Anxiety Disorders II

Mental Health "Psychiatric Care"

Signs & Symptoms

HESI Questions
Panic Attack Q1: A symptom associated with panic Panic
attacks is: disorder
Fear of death “Impending doom” � Fear of impending doom
Feeling detachment “Hallucinations”
Q2: A patient who has to undergo
Physical s/s:
surgery ... complains of chest
• Chest Pain & heart palpitations pain, feelings of choking, and hot
• Trembling & Numbness flashes. What appropriate
• Hyperventilation diagnosis does the nurse make
• Sweating & Hot flashes from the patient’s symptoms?
• Nausea & choking sensations � The patient has panic disorder

Interventions

Severe Anxiety HESI Questions ATI Questions Kaplan Questions

& Panic Attacks
Q1: Client ... becoming increasingly
1. REMAIN with the client
#1 Priority NCLEX TIP
2. Place client in a quiet room
Q2: ... new client ... spontaneous onset
“Sit with client” “remain at bedside”
3. Speaking calmly with simple
clear words
anxious. What initial actions should
the nurse take for this client?
Select all that apply.
� Stay by the client’s side
� Escort the client to a quiet place
� Use a comforting tone of voice
when speaking to the client
of hyperventilation, trembling, and
an inability to concentrate. What is
the nurse’s priority action?
� Stay with the new client
Q1: ... a client with a severe level of
anxiety is rocking back and forth
… stating, “Something bad is going
to happen.” Which action should
the nurse take?
� Sit in a chair next the client’s bed
Q2: ... client who has generalized
anxiety disorder and is trembling
and pacing during a group
activity... Which of the following
statements should the nurse make
to the client?
� Come with me to an area where
we can talk without interruption
Q1: Client with anxiety disorder…
begins to sweat profusely and
breathe rapidly.. & states “I feel like
I am having a panic attack.” Which
response by the nurse is best?
� “I’m going to help you back to
your room.”
Q2: … client reporting dizziness and a
‘racing heart’.... extremely
anxious. Which response by the
nurse is best?
� “When did you first notice that
you were feeling anxious?”

Pharmacology Effective Coping

Beta blockers “-lol” 3 NCLEX TIPS

• Atenolol
1. Increased comfort while exposed NCLEX TIP
Antidepressants to the phobia
• SSRI: Sertraline & Paroxetine Resilience:
• TCA: Amitriptyline & Imipramine 2. Verbalizing feelings & insight
• MAOI: Phenelzine & Isocarboxazid about anxiety (self-observation)
Practicing stress reduction
techniques daily
Anxiolytics MOST TESTED 3. Self-distraction: focusing on
• Benzodiazepines something other than the phobia
• Barbiturates
• Buspirone
Top Missed NCLEX Questions
A client with social anxiety disorder has been struggling with his new job when coworkers invite him to
lunch. Which of the following statements indicates the client is improving in coping mechanisms?
Select all that apply

1. I went to a restaurant with a few

coworkers & focused on our
conversation rather than my phobia.
2. I planned to go out of town rather than
attend our company’s Christmas party.

3. I must admit that I am still very nervous

Benzodiazepines Buspirone about eating in front of my coworkers,
but I am working through it.

4. I went to a coffee shop by myself and

sat to watch people.

5. I will make excuses to avoid going to

eat with my boss.

Cognitive Behavior Therapy (CBT)

CBT is a type of talk therapy that helps clients reframe their thought processes to
prevent negative thought patterns in order to adapt to stress & anxiety.