Chapter 27: Anxiety-Related, Obsessive-Compulsive, Trauma- and Stressor-
Related, Somatic, and Dissociative Disorders
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. Which statement demonstrates a nurse‘s understanding of the first intervention when caring for a
patient experiencing severe anxiety over an impending divorce?
a. ―Let me you solve the biggest problem the divorce will cause you.‖
b. ―I want you know I‘ll be here to keep you safe.‖
c. ―Please tell me what today‘s date is.‖
d. ―You can go into your room and close the door when you need privacy.‖
ANS: B
Patients with anxiety disorders experience discomfort from the anxiety. The patient must feel
safe, acknowledged, and cared for before problem-solving can begin. The nurse‘s first priority is
to provide support and understanding. Allowing the patient to remain alone fosters social
withdrawal and may allow anxiety to increase. Patients with anxiety seldom lose contact with
reality.
DIF: Cognitive level: Evaluating TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
2. A patient diagnosed with obsessive-compulsive disorder (OCD) experiences improvement after
beginning treatment with a selective serotonin reuptake inhibitor (SSRI). This phenomenon
supports the theory that OCD is associated with what neurotransmitter issue? a. Norepinephrine
deficiency
b. Serotonin dysregulation
c. Dopamine excess
, d. GABA deficiency
ANS: B
Serotonin dysregulation is hypothesized to play a part in OCD. Relief associated with SSRIs
supports this hypothesis. The other theories are nonrelated.
DIF: Cognitive level: Understanding TOP: Nursing process: Evaluation
MSC: Client Needs: Physiologic Integrity
3. A patient says, ―I have the same continuous and intrusive thoughts that my house is contaminated
with lethal bacteria. I spend hours cleaning the walls, floors, and furniture.‖ These symptoms are
most consistent with which diagnosis?
a. Social phobia
b. Panic disorder
c. Somatoform disorder
d. Obsessive compulsive disorder (OCD)
ANS: D
The patient‘s persistent intrusive thoughts are obsessions, and the need to continually clean is a
compulsion. Hence, the patient‘s disorder can be identified as OCD. The symptoms are not
consistent with a fear of interacting with others, extreme fear, or physical symptoms that have no
physiological basis.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
4. A patient‘s family member died in the 9/11 World Trade Center explosion. The patient says,
―I can‘t go into tall buildings because I get sweaty, my heart races, and I can‘t breathe. I get
terrifying feelings the building will explode.‖ Which response demonstrates the nurse‘s
understanding of this symptoms/signs?
a. ―What rituals do you preform to control your anxiety?‖
b. ―Have you ever been diagnosed with generalized anxiety disorder (GAD)?‖
, c. ―Your symptoms/signs suggest possible acute stress disorder (ASD).‖
d. ―It appears you are experiencing a specific phobia associated with your family‘s
tragedy.‖
ANS: D
Specific phobias typically develop after a traumatic event or observing others going through a
traumatic event. The extreme physical and emotional reactions are consistent with panic-level
anxiety. Rituals are associated with obsessive-compulsive disorder (OCD). GAD lacks a general
focus while an acute stress disorder would not be associated with an event so long
ago.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
5. When working with a patient diagnosed with dissociative amnesia, the nurse should begin the
care by implementing which intervention?
a. Setting mutual goals for behavioral changes
b. Instituting measures to prevent identity diffusion
c. Identifying and supporting the patient‘s strengths
d. Helping the patient develop a realistic self-concept
Related, Somatic, and Dissociative Disorders
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. Which statement demonstrates a nurse‘s understanding of the first intervention when caring for a
patient experiencing severe anxiety over an impending divorce?
a. ―Let me you solve the biggest problem the divorce will cause you.‖
b. ―I want you know I‘ll be here to keep you safe.‖
c. ―Please tell me what today‘s date is.‖
d. ―You can go into your room and close the door when you need privacy.‖
ANS: B
Patients with anxiety disorders experience discomfort from the anxiety. The patient must feel
safe, acknowledged, and cared for before problem-solving can begin. The nurse‘s first priority is
to provide support and understanding. Allowing the patient to remain alone fosters social
withdrawal and may allow anxiety to increase. Patients with anxiety seldom lose contact with
reality.
DIF: Cognitive level: Evaluating TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
2. A patient diagnosed with obsessive-compulsive disorder (OCD) experiences improvement after
beginning treatment with a selective serotonin reuptake inhibitor (SSRI). This phenomenon
supports the theory that OCD is associated with what neurotransmitter issue? a. Norepinephrine
deficiency
b. Serotonin dysregulation
c. Dopamine excess
, d. GABA deficiency
ANS: B
Serotonin dysregulation is hypothesized to play a part in OCD. Relief associated with SSRIs
supports this hypothesis. The other theories are nonrelated.
DIF: Cognitive level: Understanding TOP: Nursing process: Evaluation
MSC: Client Needs: Physiologic Integrity
3. A patient says, ―I have the same continuous and intrusive thoughts that my house is contaminated
with lethal bacteria. I spend hours cleaning the walls, floors, and furniture.‖ These symptoms are
most consistent with which diagnosis?
a. Social phobia
b. Panic disorder
c. Somatoform disorder
d. Obsessive compulsive disorder (OCD)
ANS: D
The patient‘s persistent intrusive thoughts are obsessions, and the need to continually clean is a
compulsion. Hence, the patient‘s disorder can be identified as OCD. The symptoms are not
consistent with a fear of interacting with others, extreme fear, or physical symptoms that have no
physiological basis.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
4. A patient‘s family member died in the 9/11 World Trade Center explosion. The patient says,
―I can‘t go into tall buildings because I get sweaty, my heart races, and I can‘t breathe. I get
terrifying feelings the building will explode.‖ Which response demonstrates the nurse‘s
understanding of this symptoms/signs?
a. ―What rituals do you preform to control your anxiety?‖
b. ―Have you ever been diagnosed with generalized anxiety disorder (GAD)?‖
, c. ―Your symptoms/signs suggest possible acute stress disorder (ASD).‖
d. ―It appears you are experiencing a specific phobia associated with your family‘s
tragedy.‖
ANS: D
Specific phobias typically develop after a traumatic event or observing others going through a
traumatic event. The extreme physical and emotional reactions are consistent with panic-level
anxiety. Rituals are associated with obsessive-compulsive disorder (OCD). GAD lacks a general
focus while an acute stress disorder would not be associated with an event so long
ago.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
5. When working with a patient diagnosed with dissociative amnesia, the nurse should begin the
care by implementing which intervention?
a. Setting mutual goals for behavioral changes
b. Instituting measures to prevent identity diffusion
c. Identifying and supporting the patient‘s strengths
d. Helping the patient develop a realistic self-concept
