Varcarolis Chapter 15 Flashcards

Questions and Answers

Which action should the nurse perform first when teaching alternative coping strategies to a patient experiencing severe anxiety?

Verify the patient's learning style

Assess how the patient uses defense mechanisms

Create outcomes and a teaching plan

Lower the patient's current anxiety (correct)

Which health problem is likely in a woman who feels her feet are huge and tries to conceal them?

Obsessive-compulsive disorder due to a medical condition

Body dysmorphic disorder (correct)

Separation anxiety disorder

Social anxiety disorder

What would be an appropriate response for a nurse to say to a patient experiencing moderate anxiety who states, 'I feel undone'?

What would you like me to do to help you?

Why do you suppose you are feeling anxious?

I'm not sure I understand. Give me an example. (correct)

You must get your feelings under control before we can continue.

What is the initial nursing intervention of highest priority for a patient running fearfully and crying, 'They're coming!'?

Provide for the patient's safety Signup and view all the answers

Which nursing diagnosis has the highest priority for a patient who is fearfully running and does not follow directions?

Risk for injury Signup and view all the answers

What principles are demonstrated when a patient checks electrical cords related to obsessive thoughts about a house fire?

Cognitive restructuring Signup and view all the answers

Which defense mechanism is indicated by a patient claiming, 'Nothing is wrong with me' despite evident health issues?

Denial Signup and view all the answers

What is the patient's level of anxiety if they are asking, 'What do you mean? What are they going to do?' and show tremulous voice and rapid pulse?

Moderate Signup and view all the answers

Which nursing intervention is most appropriate for a patient with moderate anxiety who is unable to understand preoperative information?

Present the information again in a calm manner using simple language Signup and view all the answers

What is the rationale for encouraging a patient with moderate anxiety to talk about their feelings?

Concerns stated aloud become less overwhelming and help problem-solving begin Signup and view all the answers

Which question would be most appropriate for a nurse to ask a patient with a tentative diagnosis of generalized anxiety disorder?

Do you find it difficult to control your worrying? Signup and view all the answers

In which room should a nurse place a patient showing disorganized behavior and incoherence?

An interview room furnished with a desk and two chairs Signup and view all the answers

What is the person's level of anxiety if they feel something awful is going to happen and exhibit nausea and tachycardia?

Severe Signup and view all the answers

What defense mechanism is evident when a nurse hears a non-promoted nurse say, 'The nurse manager had a headache the day I was interviewed'?

Projection Signup and view all the answers

What does a patient demonstrate when they express that their best friend is perfect due to external circumstances?

Rationalization Signup and view all the answers

Which medication is most appropriate to prescribe as a prn anxiolytic for a patient experiencing a sudden episode of severe anxiety?

Lorazepam Signup and view all the answers

What term best describes the supportive behavior of a nurse who felt loss but then helped the new manager transition smoothly?

Altruism Signup and view all the answers

What cognitive behavior is exemplified by a person who feels unattractive yet repeatedly emphasizes their intelligence?

Compensation Signup and view all the answers

What behavior is indicated by a person saying, 'What a lovely person. That's someone I simply adore,' about a rival for affection?

Reaction formation Signup and view all the answers

Which defense mechanism is evident when an individual experiencing sexual dysfunction blames it on their partner?

Rationalization Signup and view all the answers

What anxiety level is indicated if a student reports feeling very alert and restless before a test?

Mild anxiety Signup and view all the answers

Which nursing intervention is most appropriate for a student reporting feelings of alertness before a test?

Explain that the symptoms result from mild anxiety and discuss the helpful aspects Signup and view all the answers

Which comment demonstrates the use of rationalization by a cruel and abusive person?

That person should not have provoked me Signup and view all the answers

What is the best action for a nurse to take when a patient experiencing panic starts running and shouting, 'I'm going to explode!'?

Tell the patient, 'Stop running and take a deep breath. I will help you' Signup and view all the answers

Which intervention is appropriate for a person who has been unable to leave home due to severe anxiety?

Teach the person to use positive self-talk techniques Signup and view all the answers

Which comment indicates the possibility of obsessive-compulsive disorder by an individual experiencing anxiety?

I check where my car keys are eight times Signup and view all the answers

What should health teaching include for a patient prescribed alprazolam for acute anxiety?

Avoid alcoholic beverages Signup and view all the answers

Which statement is most likely from a patient with agoraphobia?

Being afraid to go out seems ridiculous, but I can't go out the door Signup and view all the answers

Which phrase correctly completes the nursing diagnosis for a patient with obsessive-compulsive disorder who cleans compulsively?

Persistent thoughts about bacteria, germs, and dirt Signup and view all the answers

Which action should the nurse take to help a patient with ritualistic hand washing develop more effective coping?

Encourage the patient to participate in social activities Signup and view all the answers

What should be the first nursing intervention for a patient experiencing panic?

Provide calm, brief, directive communication Signup and view all the answers

Which interventions should the nurse suggest for a child in foster care who is apprehensive and overreacts to stimuli? (Select all that apply)

Explain and reinforce reality to avoid distortions Signup and view all the answers

What should be included in health teaching for a patient diagnosed with generalized anxiety disorder on lorazepam? (Select all that apply)

The importance of caffeine restriction Signup and view all the answers

Which assessment questions would be most appropriate for a patient with possible obsessive-compulsive disorder? (Select all that apply)

Is it difficult to keep certain thoughts out of your awareness? Signup and view all the answers

Which nursing diagnoses most likely apply to an adult who is socially withdrawn and hoards? (Select all that apply)

Ineffective home maintenance Signup and view all the answers

Study Notes

Coping Strategies for Anxiety

Prioritize lowering a patient's anxiety before teaching alternative coping strategies.
Assess the patient's current anxiety to tailor interventions effectively.

Body Dysmorphic Disorder

Patients may exhibit extreme concern about perceived physical flaws, leading to seeking surgical options to alter appearance.
Social withdrawal and preoccupation with self-image can indicate body dysmorphic disorder.

Appropriate Communication Techniques

For patients with moderate anxiety, seek clarification to facilitate understanding of their feelings.
Engage patients by encouraging them to articulate their concerns, which helps in alleviating anxiety.

Patient Safety in Crisis

In acute anxiety situations, ensuring patient safety is the highest priority.
Nursing interventions must be immediate and focus on reducing the risk of injury.

Anxiety Levels and Symptoms

Recognize varying levels of anxiety: mild (awareness), moderate (increased physical symptoms), severe (disturbances in perception), and panic (loss of control).
Common signs of moderate anxiety include increased respiratory rate and heart rate.

Defense Mechanisms

Denial may be evident when patients refuse to acknowledge serious health issues despite clear symptoms.
Projection involves attributing one's own unacceptable feelings to others as a way to cope.

Cognitive Restructuring in Therapy

Counsel patients to challenge obsessive thoughts and evaluate their reality to reduce anxiety.
Techniques like cognitive restructuring help patients reframe their thought patterns.

Medication Education

Educate patients on the effects of anxiolytics like lorazepam, emphasizing the avoidance of alcohol.
Monitor and instruct patients on side effects, such as drowsiness, to ensure safe medication use.

Obsessive-Compulsive Disorder Characteristics

Patients with OCD may express repetitive behaviors, such as checking and cleaning, indicating an overwhelming need to perform certain rituals.
Assessing for family history can provide insight into the potential hereditary nature of OCD.

Addressing Agoraphobia

Patients with agoraphobia often struggle with the irrational fear of leaving home, leading to significant lifestyle restrictions.
Use supportive interventions to encourage gradual exposure and use of positive self-talk techniques.

Supportive Interventions for Children

When caring for apprehensive children in foster care, maintain a calm environment using a soothing voice and simplicity in communication.
Providing reality reinforcement helps children navigate their fears effectively.

Nursing Diagnoses

Possible nursing diagnoses for patients exhibiting anxiety may include ineffective home maintenance, low self-esteem, and risk for injury.
Accurate assessment is crucial for development of appropriate care plans.

Therapeutic Communication and Engagement

Open dialogue about anxieties and feelings fosters therapeutic relationships and aids in emotional regulation.
Direct and brief communication is effective for individuals in a state of panic, providing clarity and reducing overwhelming sensations.

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Description

Test your knowledge on Chapter 15 of Varcarolis's text, focusing on coping strategies and patient assessment in nursing. These flashcards cover essential concepts that every nursing student should master. Enhance your understanding and retention of critical nursing principles related to anxiety management.