NCLEX PN MENTAL HEALTH
The nurse is evaluating the plan of care for a client diagnosed with social
anxiety disorder who has a fear of eating and drinking in public. Which
of the following client statements demonstrate an improvement in
coping? Select all that apply.
A. "I plan dates involving outdoor activities, such as hiking, instead of
going to dinner and a movie."
B. "I sat in the pizza shop and drank a cola while watching people eat
and then bought a slice to go."
C. "I started having lunch with my coworkers even though I still become
very anxious eating in public."
D. "I went out of town on the day of the company picnic instead of
making excuses for not eating."
E. "I went to a coffee house with my boss and focused on an upcoming
project while drinking a latte."
Correct answer: B, C, and E.
,Rationale. Social anxiety disorder (ie, social phobia) is characterized
as intense anxiety or fear when exposed to a public or social
situation (eg, public speaking, eating or drinking in front of others).
Clients who have social anxiety disorder tend to avoid participating
in social situations because of the heightened anxiety and insecurity
they experience.
Treatment of social phobias may include medication (eg, selective
serotonin reuptake inhibitors, benzodiazepines) and psychotherapy
(eg, cognitive-behavioral therapy, systematic desensitization) to
assist in developing effective coping strategies. As part of systematic
desensitization, the client is gradually exposed to the phobic trigger,
which in turn decreases anxiety.
Effective coping with social phobia is demonstrated by:
· Experiencing increased comfort while engaging in phobic situations
(eg, drinking a cola while watching people eat).
· Developing insight and verbalizing feelings about the irrational fear.
· Distracting oneself by focusing on something other than the phobic
situation (eg, preparing for a meeting while drinking a latte).
Incorrect Answers
,[A. "I plan dates involving outdoor activities, such as hiking, instead of
going to dinner and a movie."] Avoiding phobic situations (eg, planning
activities unrelated to food, going out of town) reinforces maladaptive
coping and prevents the client from working through the fear.
[D. "I went out of town on the day of the company picnic instead of
making excuses for not eating."] Avoiding phobic situations (eg,
planning activities unrelated to food, going out of town) reinforces
maladaptive coping and prevents the client from working through the
fear.
Educational objective:Social anxiety disorder (ie, social phobia) is
characterized by intense anxiety or fear when exposed to a public or
social situation. Effective coping is demonstrated by experiencing
increased comfort when exposed to the phobia, developing insight and
verbalizing feelings about the phobia, and distracting oneself during the
phobic situation.
Which statement made by the nurse during a therapy session
demonstrates a need for further instruction regarding effective
therapeutic communication techniques?
A. "I don't understand what you mean. Can you give me an example?
B. "It is doubtful the president is out to get you."
C. "Tell me more about the day your child died."
, D. "Why did you get so angry when she ignored you?"
Correct Answer: D. "Why did you get so angry when she ignored you?"
Rationale. Therapeutic communication allows the nurse to develop a
healthy interpersonal relationship with the client. A "why" question
is often avoided as it is viewed negatively by clients and can make
them feel defensive about their choices or emotions.
Incorrect Answers:
[A. "I don't understand what you mean. Can you give me an example?]
Asking for an example is asking for clarification and is considered a
therapeutic communication technique.
[B. "It is doubtful the president is out to get you."] Voicing doubt is a
therapeutic communication technique that allows the nurse to dispel
misconceptions or delusions without directly confronting the client's
beliefs.
[C. "Tell me more about the day your child died."] Exploring is a
therapeutic communication technique that encourages the client to
discuss relevant situations and feelings. If the client chooses not to share
information, the nurse should respect that decision and not probe further.
Educational objective:For people who are anxious or overwhelmed, a
"why" question asked by the nurse is often interpreted as being critical,
judgmental, and intrusive. These feelings are damaging to the
The nurse is evaluating the plan of care for a client diagnosed with social
anxiety disorder who has a fear of eating and drinking in public. Which
of the following client statements demonstrate an improvement in
coping? Select all that apply.
A. "I plan dates involving outdoor activities, such as hiking, instead of
going to dinner and a movie."
B. "I sat in the pizza shop and drank a cola while watching people eat
and then bought a slice to go."
C. "I started having lunch with my coworkers even though I still become
very anxious eating in public."
D. "I went out of town on the day of the company picnic instead of
making excuses for not eating."
E. "I went to a coffee house with my boss and focused on an upcoming
project while drinking a latte."
Correct answer: B, C, and E.
,Rationale. Social anxiety disorder (ie, social phobia) is characterized
as intense anxiety or fear when exposed to a public or social
situation (eg, public speaking, eating or drinking in front of others).
Clients who have social anxiety disorder tend to avoid participating
in social situations because of the heightened anxiety and insecurity
they experience.
Treatment of social phobias may include medication (eg, selective
serotonin reuptake inhibitors, benzodiazepines) and psychotherapy
(eg, cognitive-behavioral therapy, systematic desensitization) to
assist in developing effective coping strategies. As part of systematic
desensitization, the client is gradually exposed to the phobic trigger,
which in turn decreases anxiety.
Effective coping with social phobia is demonstrated by:
· Experiencing increased comfort while engaging in phobic situations
(eg, drinking a cola while watching people eat).
· Developing insight and verbalizing feelings about the irrational fear.
· Distracting oneself by focusing on something other than the phobic
situation (eg, preparing for a meeting while drinking a latte).
Incorrect Answers
,[A. "I plan dates involving outdoor activities, such as hiking, instead of
going to dinner and a movie."] Avoiding phobic situations (eg, planning
activities unrelated to food, going out of town) reinforces maladaptive
coping and prevents the client from working through the fear.
[D. "I went out of town on the day of the company picnic instead of
making excuses for not eating."] Avoiding phobic situations (eg,
planning activities unrelated to food, going out of town) reinforces
maladaptive coping and prevents the client from working through the
fear.
Educational objective:Social anxiety disorder (ie, social phobia) is
characterized by intense anxiety or fear when exposed to a public or
social situation. Effective coping is demonstrated by experiencing
increased comfort when exposed to the phobia, developing insight and
verbalizing feelings about the phobia, and distracting oneself during the
phobic situation.
Which statement made by the nurse during a therapy session
demonstrates a need for further instruction regarding effective
therapeutic communication techniques?
A. "I don't understand what you mean. Can you give me an example?
B. "It is doubtful the president is out to get you."
C. "Tell me more about the day your child died."
, D. "Why did you get so angry when she ignored you?"
Correct Answer: D. "Why did you get so angry when she ignored you?"
Rationale. Therapeutic communication allows the nurse to develop a
healthy interpersonal relationship with the client. A "why" question
is often avoided as it is viewed negatively by clients and can make
them feel defensive about their choices or emotions.
Incorrect Answers:
[A. "I don't understand what you mean. Can you give me an example?]
Asking for an example is asking for clarification and is considered a
therapeutic communication technique.
[B. "It is doubtful the president is out to get you."] Voicing doubt is a
therapeutic communication technique that allows the nurse to dispel
misconceptions or delusions without directly confronting the client's
beliefs.
[C. "Tell me more about the day your child died."] Exploring is a
therapeutic communication technique that encourages the client to
discuss relevant situations and feelings. If the client chooses not to share
information, the nurse should respect that decision and not probe further.
Educational objective:For people who are anxious or overwhelmed, a
"why" question asked by the nurse is often interpreted as being critical,
judgmental, and intrusive. These feelings are damaging to the
