1
HESI Specialty Exam Bank: Anxiety Disorders,
Nursing Interventions & Crisis Care
Strategies
Table of Contents
Subtopic 1: General Nursing Interventions for Anxiety Management..............2
Subtopic 2: Pharmacologic Interventions for Anxiety Disorders......................9
Subtopic 3: Crisis Management in Acute Anxiety Episodes and Panic Attacks
.......................................................................................................................16
Subtopic 4: Cognitive Behavioral Therapy (CBT) and Psychotherapeutic
Interventions in Anxiety Disorders.................................................................23
Subtopic 5: Pediatric and Adolescent Anxiety—Interventions and Crisis
Support..........................................................................................................30
Subtopic 6: Anxiety Disorders in the Geriatric Population—Recognition and
Nursing Response..........................................................................................37
Subtopic 8: Pharmacological Management of Anxiety Disorders...................51
Subtopic 9: Anxiety Disorders in Pediatric & Adolescent Clients....................58
Subtopic 10: Anxiety in Special Populations (Elderly, Pregnant, LGBTQ+,
Comorbid Conditions)....................................................................................66
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Subtopic 1: General Nursing Interventions for
Anxiety Management
1. A client with generalized anxiety disorder (GAD) reports constant worry,
muscle tension, and poor sleep. Which nursing intervention is most
appropriate initially?
A. Encourage journaling for emotional release
B. Recommend group therapy
C. Teach deep breathing and relaxation techniques
D. Initiate cognitive behavioral therapy (CBT) sessions
Rationale: Deep breathing and relaxation techniques are frontline, non-
pharmacologic strategies to immediately reduce somatic symptoms of
anxiety and are appropriate for initial nursing intervention.
2. Which outcome indicates the effectiveness of nursing interventions in a
client with moderate anxiety?
A. Client requests a sedative
B. Client reports reduced tension and increased coping
C. Client withdraws from group activities
D. Client avoids discussing their stressors
Rationale: A reduction in tension and improvement in coping ability suggests
that nursing interventions are effective in managing moderate anxiety.
3. When implementing anxiety reduction techniques in adolescents, which
method is most developmentally appropriate?
A. Progressive muscle relaxation
B. Guided imagery using familiar scenarios
, 3
C. Detailed cognitive restructuring
D. Biofeedback sessions
Rationale: Guided imagery is developmentally suitable for adolescents as it
taps into imagination and familiarity, increasing engagement and
effectiveness.
4. A nurse notes that a patient begins pacing and fidgeting during an
assessment. What is the nurse's priority action?
A. Call the physician immediately
B. Acknowledge their anxiety and offer reassurance
C. Provide written information about anxiety
D. Encourage the patient to sit still
Rationale: Recognizing anxiety and providing reassurance de-escalates the
situation and builds trust, making it a priority nursing action.
5. Which nursing action is appropriate when a patient experiences a mild
level of anxiety?
A. Assist with problem-solving strategies
B. Use short, simple commands
C. Administer PRN anxiolytics
D. Isolate the patient to prevent overstimulation
Rationale: Mild anxiety allows for learning and problem-solving; the nurse
should guide the patient through decision-making.
6. Which of the following statements by a client with panic disorder indicates
effective nursing teaching?
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A. “I need to avoid all situations that trigger panic.”
B. “I’ve learned that my panic attacks are not life-threatening.”
C. “Medication is the only thing that helps.”
D. “I can’t do anything during a panic attack.”
Rationale: Understanding the nature of panic attacks reduces fear and
avoidance behavior, indicating effective psychoeducation.
7. A client with acute anxiety states, “I can't breathe!” What is the nurse’s
best first response?
A. Notify the provider of a respiratory emergency
B. Stay with the client and coach slow breathing
C. Ask when the symptom started
D. Give oxygen via nasal cannula
Rationale: Staying present and guiding controlled breathing helps reduce
hyperventilation and anxiety symptoms.
8. Which dietary advice is most appropriate for a client with chronic anxiety?
A. Eat more carbohydrates
B. Increase protein intake
C. Avoid caffeine and alcohol
D. Follow a high-fat diet
Rationale: Caffeine and alcohol can exacerbate anxiety and should be
avoided in clients managing anxiety disorders.
HESI Specialty Exam Bank: Anxiety Disorders,
Nursing Interventions & Crisis Care
Strategies
Table of Contents
Subtopic 1: General Nursing Interventions for Anxiety Management..............2
Subtopic 2: Pharmacologic Interventions for Anxiety Disorders......................9
Subtopic 3: Crisis Management in Acute Anxiety Episodes and Panic Attacks
.......................................................................................................................16
Subtopic 4: Cognitive Behavioral Therapy (CBT) and Psychotherapeutic
Interventions in Anxiety Disorders.................................................................23
Subtopic 5: Pediatric and Adolescent Anxiety—Interventions and Crisis
Support..........................................................................................................30
Subtopic 6: Anxiety Disorders in the Geriatric Population—Recognition and
Nursing Response..........................................................................................37
Subtopic 8: Pharmacological Management of Anxiety Disorders...................51
Subtopic 9: Anxiety Disorders in Pediatric & Adolescent Clients....................58
Subtopic 10: Anxiety in Special Populations (Elderly, Pregnant, LGBTQ+,
Comorbid Conditions)....................................................................................66
, 2
Subtopic 1: General Nursing Interventions for
Anxiety Management
1. A client with generalized anxiety disorder (GAD) reports constant worry,
muscle tension, and poor sleep. Which nursing intervention is most
appropriate initially?
A. Encourage journaling for emotional release
B. Recommend group therapy
C. Teach deep breathing and relaxation techniques
D. Initiate cognitive behavioral therapy (CBT) sessions
Rationale: Deep breathing and relaxation techniques are frontline, non-
pharmacologic strategies to immediately reduce somatic symptoms of
anxiety and are appropriate for initial nursing intervention.
2. Which outcome indicates the effectiveness of nursing interventions in a
client with moderate anxiety?
A. Client requests a sedative
B. Client reports reduced tension and increased coping
C. Client withdraws from group activities
D. Client avoids discussing their stressors
Rationale: A reduction in tension and improvement in coping ability suggests
that nursing interventions are effective in managing moderate anxiety.
3. When implementing anxiety reduction techniques in adolescents, which
method is most developmentally appropriate?
A. Progressive muscle relaxation
B. Guided imagery using familiar scenarios
, 3
C. Detailed cognitive restructuring
D. Biofeedback sessions
Rationale: Guided imagery is developmentally suitable for adolescents as it
taps into imagination and familiarity, increasing engagement and
effectiveness.
4. A nurse notes that a patient begins pacing and fidgeting during an
assessment. What is the nurse's priority action?
A. Call the physician immediately
B. Acknowledge their anxiety and offer reassurance
C. Provide written information about anxiety
D. Encourage the patient to sit still
Rationale: Recognizing anxiety and providing reassurance de-escalates the
situation and builds trust, making it a priority nursing action.
5. Which nursing action is appropriate when a patient experiences a mild
level of anxiety?
A. Assist with problem-solving strategies
B. Use short, simple commands
C. Administer PRN anxiolytics
D. Isolate the patient to prevent overstimulation
Rationale: Mild anxiety allows for learning and problem-solving; the nurse
should guide the patient through decision-making.
6. Which of the following statements by a client with panic disorder indicates
effective nursing teaching?
, 4
A. “I need to avoid all situations that trigger panic.”
B. “I’ve learned that my panic attacks are not life-threatening.”
C. “Medication is the only thing that helps.”
D. “I can’t do anything during a panic attack.”
Rationale: Understanding the nature of panic attacks reduces fear and
avoidance behavior, indicating effective psychoeducation.
7. A client with acute anxiety states, “I can't breathe!” What is the nurse’s
best first response?
A. Notify the provider of a respiratory emergency
B. Stay with the client and coach slow breathing
C. Ask when the symptom started
D. Give oxygen via nasal cannula
Rationale: Staying present and guiding controlled breathing helps reduce
hyperventilation and anxiety symptoms.
8. Which dietary advice is most appropriate for a client with chronic anxiety?
A. Eat more carbohydrates
B. Increase protein intake
C. Avoid caffeine and alcohol
D. Follow a high-fat diet
Rationale: Caffeine and alcohol can exacerbate anxiety and should be
avoided in clients managing anxiety disorders.
