NCLEX Quiz: Stress, Anxiety, And Mind-body Disorders

1. A group of community nurses sees and plans care for various clients with different types of problems. Which of the following clients would they consider the most vulnerable to post-traumatic stress disorder?

An eight (8)-year-old boy with asthma who has recently failed a grade in school

A 20-year-old college student with DM who experienced date rape

A 40-year-old widower who has recently lost his wife to cancer

A wife of an individual with a severe substance abuse problem

The most vulnerable client to post-traumatic stress disorder would be the 20-year-old college student with DM who experienced date rape. This client has experienced a traumatic event, which is a risk factor for developing PTSD. The combination of the traumatic event and the emotional and physical impact of the rape can contribute to the development of PTSD symptoms. Age, health condition, and recent life events all play a role in determining vulnerability to PTSD, and in this case, the college student meets these criteria.

Explanation

The most vulnerable client to post-traumatic stress disorder would be the 20-year-old college student with DM who experienced date rape. This client has experienced a traumatic event, which is a risk factor for developing PTSD. The combination of the traumatic event and the emotional and physical impact of the rape can contribute to the development of PTSD symptoms. Age, health condition, and recent life events all play a role in determining vulnerability to PTSD, and in this case, the college student meets these criteria.

2. A nurse at Nurseslabs Medical Center is developing a care plan for a female client with post-traumatic stress disorder. Which of the following would she do initially?

Instruct the client to use distraction techniques to cope with flashbacks.

Encourage the client to put the past in proper perspective.

Encourage the client to verbalize thoughts and feelings about the trauma.

Avoid discussing the traumatic event with the client.

Encouraging the client to verbalize thoughts and feelings about the trauma is the initial step in developing a care plan for a client with post-traumatic stress disorder. This allows the client to express their emotions and experiences related to the trauma, which can help them process and cope with their feelings. Verbalizing thoughts and feelings also promotes a therapeutic relationship between the nurse and the client, fostering trust and support. This approach is consistent with the principles of trauma-focused therapy, which aims to address and heal the psychological effects of trauma.

Explanation

Encouraging the client to verbalize thoughts and feelings about the trauma is the initial step in developing a care plan for a client with post-traumatic stress disorder. This allows the client to express their emotions and experiences related to the trauma, which can help them process and cope with their feelings. Verbalizing thoughts and feelings also promotes a therapeutic relationship between the nurse and the client, fostering trust and support. This approach is consistent with the principles of trauma-focused therapy, which aims to address and heal the psychological effects of trauma.

3. Mandy. a nurse who works at Nurseslabs Rehabilitation Center is assessing a client for recent stressful life events. She recognizes that stressful life events are both:

Desirable and growth-promoting.

Positive and negative.

Undesirable and harmful.

Predictable and controllable.

Stressful life events can have both positive and negative effects on individuals. While some events may bring about personal growth and development, others can be challenging and detrimental to one's well-being. It is important for a nurse like Mandy to acknowledge the dual nature of these events and provide appropriate support and guidance to clients who may be experiencing both positive and negative effects of stress.

Explanation

Stressful life events can have both positive and negative effects on individuals. While some events may bring about personal growth and development, others can be challenging and detrimental to one's well-being. It is important for a nurse like Mandy to acknowledge the dual nature of these events and provide appropriate support and guidance to clients who may be experiencing both positive and negative effects of stress.

4. During a community visit, volunteer nurses teach stress management to the participants. Which belief will the nurses most likely advocate as a method of coping with stressful life events?

Avoidance of stress is an important goal for living.

Control over one’s response to stress is possible.

Most people have no control over their level of stress.

Significant others are important in providing care and concern.

The nurses are most likely to advocate the belief that control over one's response to stress is possible as a method of coping with stressful life events. This belief suggests that individuals have the ability to manage and regulate their reactions to stressors, empowering them to take control of their emotional and physical responses. By promoting this belief, the nurses are encouraging the participants to develop skills and strategies to effectively cope with stress, rather than avoiding it or feeling helpless.

Explanation

The nurses are most likely to advocate the belief that control over one's response to stress is possible as a method of coping with stressful life events. This belief suggests that individuals have the ability to manage and regulate their reactions to stressors, empowering them to take control of their emotional and physical responses. By promoting this belief, the nurses are encouraging the participants to develop skills and strategies to effectively cope with stress, rather than avoiding it or feeling helpless.

5. Genevieve only attends social events when a family member is also present. She exhibits behavior typical of which anxiety disorder?

Agoraphobia

Generalized anxiety disorder

Obsessive-compulsive disorder

Post-traumatic stress disorder

Genevieve's behavior of only attending social events when a family member is present suggests that she may have agoraphobia. Agoraphobia is an anxiety disorder characterized by a fear of situations or places where escape might be difficult or embarrassing, or where help may not be available in case of a panic attack or other distressing symptoms. In this case, Genevieve's need for a family member's presence indicates her fear of being alone in social situations, which aligns with the symptoms of agoraphobia.

Explanation

Genevieve's behavior of only attending social events when a family member is present suggests that she may have agoraphobia. Agoraphobia is an anxiety disorder characterized by a fear of situations or places where escape might be difficult or embarrassing, or where help may not be available in case of a panic attack or other distressing symptoms. In this case, Genevieve's need for a family member's presence indicates her fear of being alone in social situations, which aligns with the symptoms of agoraphobia.

6. Nurse Martha is teaching her students about anxiety medications; she explains that benzodiazepines affect which brain chemical?

Acetylcholine

Gamma-aminobutyric acid (GABA)

Norepinephrine

Serotonin

Benzodiazepines are a class of medications that work by enhancing the effects of GABA in the brain. GABA is an inhibitory neurotransmitter that helps to reduce anxiety and promote relaxation. By increasing the activity of GABA, benzodiazepines can help to calm the brain and reduce symptoms of anxiety. Therefore, the correct answer is Gamma-aminobutyric acid (GABA).

Explanation

Benzodiazepines are a class of medications that work by enhancing the effects of GABA in the brain. GABA is an inhibitory neurotransmitter that helps to reduce anxiety and promote relaxation. By increasing the activity of GABA, benzodiazepines can help to calm the brain and reduce symptoms of anxiety. Therefore, the correct answer is Gamma-aminobutyric acid (GABA).

7. Marty is pacing and complains of racing thoughts. Nurse Lally asks the client if something upsetting happened. and Marty's response is vague and not focused on the question. Nurse Lally assess Marty's level of anxiety as:

Mild

Moderate

Severe

Panic.

Based on the given information, Marty is pacing, complaining of racing thoughts, and providing a vague and unfocused response when asked about something upsetting happening. These symptoms suggest a high level of anxiety and difficulty in managing or expressing emotions effectively. Therefore, Nurse Lally assesses Marty's level of anxiety as severe.

Explanation

Based on the given information, Marty is pacing, complaining of racing thoughts, and providing a vague and unfocused response when asked about something upsetting happening. These symptoms suggest a high level of anxiety and difficulty in managing or expressing emotions effectively. Therefore, Nurse Lally assesses Marty's level of anxiety as severe.

8. Chuck is a 20-year-old student diagnosed of having obsessive-compulsive behavior. A psychiatrist prescribes clomipramine (Anafranil) to treat his condition. Nurse Nicolette understands the rationale for this treatment is that the clomipramine:

Increases dopamine levels

Increases serotonin levels

Decreases norepinephrine levels

Decreases GABA levels

Clomipramine (Anafranil) is a tricyclic antidepressant that is commonly used to treat obsessive-compulsive disorder (OCD). It works by increasing the levels of serotonin in the brain. Serotonin is a neurotransmitter that plays a role in regulating mood, emotions, and behavior. By increasing serotonin levels, clomipramine helps to reduce the symptoms of OCD, such as intrusive thoughts and repetitive behaviors. This is why the nurse understands that the rationale for prescribing clomipramine to Chuck is to increase serotonin levels.

Explanation

Clomipramine (Anafranil) is a tricyclic antidepressant that is commonly used to treat obsessive-compulsive disorder (OCD). It works by increasing the levels of serotonin in the brain. Serotonin is a neurotransmitter that plays a role in regulating mood, emotions, and behavior. By increasing serotonin levels, clomipramine helps to reduce the symptoms of OCD, such as intrusive thoughts and repetitive behaviors. This is why the nurse understands that the rationale for prescribing clomipramine to Chuck is to increase serotonin levels.

9. Which outcome is most appropriate for Francis, who has a dissociative disorder?

Francis will deal with uncomfortable emotions on a conscious level.

Francis will modify stress with the use of relaxation techniques.

Francis will identify his anxiety responses.

Francis will use problem-solving strategies when feeling stressed.

Francis, who has a dissociative disorder, dealing with uncomfortable emotions on a conscious level is the most appropriate outcome. Dissociative disorders involve a disconnection or lack of integration between different aspects of one's identity, memory, or consciousness. By consciously addressing and acknowledging these uncomfortable emotions, Francis can work towards integrating their experiences and reducing dissociative symptoms. This approach may involve therapy techniques such as grounding exercises, mindfulness, and emotional regulation strategies to help Francis stay present and connected with their emotions.

Explanation

Francis, who has a dissociative disorder, dealing with uncomfortable emotions on a conscious level is the most appropriate outcome. Dissociative disorders involve a disconnection or lack of integration between different aspects of one's identity, memory, or consciousness. By consciously addressing and acknowledging these uncomfortable emotions, Francis can work towards integrating their experiences and reducing dissociative symptoms. This approach may involve therapy techniques such as grounding exercises, mindfulness, and emotional regulation strategies to help Francis stay present and connected with their emotions.

10. The psychiatric nurse uses cognitive-behavioral techniques when working with a client who experiences panic attacks. Which of the following techniques are common to this theoretical framework? Select all that apply.

Administering anti-anxiety medication as prescribed

Encouraging the client to restructure thoughts

Helping the client to use controlled relaxation breathing

Helping the client examine evidence of stressors

Questioning the client about early childhood relationships

Teaching the client about anxiety and panic

The correct answer choices are all techniques commonly used in cognitive-behavioral therapy (CBT) for clients experiencing panic attacks. Encouraging the client to restructure thoughts involves helping them identify and challenge negative or irrational thoughts that contribute to their panic attacks. Helping the client use controlled relaxation breathing teaches them techniques to manage their physical symptoms of anxiety during a panic attack. Helping the client examine evidence of stressors involves exploring the triggers or underlying causes of their panic attacks. Questioning the client about early childhood relationships may be used to identify any potential underlying issues or trauma that may contribute to their panic attacks.

Explanation

The correct answer choices are all techniques commonly used in cognitive-behavioral therapy (CBT) for clients experiencing panic attacks. Encouraging the client to restructure thoughts involves helping them identify and challenge negative or irrational thoughts that contribute to their panic attacks. Helping the client use controlled relaxation breathing teaches them techniques to manage their physical symptoms of anxiety during a panic attack. Helping the client examine evidence of stressors involves exploring the triggers or underlying causes of their panic attacks. Questioning the client about early childhood relationships may be used to identify any potential underlying issues or trauma that may contribute to their panic attacks.

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