A mental health nurse is assessing a client who has generalized anxiety disorder. Which of the following findings should the nurse expect?

Obsession over a fictitious defect in physical appearance.

Constant worry about the undiagnosed presence of an illness.

Sudden unexplained loss of vision without a physical medical explanation.

Prior physical health followed by the need for two surgeries within the last three months.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Obsession over a fictitious defect in physical appearance is characteristic of body dysmorphic disorder, not generalized anxiety disorder (GAD).

Individuals with body dysmorphic disorder become preoccupied with an imagined or slight defect in their appearance, often to the point of significant distress and impairment in functioning.

They may engage in excessive grooming behaviors, repeatedly check their appearance in mirrors, or avoid social situations due to their appearance concerns.

While individuals with GAD may also experience concerns about their physical appearance, these concerns are typically not as severe or pervasive as those seen in body dysmorphic disorder.

Choice B rationale:

Constant worry about the undiagnosed presence of an illness is a hallmark feature of GAD.

Individuals with GAD often experience excessive worry about a variety of things, including health, finances, relationships, and work.

This worry is often accompanied by physical symptoms such as restlessness, fatigue, difficulty concentrating, and muscle tension.

The worry is typically difficult to control and can significantly interfere with daily life.

Choice C rationale:

Sudden unexplained loss of vision without a physical medical explanation is not a common symptom of GAD. It may be indicative of a more serious medical condition, such as a stroke or a neurological disorder.

It is important to rule out any potential medical causes before attributing a symptom like this to GAD.

Choice D rationale:

Prior physical health followed by the need for two surgeries within the last three months may be a stressful life event that could contribute to the development of GAD.

However, it is not a specific symptom of GAD.

Many people experience stressful life events without developing GAD.

The presence of other symptoms, such as excessive worry and physical symptoms, is necessary for a diagnosis of GAD.

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Correct Answer is D

Explanation

Choice A: Limit the amount of time available to interact with others

While the client's behavior may indirectly limit their interactions with others by occupying their time, this is not the primary function of their actions. The core motivation lies in reducing anxiety, not social avoidance.

Choice B: Manipulate and control others' behaviors

Although the client's cleaning may influence others to tidy up, this is not a deliberate attempt to control their behavior. The primary drive stems from the client's internal need for order and cleanliness, not a desire to dictate the actions of others.

Choice C: Focus attention on meaningful tasks

While the act of cleaning can be productive and contribute to a pleasant environment, it's not the primary function or intention behind the client's behavior. Their actions are primarily driven by the need to quell anxiety, not necessarily to accomplish meaningful tasks.

Choice D: Decrease anxiety to a tolerable level

This is the most accurate rationale for the client's behavior. Individuals with OCD engage in compulsions, like excessive cleaning, to alleviate the intense anxiety associated with their intrusive thoughts and obsessions. In this case, the act of picking up after others provides the client with a sense of order and control, thereby reducing their anxiety to a manageable level.

Elaboration:

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). Individuals with OCD experience significant anxiety due to their obsessions and feel compelled to engage in compulsions to manage that anxiety.

In the scenario presented, the client's constant cleaning behavior likely stems from an obsession with order and cleanliness. This obsession triggers anxiety when the environment is perceived as messy or disorderly. The act of picking up after others serves as a compulsion, a ritualistic behavior performed to reduce the anxiety caused by the obsession. By restoring order and cleanliness, the client temporarily alleviates their anxiety and achieves a sense of control over their environment.

It's important to recognize that the client's cleaning behavior, while seemingly productive, is primarily driven by their internal need to manage anxiety, not by a genuine desire to help others or maintain a tidy environment. This understanding is crucial for the nurse to effectively support the client and guide them towards healthier coping mechanisms for managing their OCD symptoms.

A. The client tells the nurse that he is too tired to attend the group meeting. B. The client states, "I see purple bugs crawling on the wall." C. The client tells the nurse he is a government agent. D. The client states, "My heart is pounding out of my chest.".

Correct Answer is D

Explanation

Choice A rationale: Feeling too tired to attend a group meeting does not necessarily indicate anxiety. It could be due to various reasons such as lack of sleep, side effects of medication, or lack of motivation, which are not indications for administering lorazepam.

Choice B rationale: Seeing “purple bugs crawling on the wall” is a hallucination, which is a symptom of schizophrenia, not anxiety. Lorazepam is not typically used as the first-line treatment for hallucinations.

Choice C rationale: Believing that he is a government agent is a delusion, which is a symptom of schizophrenia. Lorazepam is not typically used as the first-line treatment for delusions.

Choice D rationale: “My heart is pounding out of my chest” is a common symptom of anxiety. It indicates that the client might be experiencing physiological symptoms of anxiety such as increased heart rate and palpitations. In this case, administering lorazepam, which is an anxiolytic medication, would be appropriate.

In conclusion, the nurse should consider administering lorazepam when the client states, “My heart is pounding out of my chest.”

Lorazepam is a medication belonging to the benzodiazepine class, commonly used to treat anxiety and insomnia. It works by slowing down the activity in the brain and nervous system, producing a calming effect.

Generalized Anxiety Disorder (GAD) is a chronic mental health condition characterized by excessive worry and anxiety that persists for at least 6 months, interfering with daily life.

Important Considerations:

Lorazepam is a controlled substance due to its potential for abuse and dependence.

It should only be administered under the supervision of a qualified healthcare professional, who can assess the individual's needs and potential risks.

Self-treating with lorazepam is dangerous and can lead to serious consequences.

If you have concerns about anxiety or are considering using lorazepam, please consult a licensed physician or mental health professional for proper diagnosis and treatment guidance.

Remember,

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A mental health nurse is assessing a client who has generalized anxiety disorder. Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has been diagnosed with obsessive-compulsive disorder (OCD) and is constantly picking up after others in the day room.The nurse should recognize that the client uses this behavior to do which of the following?

Correct Answer is D

Explanation

A mental health nurse is caring for a client who has schizophrenia and generalized anxiety disorder (GAD). The client has a prescription for lorazepam 2 mg PO every 6 hr PRN anxiety.For which of the following client statements should the nurse consider administering lorazepam?

Correct Answer is D

Explanation

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