NUR 1300: ANXIETY, ANXIETY
DISORDERS, AND OBSESSIVE-
COMPULSIVE DISORDERS VARCAROLIS:
ESSENTIALS TO PSYCHIATRIC MENTAL
HEALTH NURSING EXAM
A patient experiencing moderate anxiety says, “I feel undone.” An appropriate
response for the nurse would be: a. “Why do you suppose you are feeling
anxious?”
b. “What would you like me to do to help you?”
c. “I’m not sure I understand. Give me an example.”
d. “You must get your feelings under control before we can continue.”
ANS:
C
Increased anxiety results in scattered thoughts and an inability to articulate
clearly. Clarification helps the pa- tient identify his or her thoughts and feelings.
Asking the patient why he or she feels anxious is nontherapeutic, and the patient
will not likely have an answer. The patient may be unable to determine what he
or she would like the nurse to do to help. Telling the patient to get his or her
feelings under control is a directive the patient is probably unable to
accomplish.
Page 1 of 33
,DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. A patient with a high level of motor activity runs from chair to chair and
cries, “They’re coming! They’re com- ing!” The patient does not follow
instructions or respond to verbal interventions from staff. The initial nursing
intervention of highest priority is to:
a. provide for patient safety.
b. increase environmental stimuli.
c. respect the patient’s personal space.
d. encourage the clarification of feelings.
ANS: A
Safety is of highest priority; the patient who is experiencing panic is at high risk
for self-injury related to an in- crease in
ANSWERS
non–goal-directed motor activity, distorted perceptions, and disordered
thoughts. The goal should be to decrease the environmental stimuli. Respecting
the patient’s personal space is a lower priority than safety.
The clarification of feelings cannot take place until the level of anxiety is
lowered.
Page 2 of 33
,DIF: Cognitive Level: Analysis (Analyzing)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care
Environment
5. A patient with a high level of motor activity runs from chair to chair and
cries, “They’re coming! They’re com- ing!” The patient is unable to follow
instructions or respond to verbal interventions from staff. Which nursing
diagnosis has the highest priority?
a. Risk for injury
b. Self-care deficit
c. Disturbed energy field
d. Disturbed thought processes
ANS: A
A patient who is experiencing panic-level anxiety is at high risk for injury,
related to an increase in non–goal-di- rected motor activity, distorted
perceptions, and disordered thoughts. Existing data do not support the nursing
diagnoses of Self-care deficit or Disturbed energy field. This patient has
disturbed thought processes, but the risk for injury has a higher priority.
DIF: Cognitive Level: Analysis (Analyzing) TOP: Nursing Process:
Diagnosis| Nursing Process: Analysis MSC: NCLEX: Safe, Effective Care
Environment
Page 3 of 33
, 6. A supervisor assigns a worker a new project. The worker initially agrees but
feels resentful. The next day, when asked about the project, the worker says,
“I’ve been working on other things.” When asked 4 hours later, the worker says,
“Someone else was using the copier, so I couldn’t finish it.” The worker’s
behavior demon- strates: a. acting out.
b. projection.
c. suppression.
d. passive aggression.
ANS: D
A passive-aggressive person deals with emotional conflict by indirectly
expressing aggression toward others. Compliance on the surface masks covert
resistance. Resistance is expressed through procrastination, ineffi- ciency, and
stubbornness in response to assigned tasks. Acting out refers to behavioral
expression of conflict. Projection is a form of blaming.
Suppression is the conscious denial of a disturbing situation or feeling.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: Safe, Effective Care
Environment
7. A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong
with me except a stubborn chest cold.”
ANSWERS
Page 4 of 33
DISORDERS, AND OBSESSIVE-
COMPULSIVE DISORDERS VARCAROLIS:
ESSENTIALS TO PSYCHIATRIC MENTAL
HEALTH NURSING EXAM
A patient experiencing moderate anxiety says, “I feel undone.” An appropriate
response for the nurse would be: a. “Why do you suppose you are feeling
anxious?”
b. “What would you like me to do to help you?”
c. “I’m not sure I understand. Give me an example.”
d. “You must get your feelings under control before we can continue.”
ANS:
C
Increased anxiety results in scattered thoughts and an inability to articulate
clearly. Clarification helps the pa- tient identify his or her thoughts and feelings.
Asking the patient why he or she feels anxious is nontherapeutic, and the patient
will not likely have an answer. The patient may be unable to determine what he
or she would like the nurse to do to help. Telling the patient to get his or her
feelings under control is a directive the patient is probably unable to
accomplish.
Page 1 of 33
,DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. A patient with a high level of motor activity runs from chair to chair and
cries, “They’re coming! They’re com- ing!” The patient does not follow
instructions or respond to verbal interventions from staff. The initial nursing
intervention of highest priority is to:
a. provide for patient safety.
b. increase environmental stimuli.
c. respect the patient’s personal space.
d. encourage the clarification of feelings.
ANS: A
Safety is of highest priority; the patient who is experiencing panic is at high risk
for self-injury related to an in- crease in
ANSWERS
non–goal-directed motor activity, distorted perceptions, and disordered
thoughts. The goal should be to decrease the environmental stimuli. Respecting
the patient’s personal space is a lower priority than safety.
The clarification of feelings cannot take place until the level of anxiety is
lowered.
Page 2 of 33
,DIF: Cognitive Level: Analysis (Analyzing)
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care
Environment
5. A patient with a high level of motor activity runs from chair to chair and
cries, “They’re coming! They’re com- ing!” The patient is unable to follow
instructions or respond to verbal interventions from staff. Which nursing
diagnosis has the highest priority?
a. Risk for injury
b. Self-care deficit
c. Disturbed energy field
d. Disturbed thought processes
ANS: A
A patient who is experiencing panic-level anxiety is at high risk for injury,
related to an increase in non–goal-di- rected motor activity, distorted
perceptions, and disordered thoughts. Existing data do not support the nursing
diagnoses of Self-care deficit or Disturbed energy field. This patient has
disturbed thought processes, but the risk for injury has a higher priority.
DIF: Cognitive Level: Analysis (Analyzing) TOP: Nursing Process:
Diagnosis| Nursing Process: Analysis MSC: NCLEX: Safe, Effective Care
Environment
Page 3 of 33
, 6. A supervisor assigns a worker a new project. The worker initially agrees but
feels resentful. The next day, when asked about the project, the worker says,
“I’ve been working on other things.” When asked 4 hours later, the worker says,
“Someone else was using the copier, so I couldn’t finish it.” The worker’s
behavior demon- strates: a. acting out.
b. projection.
c. suppression.
d. passive aggression.
ANS: D
A passive-aggressive person deals with emotional conflict by indirectly
expressing aggression toward others. Compliance on the surface masks covert
resistance. Resistance is expressed through procrastination, ineffi- ciency, and
stubbornness in response to assigned tasks. Acting out refers to behavioral
expression of conflict. Projection is a form of blaming.
Suppression is the conscious denial of a disturbing situation or feeling.
DIF: Cognitive Level: Application (Applying)
TOP: Nursing Process: Assessment MSC: NCLEX: Safe, Effective Care
Environment
7. A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong
with me except a stubborn chest cold.”
ANSWERS
Page 4 of 33
