Varcarolis's Canadian Psychiatric Mental Health Nursing 2nd Edition Halter Test Bank
Chapter 12: Anxiety and Related Disorders
Halter: Varcarolis’s Canadian Psychiatric Mental Health Nursing, 2nd Edition
MULTIPLE CHOICE
1. A nurse wants to teach alternative coping strategies to a patient experiencing severe anxiety.
T T T T T T T T T T T T T
Which action should the nurse perform first?
T T T T T T
a. Verify the patient’s learning style.
T T T T
b. Lower the patient’s current anxiety.
T T T T
c. Create outcomes and a teaching plan.
T T T T T
d. Assess how the patient uses defence mechanisms.
T T T T T T
ANS: B T
A patient experiencing severe anxiety has a markedly narrowed perceptual field and
T T T T T T T T T T T T
difficulty attending to events in the environment. A patient experiencing severe anxiety will
T T T T T T T T T T T T T
not learn readily. Determining preferred modes of learning, devising outcomes, and
T T T T T T T T T T T
constructing teaching plans are relevant to the task, but are not the priority measure. The
T T T T T T T T T T T T T T T
nurse has already assessed the patient’s anxiety level. Use of defence mechanisms does not
T T T T T T T T T T T T T T
apply.
DIF: Cognitive Level: Apply (Application) T T T
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
T T T T T T
2. Which is an intermediate indicator of the nursing outcome of anxiety self-control?
T T T T T T T T T T T
a. Maintains adequate sleep T T
b. Monitors intensity of a nNx i eR
t y IGB.CM
c. Controls anxiety response
U S N T T
T
o T
T
T T T T T
d. Uses relaxation techniques to lower anxiety
T T T T T
ANS: C T
Intermediate indicators of the nursing outcome anxiety self-control are controls anxiety
T T T T T T T T T T T
response and maintains role performance. Maintains adequate sleep, monitors intensity of
T T T T T T T T T T T
anxiety and uses relaxation techniques to lower anxiety, are short term indicators of the
T T T T T T T T T T T T T T
outcomes of anxiety self-control. T T T
DIF: Cognitive Level: Understand (Comprehension) T T T
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
T T T T T T
3. A patient experiencing moderate anxiety says, “I feel undone.” An appropriate response for
T T T T T T T T T T T T T
the nurse would be which of the following?
T T T T T T T
a. “What would you like me to do to help you?”
T T T T T T T T T
b. “Why do you suppose you are feeling anxious?”
T T T T T T T
c. “I’m not sure I understand. Give me an example.”
T T T T T T T T
d. “You must get your feelings under control before we can continue.”
T T T T T T T T T T
ANS: C T
,Varcarolis's Canadian Psychiatric Mental Health Nursing 2nd Edition Halter Test Bank
Increased anxiety results in scattered thoughts and an inability to articulate clearly.
T T T T T T T T T T T T
Clarifying helps the patient identify thoughts and feelings. Asking the patient why he or she
T T T T T T T T T T T T T T T
feels anxious is nontherapeutic; the patient likely does not have an answer. The patient may
T T T T T T T T T T T T T T T
be unable to determine what he or she would like the nurse to do in order to help. Telling the
T T T T T T T T T T T T T T T T T T T T
patient to get his or her feelings under control is a directive the patient is probably unable to
T T T T T T T T T T T T T T T T T T
accomplish.
DIF: Cognitive Level: Apply (Application) T T T
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity T T T T T T
4. A patient fearfully runs from chair to chair, crying, “They’re coming! They’re coming!” The
T T T T T T T T T T T T T T
patient does not follow the staff’s directions or respond to verbal interventions. The initial
T T T T T T T T T T T T T T
nursing intervention of highest priority is to do which of the following?
T T T T T T T T T T T
a. Provide for the patient’s safety T T T T
b. Encourage clarification of feelings T T T
c. Respect the patient’s personal space T T T T
d. Offer an outlet for the patient’s energy
T T T T T T
ANS: A T
Safety is of highest priority because the patient experiencing panic is at high risk for
T T T T T T T T T T T T T T
self-injury related to increased nongoal-directed motor activity, distorted perceptions, and
T T T T T T T T T T
disordered thoughts. Offering an outlet for the patient’s energy can occur when the current
T T T T T T T T T T T T T T
panic level subsides. Respecting the patient’s personal space is a lower priority than safety.
T T T T T T T T T T T T T T
Clarification of feelings cannot take place until the level of anxiety is lowered.
T T T T T T T T T T T T
DIF: Cognitive Level: Analyze (Analysis) T T T
TOP: Nursing Process: PlNanUnR
inSg I NG TB.C oM T T
MSC: Client Needs: Safe Effective Care Environment
T T T T T T
5. A patient fearfully runs from chair to chair, crying, “They’re coming! They’re coming!” The
T T T T T T T T T T T T T T
patient does not follow the staff’s directions or respond to verbal interventions. Which
T T T T T T T T T T T T T
nursing diagnosis has the highest priority?
T T T T T
a. Fear
b. Risk for injury T T
c. Self-care deficit T
d. Disturbed thought processes T T
ANS: B T
A patient experiencing panic-level anxiety is at high risk for injury related to increased
T T T T T T T T T T T T T T
nongoal-directed motor activity, distorted perceptions, and disordered thoughts. Data are not T T T T T T T T T T T
present to support a nursing diagnosis of self-care deficit or disturbed thought processes.
T T T T T T T T T T T T
The patient may have fear, but the risk for injury has a higher priority.
T T T T T T T T T T T T T
DIF: Cognitive Level: Analyze (Analysis) T T T T
TOP: Nursing Process: Diagnosis/Analysis T T
MSC: Client Needs: Safe Effective Care Environment
T T T T T T
,Varcarolis's Canadian Psychiatric Mental Health Nursing 2nd Edition Halter Test Bank
6. A patient checks and rechecks electrical cords related to an obsessive thought that the house
T T T T T T T T T T T T T T T
may burn down. The nurse and patient explore the likelihood of an actual fire. The patient
T T T T T T T T T T T T T T T T
states this event is not likely. This counselling demonstrates principles of which of the
T T T T T T T T T T T T T T
following?
a. Flooding
b. Desensitization
c. Relaxation technique T
d. Cognitive restructuring T
ANS: D T T
Cognitive restructuring involves the patient in testing automatic thoughts and drawing new
T T T T T T T T T T T T
conclusions. Desensitization involves graduated exposure to a feared object. Relaxation
T T T T T T T T T T
training teaches the patient to produce the opposite of the stress response. Flooding exposes
T T T T T T T T T T T T T T
the patient to a large amount of an undesirable stimulus in an effort to extinguish the anxiety
T T T T T T T T T T T T T T T T T
response.
DIF: Cognitive Level: Understand (Comprehension) T T T
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity T T T T T T
7. A patient undergoing diagnostic tests says, “Nothing is wrong with me except a stubborn
T T T T T T T T T T T T T T
chest cold.” The spouse reports the patient smokes, coughs daily, lost 15 pounds, and is
T T T T T T T T T T T T T T T
easily fatigued. Which defence mechanism is the patient using?
T T T T T T T T
a. Displacement
b. Regression
c. Projection
d. Denial
ANS: D T
NURSINGTB.CoM
T
Denial is an unconscious blocking of threatening or painful information or feelings.
T T T T T T T T T T T T
Regression involves using behaviours appropriate at an earlier stage of psychosexual
T T T T T T T T T T T
development. Displacement shifts feelings to a more neutral person or object. Projection
T T T T T T T T T T T T
attributes one’s own unacceptable thoughts or feelings to another.
T T T T T T T T
DIF: Cognitive Level: Understand (Comprehension) T T T
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity T T T T T T
8. A patient with an abdominal mass is scheduled for a biopsy. The patient has difficulty
T T T T T T T T T T T T T T T
understanding the nurse’s comments and asks, “What do you mean? What are they going to
T T T T T T T T T T T T T T T
do?” Assessment findings include tremulous voice, respirations 28, and pulse 110. What is
T T T T T T T T T T T T T
the patient’s level of anxiety?
T T T T
a. Mild
b. Moderate
c. Severe
d. Panic
ANS: B T
Moderate anxiety causes the individual to grasp less information and reduces
T T T T T T T T T T
problem-solving ability to a less-than-optimal level. Mild anxiety heightens attention and
T T T T T T T T T T T
enhances problem solving. Severe anxiety causes great reduction in the perceptual field.
T T T T T T T T T T T T
Panic-level anxiety results in disorganized behaviour.
T T T T T
, Varcarolis's Canadian Psychiatric Mental Health Nursing 2nd Edition Halter Test Bank
DIF: T T Cognitive Level: Understand (Comprehension) T T T
TOP: T T Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
T T T T T T
9. A patient preparing for surgery has moderate anxiety and is unable to understand
T T T T T T T T T T T T T
preoperative information. Which nursing intervention is most appropriate?
T T T T T T T
a. Reassure the patient that all nurses are skilled in providing postoperative care.
T T T T T T T T T T T
b. Present the information again in a calm manner using simple language.
T T T T T T T T T T
c. Tell the patient that staff is prepared to promote recovery.
T T T T T T T T T
d. Encourage the patient to express feelings to family. T T T T T T T
ANS: B T T
Giving information in a calm, simple manner will help the patient grasp the important facts.
T T T T T T T T T T T T T T T
Introducing extraneous topics as described in the distracters will further scatter the patient’s
T T T T T T T T T T T T T
attention.
DIF: Cognitive Level: Apply (Application)
T T T T T
TOP: Nursing Process: Implementation
T T MSC: Client Needs: Psychosocial Integrity T T T T T T T T
10. A patient is experiencing moderate anxiety. The nurse encourages the patient to talk about
T T T T T T T T T T T T T T
feelings and concerns. What is the rationale for this intervention?
T T T T T T T T T
a. Offering hope allays and defuses the patient’s anxiety. T T T T T T T
b. Concerns stated aloud become less overwhelming and help problem solving begin.
T T T T T T T T T T
c. Anxiety is reduced by focusing on and validating what is occurring in the
T T T T T T T T T T T T T
environment.
d. Encouraging patients to explore alternatives increases the sense of control and T T T T T T T T T T
lessens anxiety. T
ANS: B T
All principles listed are valid, but the only rationale directly related to the intervention of
T T T T T T T T T T T T T T T
assisting the patient to talk about feelings and concerns is the one that states that concerns
T T T T T T T T T T T T T T T T
spoken aloud become less overwhelming and help problem solving begin.
T T T T T T T T T
DIF: T T Cognitive Level: Understand (Comprehension) T T T
TOP: T T Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
T T T T T T T T
11. A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which
T T T T T T T T T T T T T T
question would be most appropriate for the nurse to ask?
T T T T T T T T T
a. “Have you been a victim of a crime or seen someone badly injured or killed?”
T T T T T T T T T T T T T T
b. “Do you feel especially uncomfortable in social situations involving people?”
T T T T T T T T T
c. “Do you repeatedly do certain things over and over again?”
T T T T T T T T T
d. “Do you find it difficult to control your worrying?”
T T T T T T T T
ANS: D T
Patients with generalized anxiety disorder frequently engage in excessive worrying. They
T T T T T T T T T T T
are less likely to engage in ritualistic behaviour, fear social situations, or have been involved
T T T T T T T T T T T T T T T
in a highly traumatic event.
T T T T
DIF: Cognitive Level: Apply (Application) T T T
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity T T T T T T
Chapter 12: Anxiety and Related Disorders
Halter: Varcarolis’s Canadian Psychiatric Mental Health Nursing, 2nd Edition
MULTIPLE CHOICE
1. A nurse wants to teach alternative coping strategies to a patient experiencing severe anxiety.
T T T T T T T T T T T T T
Which action should the nurse perform first?
T T T T T T
a. Verify the patient’s learning style.
T T T T
b. Lower the patient’s current anxiety.
T T T T
c. Create outcomes and a teaching plan.
T T T T T
d. Assess how the patient uses defence mechanisms.
T T T T T T
ANS: B T
A patient experiencing severe anxiety has a markedly narrowed perceptual field and
T T T T T T T T T T T T
difficulty attending to events in the environment. A patient experiencing severe anxiety will
T T T T T T T T T T T T T
not learn readily. Determining preferred modes of learning, devising outcomes, and
T T T T T T T T T T T
constructing teaching plans are relevant to the task, but are not the priority measure. The
T T T T T T T T T T T T T T T
nurse has already assessed the patient’s anxiety level. Use of defence mechanisms does not
T T T T T T T T T T T T T T
apply.
DIF: Cognitive Level: Apply (Application) T T T
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
T T T T T T
2. Which is an intermediate indicator of the nursing outcome of anxiety self-control?
T T T T T T T T T T T
a. Maintains adequate sleep T T
b. Monitors intensity of a nNx i eR
t y IGB.CM
c. Controls anxiety response
U S N T T
T
o T
T
T T T T T
d. Uses relaxation techniques to lower anxiety
T T T T T
ANS: C T
Intermediate indicators of the nursing outcome anxiety self-control are controls anxiety
T T T T T T T T T T T
response and maintains role performance. Maintains adequate sleep, monitors intensity of
T T T T T T T T T T T
anxiety and uses relaxation techniques to lower anxiety, are short term indicators of the
T T T T T T T T T T T T T T
outcomes of anxiety self-control. T T T
DIF: Cognitive Level: Understand (Comprehension) T T T
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
T T T T T T
3. A patient experiencing moderate anxiety says, “I feel undone.” An appropriate response for
T T T T T T T T T T T T T
the nurse would be which of the following?
T T T T T T T
a. “What would you like me to do to help you?”
T T T T T T T T T
b. “Why do you suppose you are feeling anxious?”
T T T T T T T
c. “I’m not sure I understand. Give me an example.”
T T T T T T T T
d. “You must get your feelings under control before we can continue.”
T T T T T T T T T T
ANS: C T
,Varcarolis's Canadian Psychiatric Mental Health Nursing 2nd Edition Halter Test Bank
Increased anxiety results in scattered thoughts and an inability to articulate clearly.
T T T T T T T T T T T T
Clarifying helps the patient identify thoughts and feelings. Asking the patient why he or she
T T T T T T T T T T T T T T T
feels anxious is nontherapeutic; the patient likely does not have an answer. The patient may
T T T T T T T T T T T T T T T
be unable to determine what he or she would like the nurse to do in order to help. Telling the
T T T T T T T T T T T T T T T T T T T T
patient to get his or her feelings under control is a directive the patient is probably unable to
T T T T T T T T T T T T T T T T T T
accomplish.
DIF: Cognitive Level: Apply (Application) T T T
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity T T T T T T
4. A patient fearfully runs from chair to chair, crying, “They’re coming! They’re coming!” The
T T T T T T T T T T T T T T
patient does not follow the staff’s directions or respond to verbal interventions. The initial
T T T T T T T T T T T T T T
nursing intervention of highest priority is to do which of the following?
T T T T T T T T T T T
a. Provide for the patient’s safety T T T T
b. Encourage clarification of feelings T T T
c. Respect the patient’s personal space T T T T
d. Offer an outlet for the patient’s energy
T T T T T T
ANS: A T
Safety is of highest priority because the patient experiencing panic is at high risk for
T T T T T T T T T T T T T T
self-injury related to increased nongoal-directed motor activity, distorted perceptions, and
T T T T T T T T T T
disordered thoughts. Offering an outlet for the patient’s energy can occur when the current
T T T T T T T T T T T T T T
panic level subsides. Respecting the patient’s personal space is a lower priority than safety.
T T T T T T T T T T T T T T
Clarification of feelings cannot take place until the level of anxiety is lowered.
T T T T T T T T T T T T
DIF: Cognitive Level: Analyze (Analysis) T T T
TOP: Nursing Process: PlNanUnR
inSg I NG TB.C oM T T
MSC: Client Needs: Safe Effective Care Environment
T T T T T T
5. A patient fearfully runs from chair to chair, crying, “They’re coming! They’re coming!” The
T T T T T T T T T T T T T T
patient does not follow the staff’s directions or respond to verbal interventions. Which
T T T T T T T T T T T T T
nursing diagnosis has the highest priority?
T T T T T
a. Fear
b. Risk for injury T T
c. Self-care deficit T
d. Disturbed thought processes T T
ANS: B T
A patient experiencing panic-level anxiety is at high risk for injury related to increased
T T T T T T T T T T T T T T
nongoal-directed motor activity, distorted perceptions, and disordered thoughts. Data are not T T T T T T T T T T T
present to support a nursing diagnosis of self-care deficit or disturbed thought processes.
T T T T T T T T T T T T
The patient may have fear, but the risk for injury has a higher priority.
T T T T T T T T T T T T T
DIF: Cognitive Level: Analyze (Analysis) T T T T
TOP: Nursing Process: Diagnosis/Analysis T T
MSC: Client Needs: Safe Effective Care Environment
T T T T T T
,Varcarolis's Canadian Psychiatric Mental Health Nursing 2nd Edition Halter Test Bank
6. A patient checks and rechecks electrical cords related to an obsessive thought that the house
T T T T T T T T T T T T T T T
may burn down. The nurse and patient explore the likelihood of an actual fire. The patient
T T T T T T T T T T T T T T T T
states this event is not likely. This counselling demonstrates principles of which of the
T T T T T T T T T T T T T T
following?
a. Flooding
b. Desensitization
c. Relaxation technique T
d. Cognitive restructuring T
ANS: D T T
Cognitive restructuring involves the patient in testing automatic thoughts and drawing new
T T T T T T T T T T T T
conclusions. Desensitization involves graduated exposure to a feared object. Relaxation
T T T T T T T T T T
training teaches the patient to produce the opposite of the stress response. Flooding exposes
T T T T T T T T T T T T T T
the patient to a large amount of an undesirable stimulus in an effort to extinguish the anxiety
T T T T T T T T T T T T T T T T T
response.
DIF: Cognitive Level: Understand (Comprehension) T T T
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity T T T T T T
7. A patient undergoing diagnostic tests says, “Nothing is wrong with me except a stubborn
T T T T T T T T T T T T T T
chest cold.” The spouse reports the patient smokes, coughs daily, lost 15 pounds, and is
T T T T T T T T T T T T T T T
easily fatigued. Which defence mechanism is the patient using?
T T T T T T T T
a. Displacement
b. Regression
c. Projection
d. Denial
ANS: D T
NURSINGTB.CoM
T
Denial is an unconscious blocking of threatening or painful information or feelings.
T T T T T T T T T T T T
Regression involves using behaviours appropriate at an earlier stage of psychosexual
T T T T T T T T T T T
development. Displacement shifts feelings to a more neutral person or object. Projection
T T T T T T T T T T T T
attributes one’s own unacceptable thoughts or feelings to another.
T T T T T T T T
DIF: Cognitive Level: Understand (Comprehension) T T T
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity T T T T T T
8. A patient with an abdominal mass is scheduled for a biopsy. The patient has difficulty
T T T T T T T T T T T T T T T
understanding the nurse’s comments and asks, “What do you mean? What are they going to
T T T T T T T T T T T T T T T
do?” Assessment findings include tremulous voice, respirations 28, and pulse 110. What is
T T T T T T T T T T T T T
the patient’s level of anxiety?
T T T T
a. Mild
b. Moderate
c. Severe
d. Panic
ANS: B T
Moderate anxiety causes the individual to grasp less information and reduces
T T T T T T T T T T
problem-solving ability to a less-than-optimal level. Mild anxiety heightens attention and
T T T T T T T T T T T
enhances problem solving. Severe anxiety causes great reduction in the perceptual field.
T T T T T T T T T T T T
Panic-level anxiety results in disorganized behaviour.
T T T T T
, Varcarolis's Canadian Psychiatric Mental Health Nursing 2nd Edition Halter Test Bank
DIF: T T Cognitive Level: Understand (Comprehension) T T T
TOP: T T Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
T T T T T T
9. A patient preparing for surgery has moderate anxiety and is unable to understand
T T T T T T T T T T T T T
preoperative information. Which nursing intervention is most appropriate?
T T T T T T T
a. Reassure the patient that all nurses are skilled in providing postoperative care.
T T T T T T T T T T T
b. Present the information again in a calm manner using simple language.
T T T T T T T T T T
c. Tell the patient that staff is prepared to promote recovery.
T T T T T T T T T
d. Encourage the patient to express feelings to family. T T T T T T T
ANS: B T T
Giving information in a calm, simple manner will help the patient grasp the important facts.
T T T T T T T T T T T T T T T
Introducing extraneous topics as described in the distracters will further scatter the patient’s
T T T T T T T T T T T T T
attention.
DIF: Cognitive Level: Apply (Application)
T T T T T
TOP: Nursing Process: Implementation
T T MSC: Client Needs: Psychosocial Integrity T T T T T T T T
10. A patient is experiencing moderate anxiety. The nurse encourages the patient to talk about
T T T T T T T T T T T T T T
feelings and concerns. What is the rationale for this intervention?
T T T T T T T T T
a. Offering hope allays and defuses the patient’s anxiety. T T T T T T T
b. Concerns stated aloud become less overwhelming and help problem solving begin.
T T T T T T T T T T
c. Anxiety is reduced by focusing on and validating what is occurring in the
T T T T T T T T T T T T T
environment.
d. Encouraging patients to explore alternatives increases the sense of control and T T T T T T T T T T
lessens anxiety. T
ANS: B T
All principles listed are valid, but the only rationale directly related to the intervention of
T T T T T T T T T T T T T T T
assisting the patient to talk about feelings and concerns is the one that states that concerns
T T T T T T T T T T T T T T T T
spoken aloud become less overwhelming and help problem solving begin.
T T T T T T T T T
DIF: T T Cognitive Level: Understand (Comprehension) T T T
TOP: T T Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
T T T T T T T T
11. A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which
T T T T T T T T T T T T T T
question would be most appropriate for the nurse to ask?
T T T T T T T T T
a. “Have you been a victim of a crime or seen someone badly injured or killed?”
T T T T T T T T T T T T T T
b. “Do you feel especially uncomfortable in social situations involving people?”
T T T T T T T T T
c. “Do you repeatedly do certain things over and over again?”
T T T T T T T T T
d. “Do you find it difficult to control your worrying?”
T T T T T T T T
ANS: D T
Patients with generalized anxiety disorder frequently engage in excessive worrying. They
T T T T T T T T T T T
are less likely to engage in ritualistic behaviour, fear social situations, or have been involved
T T T T T T T T T T T T T T T
in a highly traumatic event.
T T T T
DIF: Cognitive Level: Apply (Application) T T T
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity T T T T T T
