1
HESI Exit Exam Prep: Nursing
Interventions for Anxiety vs.
Panic Disorders
Table of Contents
Subtopic 1: Differentiating Generalized Anxiety Disorder (GAD) and panic
disorder – Assessment and Presentation.........................................................2
Subtopic 2: Nursing Interventions in Managing Anxiety and Panic Episodes...9
Subtopic 3: Pharmacological Interventions for Anxiety and Panic Disorders –
Nursing Considerations..................................................................................17
Subtopic 4: Psychosocial Support Strategies and Patient-Centered
Approaches in Anxiety and Panic Disorders...................................................25
Subtopic 5: Crisis Management and Emergency Response for Severe Panic
Attacks...........................................................................................................33
Subtopic 6: Pediatric and Adolescent Considerations in Anxiety and Panic
Disorders........................................................................................................41
Subtopic 7: Pharmacologic Interventions and Nursing Implications in Anxiety
and Panic Disorders.......................................................................................49
Subtopic 8: Cultural, Ethical, and Communication Considerations in Anxiety
and Panic Disorders.......................................................................................57
Subtopic 9: Pediatric and Adolescent Anxiety Disorders – Distinctions and
Nursing Interventions.....................................................................................65
Subtopic 10: Evaluating Outcomes, Relapse Prevention & Long-Term
Management of Anxiety and Panic Disorders.................................................73
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Subtopic 1: Differentiating Generalized
Anxiety Disorder (GAD) and panic disorder –
Assessment and Presentation
Question 1
A nurse is assessing a client with suspected generalized anxiety disorder
(GAD). Which of the following symptoms best differentiates GAD from panic
disorder?
A. Sudden onset of heart palpitations
B. Excessive worry occurring more days than not for at least 6 months
C. Fear of dying
D. Chest pain with shortness of breath
Correct Answer: B
Rationale: GAD is characterized by chronic, excessive worry lasting 6 months
or longer, whereas panic disorder involves recurrent, unexpected panic
attacks with sudden onset symptoms.
Question 2
A patient reports persistent nervousness, muscle tension, and difficulty
sleeping for the past eight months. What does the nurse suspect?
A. Acute stress reaction
B. Generalized anxiety disorder
C. Panic disorder
D. Post-traumatic stress disorder
Correct Answer: B
Rationale: These are hallmark symptoms of GAD, which is diagnosed when
anxiety symptoms are persistent for 6 months or more.
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Question 3
During a panic attack, a client repeatedly says, “I feel like I’m going to die.”
What is the nurse’s priority response?
A. “Let’s talk about what triggered this.”
B. “You're safe now. Try to rest.”
C. “You are experiencing a panic attack. Let’s do breathing exercises
together.”
D. “It’s just in your head; nothing is wrong.”
Correct Answer: C
Rationale: Recognizing and labeling the panic attack while promoting
calming techniques like breathing helps ground the client and reduce
symptoms.
Question 4
Which symptom is most likely to be reported only during a panic attack, not
generalized anxiety?
A. Constant fatigue
B. Irritability
C. Derealization or depersonalization
D. Muscle tension
Correct Answer: C
Rationale: Derealization and depersonalization are common during intense
panic attacks, but not typical in GAD.
Question 5
Which of the following physical symptoms is more associated with panic
disorder than with GAD?
A. Headaches
B. Rapid heartbeat and chest pain
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C. Muscle stiffness
D. Poor concentration
Correct Answer: B
Rationale: Sudden onset of chest pain and palpitations is a classic
presentation during a panic attack.
Question 6
A nurse evaluates a client who says, “I worry all the time, even about little
things.” What is the most likely diagnosis?
A. Social anxiety disorder
B. Panic disorder
C. Generalized anxiety disorder
D. Phobia
Correct Answer: C
Rationale: Chronic, uncontrollable worry about various issues is the hallmark
of GAD.
Question 7
Which of the following statements by a client indicates a symptom of panic
disorder rather than generalized anxiety disorder?
A. “I feel anxious all day.”
B. “The fear hits me out of nowhere and I feel like I’m choking.”
C. “I can't stop worrying about my kids.”
D. “I struggle to fall asleep at night.”
Correct Answer: B
Rationale: Sudden and intense fear with physical symptoms like choking
suggests panic disorder.
HESI Exit Exam Prep: Nursing
Interventions for Anxiety vs.
Panic Disorders
Table of Contents
Subtopic 1: Differentiating Generalized Anxiety Disorder (GAD) and panic
disorder – Assessment and Presentation.........................................................2
Subtopic 2: Nursing Interventions in Managing Anxiety and Panic Episodes...9
Subtopic 3: Pharmacological Interventions for Anxiety and Panic Disorders –
Nursing Considerations..................................................................................17
Subtopic 4: Psychosocial Support Strategies and Patient-Centered
Approaches in Anxiety and Panic Disorders...................................................25
Subtopic 5: Crisis Management and Emergency Response for Severe Panic
Attacks...........................................................................................................33
Subtopic 6: Pediatric and Adolescent Considerations in Anxiety and Panic
Disorders........................................................................................................41
Subtopic 7: Pharmacologic Interventions and Nursing Implications in Anxiety
and Panic Disorders.......................................................................................49
Subtopic 8: Cultural, Ethical, and Communication Considerations in Anxiety
and Panic Disorders.......................................................................................57
Subtopic 9: Pediatric and Adolescent Anxiety Disorders – Distinctions and
Nursing Interventions.....................................................................................65
Subtopic 10: Evaluating Outcomes, Relapse Prevention & Long-Term
Management of Anxiety and Panic Disorders.................................................73
, 2
Subtopic 1: Differentiating Generalized
Anxiety Disorder (GAD) and panic disorder –
Assessment and Presentation
Question 1
A nurse is assessing a client with suspected generalized anxiety disorder
(GAD). Which of the following symptoms best differentiates GAD from panic
disorder?
A. Sudden onset of heart palpitations
B. Excessive worry occurring more days than not for at least 6 months
C. Fear of dying
D. Chest pain with shortness of breath
Correct Answer: B
Rationale: GAD is characterized by chronic, excessive worry lasting 6 months
or longer, whereas panic disorder involves recurrent, unexpected panic
attacks with sudden onset symptoms.
Question 2
A patient reports persistent nervousness, muscle tension, and difficulty
sleeping for the past eight months. What does the nurse suspect?
A. Acute stress reaction
B. Generalized anxiety disorder
C. Panic disorder
D. Post-traumatic stress disorder
Correct Answer: B
Rationale: These are hallmark symptoms of GAD, which is diagnosed when
anxiety symptoms are persistent for 6 months or more.
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Question 3
During a panic attack, a client repeatedly says, “I feel like I’m going to die.”
What is the nurse’s priority response?
A. “Let’s talk about what triggered this.”
B. “You're safe now. Try to rest.”
C. “You are experiencing a panic attack. Let’s do breathing exercises
together.”
D. “It’s just in your head; nothing is wrong.”
Correct Answer: C
Rationale: Recognizing and labeling the panic attack while promoting
calming techniques like breathing helps ground the client and reduce
symptoms.
Question 4
Which symptom is most likely to be reported only during a panic attack, not
generalized anxiety?
A. Constant fatigue
B. Irritability
C. Derealization or depersonalization
D. Muscle tension
Correct Answer: C
Rationale: Derealization and depersonalization are common during intense
panic attacks, but not typical in GAD.
Question 5
Which of the following physical symptoms is more associated with panic
disorder than with GAD?
A. Headaches
B. Rapid heartbeat and chest pain
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C. Muscle stiffness
D. Poor concentration
Correct Answer: B
Rationale: Sudden onset of chest pain and palpitations is a classic
presentation during a panic attack.
Question 6
A nurse evaluates a client who says, “I worry all the time, even about little
things.” What is the most likely diagnosis?
A. Social anxiety disorder
B. Panic disorder
C. Generalized anxiety disorder
D. Phobia
Correct Answer: C
Rationale: Chronic, uncontrollable worry about various issues is the hallmark
of GAD.
Question 7
Which of the following statements by a client indicates a symptom of panic
disorder rather than generalized anxiety disorder?
A. “I feel anxious all day.”
B. “The fear hits me out of nowhere and I feel like I’m choking.”
C. “I can't stop worrying about my kids.”
D. “I struggle to fall asleep at night.”
Correct Answer: B
Rationale: Sudden and intense fear with physical symptoms like choking
suggests panic disorder.
