A client diagnosed with generalized anxiety disorder has a nursing diagnosis of panic anxiety related to altered perceptions. Which of the following short-term outcomes is most appropriate for this client?

The client will be able to intervene before reaching panic levels of anxiety by discharge.

The client will verbalize decreased levels of anxiety by day 2.

The client will take control of life situations by using problem-solving methods effectively.

The client will voluntarily participate in group therapy activities by discharge.

Answer and Explanation

The Correct Answer is B

Panic anxiety is an acute, intense episode of fear or discomfort that peaks within minutes and is often accompanied by somatic symptoms such as chest pain, palpitations, and shortness of breath. It stems from altered perceptions and distorted cognitive processing, leading to catastrophic misinterpretations of bodily sensations or environmental cues. Management includes rapid symptom containment, cognitive restructuring, and grounding techniques. Short-term goals focus on stabilization and symptom reduction, while long-term goals address coping and insight. SSRIs are first-line pharmacologic agents; benzodiazepines may be used short-term.

Rationale for correct answers

2. Verbalizing anxiety and tracking symptom change are measurable and achievable within 48 hours. This outcome reflects early therapeutic engagement and emotional awareness, which are critical in managing panic anxiety. It allows the nurse to monitor progress and adjust interventions accordingly.

Rationale for incorrect answers

1. Intervening before panic escalation is a long-term behavioral goal requiring insight, skill acquisition, and practice. It is not realistic as a short-term outcome, especially for a client with altered perceptions.

3. Effective problem-solving reflects higher-order cognitive functioning and emotional regulation. This is a long-term adaptive goal, not suitable for acute-phase planning.

4. Voluntary group participation is a discharge-level goal indicating improved social functioning and reduced avoidance. It does not address immediate symptom relief or emotional stabilization.

Take Home Points

Panic anxiety involves acute fear with distorted perceptions and intense somatic symptoms.
Short-term goals should focus on symptom awareness and reduction, not behavioral mastery.
Verbalizing anxiety levels is a realistic and measurable early outcome.
Long-term goals include cognitive restructuring, coping skill development, and social reintegration.

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Correct Answer is B

Explanation

Benzodiazepinesare central nervous system depressants that enhance the effect of gamma-aminobutyric acid (GABA), producing sedative, anxiolytic, anticonvulsant, and muscle relaxant effects. They are indicated for short-termmanagement of anxiety, alcohol withdrawal, and procedural sedation. Long-term use is discouraged due to risks of dependence, tolerance, and cognitive impairment. Common side effects include drowsiness, confusion, and respiratory depression. Contraindications include sleep apnea, substance use disorders, and concurrent use with opioids or alcohol due to synergistic CNS depression.

Rationale for correct answers

2.Benzodiazepines are appropriate for short-term treatment of generalized anxiety disorder, alcohol withdrawal, and preoperative sedationdue to their rapid onset and calming effects. These uses align with their pharmacologic profile and safety guidelines for limited duration.

Rationale for incorrect answers

1.Long-term use for PTSD and convulsive disorders is discouraged due to risk of dependenceand tolerance. While benzodiazepines may be used acutely in alcohol withdrawal, chronic use is not recommended.

3.Benzodiazepines are not first-line for obsessive-compulsive disorder or essential hypertension. They may relieve muscle spasms but are not indicated for long-termmanagement of these conditions.

4.Long-term treatment of panic disorder and bipolar mania with benzodiazepines is not standard due to risk of addiction. Alcohol dependence requires structured withdrawal protocols, not maintenance benzodiazepine therapy.

Take Home Points

Benzodiazepines are best suited for short-term use in anxiety, alcohol withdrawal, and procedural sedation.
Long-term use increases risk of dependence, tolerance, and cognitive decline.
They are contraindicated in patients with substance use disorders or respiratory compromise.
SSRIs and other non-addictive agents are preferred for chronic anxiety and mood disorders.

A. Expansive mood with pressured speech B. Restlessness or feeling keyed up or on edge C. Difficulty controlling the anxiety D. Irritability E. Muscle tension

Correct Answer is ["B","C","D","E"]

Explanation

Generalized anxiety disorder (GAD)is a chronic psychiatric condition characterized by excessive, uncontrollable worry occurring more days than not for at least 6 months. It affects both psychological and physiological domains, with hallmark features including restlessness, difficulty concentrating, and muscle tension. Adults must exhibit at least three of six DSM-5 criteria: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

Rationale for correct answers

2.Restlessness or feeling keyed up is a core DSM-5 criterion. It reflects autonomic hyperactivityand heightened arousal, commonly seen in GAD.

3.Difficulty controlling anxiety is central to the diagnosis. Persistent worry is excessive and intrusive, often disproportionate to actual circumstances.

4.Irritability is a frequent emotional manifestation. It results from cognitive overloadand sustained psychological tension.

5.Muscle tension is a defining somatic symptom. Chronic neuromuscular contractionreflects prolonged sympathetic activation.

Rationale for incorrect answers

1.Expansive mood with pressured speechis characteristic of manic episodes in bipolar disorder, not GAD. It reflects elevated mood and increased goal-directed activity, which are absent in anxiety disorders.

Take Home Points

GAD requires excessive worry lasting ≥6 months with ≥3 DSM-5 symptoms in adults.
Somatic symptoms like muscle tension and restlessness reflect autonomic dysregulation.
Emotional symptoms such as irritability and difficulty controlling worry are diagnostic hallmarks.
GAD must be differentiated from mood disorders like bipolar disorder, which present with expansive mood and pressured speech.

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A client diagnosed with generalized anxiety disorder has a nursing diagnosis of panic anxiety related to altered perceptions. Which of the following short-term outcomes is most appropriate for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In which situation would benzodiazepines be prescribed appropriately?

Correct Answer is B

Explanation

A nurse is admitting a client diagnosed with generalized anxiety disorder. During the client’s assessment, the nurse determines that which findings would be consistent with generalized anxiety disorder? Select all that apply.

Correct Answer is ["B","C","D","E"]

Explanation

Which assessment information would be evaluated as objective data?

Which client would the charge nurse assign to an agency nurse who is new to a psychiatric setting?

After a nurse teaches a client with generalized anxiety disorder some strategies for coping with stressors, another goal for the client would be to:

In the United States, which diagnosis has the lowest percentage of occurrence?

A nurse is caring for a client who has generalized anxiety disorder. Which statement about this client is true?

A client diagnosed with generalized anxiety disorder is placed on clonazepam (Klonopin) and buspirone (BuSpar). Which client statement indicates teaching has been effective?

Which of the following symptom assessments would validate the diagnosis of generalized anxiety disorder? Select all that apply.

A client diagnosed with generalized anxiety disorder has a nursing diagnosis of panic anxiety related to altered perceptions. Which of the following short-term outcomes is most appropriate for this client?