Chapter 9: Anxiety Disorders
MULTIPLE CHOICE
1. A nurse wants to teach alternative coping strategies to a patient experiencing severe anxiety.
Which action should the nurse perform first?
a. Verify the patients learning style.
b. Lower the patients current anxiety.
c. Create outcomes and a teaching plan.
d. Assess how the patient uses defense mechanisms.
ANS: B
A patient experiencing severe anxiety has a markedly narrowed perceptual field and difficulty
attending to events in the environment. A patient experiencing severe anxiety will not learn
readily. Determining preferred modes of learning, devising outcomes, and constructing teaching
plans are relevant to the task but are not the priority measure. The nurse has already assessed the
patients anxiety level. Use of defense mechanisms does not apply.
2. A woman is 57, 160 lbs, and wears a size 8 shoe. She says, My feet are huge. Ive asked three
orthopedists to surgically reduce my feet. This person tries to buy shoes to make her feet look
smaller and, in social settings, conceals both feet under a table or chair. Which health problem is
likely?
a. Social anxiety disorder
b. Body dysmorphic disorder
c. Separation anxiety disorder
d. Obsessive-compulsive disorder due to a medical condition
ANS: B
Body dysmorphic disorder refers to a preoccupation with an imagined defect in appearance in a
normal-appearing person. The patients feet are proportional to the rest of the body. In obsessive-
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,compulsive or related disorder due to a medical condition, the individuals symptoms of
obsessions and compulsions are a direct physiological result of a medical condition. Social
anxiety disorder, also called social phobia, is characterized by severe anxiety or fear provoked by
exposure to a social or a performance situation that will be evaluated negatively by others.
People with separation anxiety disorder exhibit developmentally inappropriate levels of concern
over being away from a significant other.
3. A patient experiencing moderate anxiety says, I feel undone. An appropriate response for the
nurse would be:
a. What would you like me to do to help you?
b. Why do you suppose you are feeling anxious?
c. Im not sure I understand. Give me an example.
d. You must get your feelings under control before we can continue.
ANS: C
Increased anxiety results in scattered thoughts and an inability to articulate clearly. Clarifying
helps the patient identify thoughts and feelings. Asking the patient why he or she feels anxious is
non-therapeutic; the patient likely does not have an answer. The patient may be unable to
determine what he or she would like the nurse to do in order to help. Telling the patient to get his
or her feelings under control is a directive the patient is probably unable to accomplish.
4. A patient fearfully runs from chair to chair crying, Theyre coming! Theyre coming! The
patient does not follow the staffs directions or respond to verbal interventions. The initial nursing
intervention of highest priority is to:
a. provide for the patients safety.
b. encourage clarification of feelings.
c. respect the patients personal space.
d. offer an outlet for the patients energy.
ANS: A
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, Safety is of highest priority because the patient experiencing panic is at high risk for self-injury
related to increased non-goal-directed motor activity, distorted perceptions, and disordered
thoughts. Offering an outlet for the patients energy can occur when the current panic level
subsides. Respecting the patients personal space is a lower priority than safety. Clarification of
feelings cannot take place until the level of anxiety is lowered.
5. A patient fearfully runs from chair to chair crying, Theyre coming! Theyre coming! The
patient does not follow the staffs directions or respond to verbal interventions. Which nursing
diagnosis has the highest priority?
a. Fear c. Self-care deficit
b. Risk for injury d. Disturbed thought processes
ANS: B
A patient experiencing panic-level anxiety is at high risk for injury related to increased non-goal-
directed motor activity, distorted perceptions, and disordered thoughts. Data are not present to
support a nursing diagnosis of self-care deficit or disturbed thought processes. The patient may
have fear, but the risk for injury has a higher priority.
6. A patient checks and rechecks electrical cords related to an obsessive thought that the house
may burn down. The nurse and patient explore the likelihood of an actual fire. The patient states
this event is not likely. This counseling demonstrates principles of:
a. flooding. c. relaxation technique.
b. desensitization. d. cognitive restructuring.
ANS: D
Cognitive restructuring involves the patient in testing automatic thoughts and drawing new
conclusions. Desensitization involves graduated exposure to a feared object. Relaxation training
teaches the patient to produce the opposite of the stress response. Flooding exposes the patient to
a large amount of an undesirable stimulus in an effort to extinguish the anxiety response.
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MULTIPLE CHOICE
1. A nurse wants to teach alternative coping strategies to a patient experiencing severe anxiety.
Which action should the nurse perform first?
a. Verify the patients learning style.
b. Lower the patients current anxiety.
c. Create outcomes and a teaching plan.
d. Assess how the patient uses defense mechanisms.
ANS: B
A patient experiencing severe anxiety has a markedly narrowed perceptual field and difficulty
attending to events in the environment. A patient experiencing severe anxiety will not learn
readily. Determining preferred modes of learning, devising outcomes, and constructing teaching
plans are relevant to the task but are not the priority measure. The nurse has already assessed the
patients anxiety level. Use of defense mechanisms does not apply.
2. A woman is 57, 160 lbs, and wears a size 8 shoe. She says, My feet are huge. Ive asked three
orthopedists to surgically reduce my feet. This person tries to buy shoes to make her feet look
smaller and, in social settings, conceals both feet under a table or chair. Which health problem is
likely?
a. Social anxiety disorder
b. Body dysmorphic disorder
c. Separation anxiety disorder
d. Obsessive-compulsive disorder due to a medical condition
ANS: B
Body dysmorphic disorder refers to a preoccupation with an imagined defect in appearance in a
normal-appearing person. The patients feet are proportional to the rest of the body. In obsessive-
HTTPS://PASINGGRADES.COM/
,compulsive or related disorder due to a medical condition, the individuals symptoms of
obsessions and compulsions are a direct physiological result of a medical condition. Social
anxiety disorder, also called social phobia, is characterized by severe anxiety or fear provoked by
exposure to a social or a performance situation that will be evaluated negatively by others.
People with separation anxiety disorder exhibit developmentally inappropriate levels of concern
over being away from a significant other.
3. A patient experiencing moderate anxiety says, I feel undone. An appropriate response for the
nurse would be:
a. What would you like me to do to help you?
b. Why do you suppose you are feeling anxious?
c. Im not sure I understand. Give me an example.
d. You must get your feelings under control before we can continue.
ANS: C
Increased anxiety results in scattered thoughts and an inability to articulate clearly. Clarifying
helps the patient identify thoughts and feelings. Asking the patient why he or she feels anxious is
non-therapeutic; the patient likely does not have an answer. The patient may be unable to
determine what he or she would like the nurse to do in order to help. Telling the patient to get his
or her feelings under control is a directive the patient is probably unable to accomplish.
4. A patient fearfully runs from chair to chair crying, Theyre coming! Theyre coming! The
patient does not follow the staffs directions or respond to verbal interventions. The initial nursing
intervention of highest priority is to:
a. provide for the patients safety.
b. encourage clarification of feelings.
c. respect the patients personal space.
d. offer an outlet for the patients energy.
ANS: A
HTTPS://PASINGGRADES.COM/
, Safety is of highest priority because the patient experiencing panic is at high risk for self-injury
related to increased non-goal-directed motor activity, distorted perceptions, and disordered
thoughts. Offering an outlet for the patients energy can occur when the current panic level
subsides. Respecting the patients personal space is a lower priority than safety. Clarification of
feelings cannot take place until the level of anxiety is lowered.
5. A patient fearfully runs from chair to chair crying, Theyre coming! Theyre coming! The
patient does not follow the staffs directions or respond to verbal interventions. Which nursing
diagnosis has the highest priority?
a. Fear c. Self-care deficit
b. Risk for injury d. Disturbed thought processes
ANS: B
A patient experiencing panic-level anxiety is at high risk for injury related to increased non-goal-
directed motor activity, distorted perceptions, and disordered thoughts. Data are not present to
support a nursing diagnosis of self-care deficit or disturbed thought processes. The patient may
have fear, but the risk for injury has a higher priority.
6. A patient checks and rechecks electrical cords related to an obsessive thought that the house
may burn down. The nurse and patient explore the likelihood of an actual fire. The patient states
this event is not likely. This counseling demonstrates principles of:
a. flooding. c. relaxation technique.
b. desensitization. d. cognitive restructuring.
ANS: D
Cognitive restructuring involves the patient in testing automatic thoughts and drawing new
conclusions. Desensitization involves graduated exposure to a feared object. Relaxation training
teaches the patient to produce the opposite of the stress response. Flooding exposes the patient to
a large amount of an undesirable stimulus in an effort to extinguish the anxiety response.
HTTPS://PASINGGRADES.COM/
