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

Generalized anxiety disorder involves excessive, uncontrollable worry that persists for at least six months and interferes with daily functioning. It presents with restlessness, muscle tension, and impaired concentration. Suppression of thoughts, such as trying to "forget worries," is maladaptive and prevents emotional processing. Effective treatment includes cognitive behavioral therapy and anxiety-reducing techniques like relaxation training and exposure to triggers through guided therapy.

Rationale for correct answers

C. The desire to forget worries suggests avoidance, not processing. This shows the client needs to verbalize emotions to reduce internal tension and improve long-term coping.

Rationale for incorrect answers

A. Insight involves recognizing the impact of anxiety and understanding patterns. Avoidance behavior, like trying to forget, lacks self-awareness and does not reflect insight.

B. Improved coping is shown by active management such as cognitive restructuring or relaxation. Forgetting worries is a passive, ineffective defense that hinders emotional resolution.

D. Treatment success includes functional improvements and adaptive coping. Avoiding thoughts contradicts therapeutic goals of confronting and managing anxiety consciously.

Take Home Points

• Avoidance of anxiety triggers is a common but ineffective defense mechanism in GAD.
• Emotional verbalization is essential for processing and managing anxiety disorders.
• Insight involves recognizing the nature of one’s condition and its effects on behavior.
• Effective coping in GAD includes cognitive and behavioral strategies, not suppression.

Panic attack is an abrupt surge of intense fear or discomfort accompanied by physical and cognitive symptoms such as palpitations, shortness of breath, dizziness, and fear of losing control. During an attack, clients experience overwhelming anxiety that impairs their ability to process complex information. Communication must be clear and simple to avoid increasing distress. The goal is to help the client regain control and calm without challenging or minimizing their feelings.

Rationale for correct answers

B. Speaking in short, simple sentences facilitates understanding during the acute panic episode when cognitive processing is impaired. It helps the client focus and reduces confusion or overwhelm.

Rationale for incorrect answers

A. Telling the client there’s no need to panic invalidates their feelings and may increase anxiety. It can be perceived as dismissive rather than supportive.

C. Explaining that there’s no need to worry is also minimizing the client's experience, which can worsen panic and reduce trust.

D. Providing a detailed explanation during the panic attack is ineffective because the client is unlikely to comprehend or retain complex information when overwhelmed.

Take Home Points

• Panic attacks cause severe cognitive and physiological symptoms that impair processing.
• Use clear, simple communication to support the client during an attack.
• Avoid minimizing or dismissing the client’s feelings to prevent increased anxiety.
• Detailed education about panic reactions is best provided after the episode has resolved.