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A)

B)
C)
D)

1.The client has an order for an anxiolytic agent, lorazepam (Ativan). Which of the
following statements by the client would indicate that client education about this
medication has been effective?
My anxiety will be eliminated if I take this medication as prescribed.
This medication presents no risk of addiction or dependence.
I will probably always need to take this medication for my anxiety.
This medication will relax me so I can focus on problem solving.

A)
B)
C)
D)

2.Which of the following communication techniques is most effective to use with anxious
clients?
Ask open-ended questions to facilitate self-expression.
Provide an open, populated area to decrease fears of abandonment.
Speak slightly louder than usual to improve communication.
Stand or sit in the center of the client's visual field to facilitate attention.

A)
B)
C)
D)

3.The nurse is teaching about postoperative wound care. As the wound is uncovered, the
client begins mumbling, breathing rapidly, and trying to get out of bed, and the client
does not respond when the nurse calls his name. Which of the following should be the
nurse's first action?
Ask the client to describe his feelings
Proceed with wound care quickly
Replace the dressing on the wound
Get the assistance of another nurse

A)
B)
C)
D)

4.When teaching a client with generalized anxiety disorder, the nurse instructs the client to
avoid which of the following?
Caffeine
High-fat foods
Refined sugars
Sodium

A)
B)
C)
D)

5.The client with obsessive-compulsive disorder attempts to control anxiety through


ritualistic behaviors. Which of the following interventions by the nurse will increase the
client's sense of security?
Allowing the client to perform the rituals
Distracting the client from rituals with other activities
Encouraging the client to talk about the purpose of the rituals
Stopping the client from performing the rituals

A)
B)

6.Nursing interventions that are appropriate for all clients with anxiety disorders are to
reduce anxiety and
Accept the fact that underlying conflicts cannot be treated
Develop alternative responses to anxiety-provoking situations
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C)
D)

Learn to control primitive impulses


Strive for insight through psychoanalysis

A)
B)
C)
D)

7.When a client is experiencing severe anxiety, which of the following is the priority
intervention?
Give the client medication immediately
Move the client to a quiet environment
Offer the client therapy to calm down
Put the client in seclusion temporarily

A)
B)
C)
D)

8.A client is learning to cope with anxiety and stress. The expected outcome is that the
client will
Change reactions to stressors
Ignore situations that cause stress
Limit major stressors in his or her life
Revise his or her lifestyle

A)
B)
C)
D)

9.The nurse enters the client's room and finds the client anxiously pacing the floor. The
client begins shouting at the nurse, Get out of my room! The best intervention by the
nurse would be to
Approach the client and ask, What's wrong?
Call for help and say, Calm down.
Say, I'm leaving now, but I'll be back.
Stand at the doorway and say, You seem upset.

A)
B)
C)
D)

10.Before eating a meal, a client with obsessive-compulsive disorder must wash her hands
for 14 minutes, comb her hair for 114 strokes, and switch the light off and on 44 times.
What is the most important treatment goal for this client?
Allow ample time for completion of all rituals before each meal.
Gradually decrease the amount of time spent performing rituals.
Increase the client's acceptance of the need for medication to control rituals.
Omit one ritualistic behavior every 4 days until all rituals are eliminated.

A)
B)
C)
D)

11.According to Selye (1956, 1974), which stage of reaction to stress stimulates the body to
send messages from the hypothalamus to the glands and organs to prepare for potential
defense needs?
Resistance
Exhaustion
Alarm reaction
Autonomic

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A)
B)
C)
D)

12.Patients in a stress management class ask the nurse, What is the difference between
stress and anxiety? The most accurate reply from the nurse would be:
There is no difference. The terms are interchangeable.
Stress is the emotional and cognitive responses to lifes difficulties. Anxiety is the
energy that is gives power to overcome stress.
Stress is the wear on our bodies caused by lifes difficulties. Anxiety is the
physical, emotional, and cognitive responses to the stress that wears on us.
Stress is a normal response to daily life. Anxiety consists of abnormally high levels
of stress.

A)
B)
C)
D)

13.The nurse plans to teach a patient about dietary modifications to manage diabetes.
Teaching would be most effective if the patient displayed the following characteristics:
Focusing only on immediate task
Faster rate of speech
Narrowed perceptual field
Heightened focus

A)
B)
C)
D)

14.A patient says to the nurse, I just cant talk in front of the group. I feel like Im going to
pass out. The nurse assesses the patients anxiety to be at which level?
Mild
Moderate
Severe
Panic

A)
B)
C)
D)

15.A student is preparing to give a class presentation. A few minutes before the presentation
is to begin, the student asks to be excused to go to the bathroom. The professor
understands that the student is likely experiencing which level of stress?
Mild
Moderate
Severe
Panic

A)
B)
C)
D)

16.A patient who suffers from frequent panic attacks describes the attack as feeling
disconnected from himself. The nurse notes in the patients chart that the patient reports
experiencing:
hallucinations
depersonalization
derealization
denial

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A)
B)
C)
D)

17.A patient asks how his prescribed alprazolam (Xanax) helps his anxiety disorder. The
nurse explains that antianxiety medications such as alprazolam affect the function of
which neurotransmitter that is believed to be dysfunctional in anxiety disorders?
Serotonin
Norepinephrine
GABA
Dopamine

A)
B)
C)
D)

18.Which of the following best explains the etiology of anxiety disorders from an
interpersonal perspective?
Anxiety is learned in childhood through interactions with caregivers
Anxiety is a learned throughout life as a response to life experiences
Anxiety stems from an unconscious attempt to control awareness
Anxiety results from conforming to the norms of a cultural group

C)
D)

19.A patient asks the nurse, Why do I have to go to counseling? Why cant I just take
medications? The best response by the nurse would be:
Both therapies are effective. You can eventually choose one or the other.
You cannot get the full effect of your medications without cognitive therapy as
well.
As soon as your medications reach therapeutic level you can omit the therapy.
Medications combined with therapy help you change how well you function.

A)
B)
C)
D)

20.A patient states, I will just die if I dont get this job. The nurse then asks the patient,
What will be the worst that will happen if you dont get the job? The nurse is using this
response to:
appraise his situation more realistically.
assist the patient to make alternative plans for the future.
assess if the patient has health problems compounded by stress.
clarify the patients meaning.

A)
B)
C)
D)

21.A nurse is working with a patient to develop assertive communication skills. The nurse
documents achievement of treatment outcomes when the patient makes a statement such
as:
Im sorry. Im not picking this up very quickly.
I feel upset when you interrupt me.
You are pushing me too hard.
Im not going to let people push me around anymore.

A)
B)

22.A client is diagnosed with obsessive-compulsive disorder. Which intervention should the
nurse include when developing the care plan?

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A)
B)
C)
D)

Giving the client time to perform rituals


Setting strict limits on compulsive behavior
Increasing environmental stimulation
Preventing ritualistic behavior

A)
B)
C)
D)

23.According to Selye (1956, 1974), which stage of reaction to stress causes the digestive
system to reduce function to shunt blood to areas needed for defense?
Resistance
Exhaustion
Alarm reaction
Autonomic

A)
B)
C)
D)
E)

24.A nurse is planning a stress management program at an outpatient treatment center.


Topics to include in the planning of this program include which of the following? (Select
all that apply)
Try to maintain control as much as possible
Set realistic goals for yourself
Practice relaxation skills as needed when stress is excessive
Balance sleep, rest, and exercise
Express emotions appropriately

A)
B)
C)
D)

25.A patient is currently experiencing a panic attack. Which of the following is the most
appropriate response by the nurse?
Just try to relax.
There is nothing here to harm you.
You are safe. Take a deep breath.
What are you feeling right now?

A)
B)
C)
D)

26.The nurse is teaching a patient with an anxiety disorder ways to manage anxiety. The
nurse suggests the following schedule for practicing stress management techniques:
Practice the techniques each morning and night as part of a daily a routine
Use the techniques as needed when experiencing severe anxiety
Practice the techniques when relatively calm
Expect to practice the techniques when meeting with a therapist

27.A patient experiences panic attacks when confronted with riding in elevators. The
therapist is teaching the patient ways to relax while incrementally exposing the patient to
getting on an elevator. This technique is called:
A)
Systematic desensitization
B)
Flooding
C)
Cognitive restructuring

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D)

A)
B)
C)
D)
E)

A)
B)
C)
D)

Exposure therapy
28.The nurse is educating a patient and family about managing panic attacks after discharge
from treatment. The nurse includes which of the following in the discharge teaching:
(Select all that apply)
Continued development of positive coping skills
Weaning off of medications as necessary
Lessening the amount of daily responsibilities
Continued practice of relaxation techniques
Development of a regular exercise program
29.The graduate nurse is caring for her first patient with Obsessive Compulsive Disorder.
During the treatment team meeting the nurse shares her frustration as to the patients
inability to stop washing his hands. The nurse manager offers the following explanation:
The hand washing represents a way to exert independence from the staff
The patient is not aware of the excessive hand washing
The patient does not think anything is abnormal with washing his hands repeatedly
The patient feels terrible but cannot stop washing his hands to try to get rid of his
anxiety

A)
B)
C)
D)

30.A client is experiencing a panic attack. Which term describes sensing that things are not
real?
Automatisms
Derealization
Depersonalization
Agoraphobia

A)
B)
C)
D)

31.When traveling alone and away from home, a client experiences trembling and
palpitations. These symptoms have impeded the client from leaving her home. The nurse
would correctly note that these are symptoms of which type of phobia?
Obsession
OCD
Compulsion
Agoraphobia

A)
B)
C)
D)

32.A client spends hours arranging and rearranging furniture in his room. This behavior is
identified as a
Phobia
Compulsion
Obsession
Derealization

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Answer Key
1.D
2.D
3.C
4.A
5.A
6.B
7.B
8.A
9.D
10.B
11.C
12.C
13.D
14.C
15.B
16.B
17.C
18.A
19.D
20.A
21.A
22.A
23.A
24.B, D, E
25.C
26.C
27.A
28.A, D, E
29.D
30.B
31.D
32.B

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