Anxiety Disorder NCLEX Questions 11-20

The following are anxiety disorder NCLEX questions

Situation: F. the nurse-manager in the cardiac clinic, notes that many patients seem confused and overwhelmed by the number of medications prescribed for their heart conditions. She suggests implementing medication management groups. The idea is well received by the treatment team. Anxiety Disorder NCLEX Questions are:

11. F. should begin planning for the groups by carefully assessing:

a) the nature of the problems that patients are having with their medications
b) which patients would be interested in joining such a group
c) which staff members are prepared to be leaders or co-leaders of the groups
d) the best time of day to offer such groups

12. F. consults the hospital's clinical nurse specialist in psychiatric nursing about group size. The nurse specialist will most likely say that the optimal number of patients in each group is:

a) 5
b) 10
c) 20
d) unlimited

13. The nurse specialist recommends forming three medication management groups with F. as leader and another nurse as co-leader. Each group meets once a week for 30 minutes in 4 week cycles. What is the best approach to establishing membership in each group?

a) require all cardiac clinic patients to attend
b) assign patients to groups that are offered on their clinic visit days
c) permit patients to join any group or attend any session
d) screen patients, and explain the group's goals and purposes to them

14. Anxiety Disorder NCLEX Questions: F. and her co-leader plan to meet weekly with the clinical nurse specialist for supervision and review of group progress. To facilitate these sessions, the nurse specialist should:

a) ask the leader and co-leader to keep a log or journal of each group session
b) review each group member's chart weekly
c) ask the patients how they feel about the group and its progress
d) meet with the leader and co-leader separately for supervision

15. During the group sessions, F. identifies several patients who demonstrate anxiety, ineffective coping, and hopelessness related to the impact of adjusting to serious cardiac illness. The most beneficial form of group therapy for these patients is likely to be led by:

a) F. and another nurse
b) a psychiatric clinical nurse specialist
c) a cardiology resident
d) other cardiac patients who have coped successfully with similar problems

Anxiety Disorder NCLEX Questions Situation: T., a 44 year old married woman with one son, was referred to the mental health clinic by her family physician after he ruled out any physical basis for her complaints of insomnia, anxiety, fatigue, and loss of interest in her usual activities. On arrival at the clinic, T. sates that her symptoms have increased over the last few weeks to the point that she feels "too tired" most of the time to take care o her home or leave the house.

16. During the initial assessment, the nurse suspects that T. may be having a situational crisis. Which question is most effective in beginning to explore this possibility?

a) what has changed in your life recently?
b) do you think your symptoms are related to a recent event in your life
c) what do you think is causing your symptoms
d) tell me all about yourself

17. T. relates that her father died 7 years ago and that her mother is extremely lonely and misses her father very much. While listening to T., the nurse should further assess for:

a) the patient's feelings about her mother
b) the patient's feelings about her father
c) any recent losses in the patient's life
d) the patient's relationships with relatives and friends

18. Anxiety Disorder NCLEX Questions: During the assessment interview, T. reveals that her only son moved to another state 2 months ago and that her husband has been traveling frequently on business lately. The nurse inquires about the patient's close relatives and friends. These inquiries should be directed at:

a) encouraging the patient to form closer relationships with others to replace those with her son and husband
b) identifying the patient's available support systems
c) helping the patient to realize she is not alone
d) helping the patient to develop new coping mechanisms

19. The treatment team determines that T. is in a situational crisis. Which nursing diagnostic category is most applicable at this time?

a) dysfunctional grieving
b) altered thought processes
c) adjustment disorder
d) ineffective individual coping

20. All of the following therapeutic approaches are appropriate for counseling T. except:

a) ventilation
b) clarification
c) support of defense
d) interpretation

Anxiety Disorder NCLEX Questions

11) A
- when planning groups, the nurse must begin by assessing the patient's needs and resources. Ascertaining the nature of the patient's medication problem is crucial. Once this is accomplished, the nurse can select the leaders and co-leaders who are best able to meet the identified patient needs. Establishing the level of patient interest in a group and determining the best time to meet are part of later planning.

12) B
- Anxiety Disorder NCLEX Questions Rationale: although there is no hard and fast agreement, 10 patients usually is considered an ideal size for therapeutic group. A group of this size permits opportunities for maximum therapeutic exchange and participation. With 5 or fewer members, participation often is inhibited by self-consciousness. In groups or more than 15 members, overall participation may be inhibited by the formation of smaller patient subgroups. Permitting an unlimited number of members in a group is unwise. Part of the therapeutic benefit is lost if there is no consistency of membership or if the group becomes too large to permit therapeutic interaction.

13) D
- group leaders should meet before the group sessions to screen and orient prospective members. At this time, the leader can determine a patient's appropriateness for the group -- for example, a patient with a serious hearing problem may benefit more from an individual approach. The screening period also provides the leaders with an opportunity to explain the purpose and goals of the group and to clarify patient expectations. Requiring or assigning patients to groups limits their participation in treatment planning and may result in inappropriate group membership that could be non-therapeutic for other patients. Because consistent group membership encourages attainment of the therapeutic goals, planned patient selection is important.

14) A
- Anxiety Disorder NCLEX Questions Rationale: using a log or journal to follow and review group progress is an important supervisory aid. The log should document group themes, individual patient responses. and interventions and their effect. The co-leader can keep the log during the group meeting or write it as soon as possible after the session ends. The leaders and supervisor can use the log to review group progress and to analyze interventions and strategies. (Other effective methods of tracking group sessions include audiotaping, audiovisual recording, and inviting outsiders to record their observations; however, these methods usually require the patient's consent.) Although patient's records and interviews are useful part of the group's overall evaluation and effectiveness, they are not helpful in reviewing group progress during supervisory sessions; supervisory sessions should focus on the group leaders and their feelings about the progress of sessions. Having the leader and co-leader attend supervisory sessions together allows them to discuss their perceptions of events and enables the supervisor to pursue conflicting statements while the leaders are together.

15) B
- the psychiatric clinical nurse specialist is an appropriate leader for group therapy with cardiac patients who demonstrate anxiety, ineffective individual coping, and hopelessness. A psychiatric clinical nurse specialist with a master's degree who has been supervised in group therapy has the knowledge and experience necessary for this level of nursing intervention. F., as nurse-manager, might be asked to participate as a co-leader but does not have the expertise to lead on her own. A cardiology resident has expertise in medical management but not in group therapy. After the patients have been assisted to develop more effective coping skills, a self-help group composed of other cardiac patients is a means of maintaining these skills.

16) A
- Anxiety Disorder NCLEX Questions Rationale: crisis intervention focuses on identifying and solving the patient's immediate presenting problem. By asking about recent changes in the patient's life, the nurse tries to identify factors related to the problem. It is too early in the therapeutic relationship to ask the patient to link her present symptoms to recent life changes. Such analysis needs further exploration and should be based on trust established in the nurse-patient relationship. Because the patient is seeking an answer to her problem, asking her to identify what is causing the symptoms is not helpful. Complete diagnostic assessments typically include extensive explorations of the past and are not done in crisis intervention.

17) C
- identifying underlying themes is an important part of the assessment process in crisis intervention. In this situation, the nurse identifies a theme of loss or abandonment and seeks further clues to recent losses that may have activated the patient's anxiety. The patient's feelings about her mother and father are less important than recent events and her response to them. Once the stressors and the patient's needs are identified, the nurse can assist the patient in identifying positive relationships with friends and relatives.

18) B
- Anxiety Disorder NCLEX Questions Rationale: during a crisis, a patient typically has difficulty dealing realistically with events, plans, and decisions. Identifying available support networks is an essential part of crisis intervention. The nurse tries to foster adaptive coping and encourage the use of available support systems to help the patient reestablish equilibrium. The nurse should never imply that relationships are replaceable, which belittles the patient's feelings. The nurse may find that the patient has no readily available support system. In this case, the nurse should direct the patient to a crisis group that can provide the needed support. Developing new coping mechanisms is not a primary goal of crisis intervention, which focuses on short-term solutions and is directed toward supporting previous healthy coping mechanisms. Some patients, however, do develop new coping mechanisms in times of crisis.

19) D
- Anxiety Disorder NCLEX Questions Rationale: the most appropriate nursing diagnostic category for T. is Ineffective individual coping. In a crisis, a patient's coping skills are compromised or overwhelmed and become ineffective; equilibrium is typically upset by external events, such as T.'s son moving away and her husband's increased travel. Because the onset of symptoms is clearly related to these events and not to her father's death, the nursing diagnostic category of Dysfunctional grieving is unsupported. No evidence supports the diagnostic category of Altered thought processes, and Adjustment disorder is a medical diagnosis, not a nursing diagnostic category.

20) D
- the therapeutic technique of interpretation rarely is used in crisis counseling. Interpretation, which is directed at helping a patient link unconscious factors with present behaviors, is more appropriate in long-term therapy. Ventilation encourages the patient to talk about pent-up feelings to relieve tension. Clarification, a process of verbalizing relationships between events, helps the patient link events in a crisis and understand their relationship; if the patient cannot see the relationships, the nurse may need to point them out. Crisis intervention seeks to support healthy, adaptive defenses rather than develop new ones.

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Anxiety Disorder NCLEX Questions 1-10

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Anxiety Disorder NCLEX Questions 21-30