply).
- |Vital |signs
- |Auscultation |of |heart |and |lungs
- |Palpation |of |thyroid
- |Cranial |nerve |assessment
- |Blood |and |urine |studies **Autonomic |activation |can |manifest |in |hypertension, |tachycardia, |tachypnea, |diaphoresis, |ataxia, | tremulousness, |gastrointestinal |distress, |and |muscular |tension. |But |making |a |determination |of |anxiety |should |never |be |done |before |other |high-risk |mx |explanations |are |ruled |out |(MI, |stroke, |etc)/ Mental |Status |Examination:
- |Appearance
- |Attitude
- |Behavior
- |Mood |and |affect
- |Speech
- |Thought |process
- |Thought |content
- |Perceptions
- |Cognition
- |Insight
- |Judgment During |initial |assessment, |which |areas |are |most |characteristic |of |anxiety? |- |VERIFIED |ANSWER✔✔- Symptoms |of |restlessness, |difficulty |concentration, |irritability Increasing |symptoms |of |depression, |with |low/sad |mood. Suicidal |ideation
What |should |a |nurse |tell |a |patient |about |Wellbutrin? |- |VERIFIED |ANSWER✔✔-Anxiety |levels |may | increase What |should |the |nurse |ensure |the |patient |has |o |history |of |prior |to |prescribing |Wellbutrin? |- |VERIFIED |ANSWER✔✔-Anorexia/bulimia Seizures S/S |of |hypophosphatemia |- |VERIFIED |ANSWER✔✔-Shallow |respirations Weak |cardiac |contractions Seizure |activity | AMS During |nasogastric |feedings |the |nurse |should: |- |VERIFIED |ANSWER✔✔-Monitor |F/E Supervise |client |during |and |after |feedings Perform |skin |assessments |each |shift Measure/document |I/O
