A nurse is assessing a client with anxiety. When assessing a client with anxiety, the nurse’s questions should be:

Avoided until the anxiety is gone.

Open ended.

Postponed until the client volunteers information.

Specific and direct.

Answer and Explanation

The Correct Answer is D

Anxiety is a physiological and psychological response to perceived stress, involving heightened arousal and activation of the sympathetic nervous system. In clinical states, anxiety can impair concentration, memory, and communication. When anxiety progresses to moderate or severe levels, the client may struggle to focus, process information, or make decisions. The ability to understand and answer complex or abstract questions diminishes as the brain becomes preoccupied with perceived threat or danger. Immediate care in such situations must focus on reducing stimuli and providing structure and clarity.

Rationale for correct answers

D. When anxiety is high, cognitive processing is limited. The brain prioritizes perceived threats, making it harder to understand vague or complex questions. Specific and direct questions help anchor the client in reality and simplify communication, which supports accurate assessment and early de-escalation.

Rationale for incorrect answers

A. Avoiding assessment delays care and fails to address the client's immediate needs. Anxiety may not resolve on its own, and avoidance increases the risk of missing safety threats or escalating symptoms. Prompt, calm, and structured interaction is key.

B. Open-ended questions are ideal for calm, reflective discussion but can overwhelm someone with high anxiety. Such questions require abstract thinking, which is impaired during moderate to severe anxiety states, leading to frustration or withdrawal.

C. Waiting for the client to volunteer information is not therapeutic during anxiety. Clients often become too overwhelmed to initiate communication. This passive approach misses opportunities for support and may compromise safety or rapport.

Take Home Points

In high anxiety, structured, direct communication is essential to reduce overwhelm and gather critical data.
Open-ended questions are better used when anxiety is low or the client is more stable.
Assessment should not be delayed even if anxiety is present; timing and method of questioning matter.
Anxiety should be distinguished from related conditions like acute stress or panic disorder, which may need different interventions.

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Correct Answer is B

Explanation

Generalized anxiety disorder (GAD) is characterized by excessive, uncontrollable worry about multiple aspects of life. Clients often experience physical symptoms such as muscle tension and restlessness. Effective management requires early recognition of anxiety escalation and use of coping strategies before symptoms worsen. Teaching clients to seek help promptly when anxiety increases supports better control and prevents exacerbation. This aligns with Maslow’s hierarchy, emphasizing safety needs through support and assistance.

Rationale for correct answers

B. Learning to obtain assistance when anxiety is increasing is crucial for timely intervention and effective management. It reflects improved insight and promotes safety by preventing escalation.

Rationale for incorrect answers

A. Recognizing signs of elevated mood relates more to mood disorders like bipolar disorder, not GAD, which primarily involves anxiety symptoms.

C. Developing guidelines to manage manipulative peer behavior is unrelated to anxiety management and focuses on external social control rather than internal coping.

D. Facilitating participation in self-care is important but less specific to anxiety management compared to recognizing increasing anxiety and seeking help.

Take Home Points

GAD involves chronic, excessive worry with physical and cognitive symptoms.
Early recognition of anxiety escalation is essential for effective coping.
Seeking assistance when anxiety rises supports safety and symptom control.
Differentiating GAD from mood disorders is important for targeted interventions.

A. Involve the client in a physical activity. B. Offer a distraction such as music. C. Remain with the client. D. Teach the client a relaxation technique.

Correct Answer is C

Explanation

Panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. It often includes palpitations, shortness of breath, and fear of losing control. Symptoms peak within 10 minutes and can mimic life-threatening conditions like myocardial infarction, making prompt assessment critical. During an attack, the ability to process new information is impaired due to heightened autonomic arousal and distorted cognitive processing. The priority is safety, reducing stimulation, and ensuring the client feels secure until the attack subsides.

Rationale for correct answers

C. The nurse’s physical presence helps maintain safety and offers reassurance during a time of intense fear. It supports grounding and helps the client feel less isolated, reducing escalation of symptoms.

Rationale for incorrect answers

A. Physical activity may increase heart rate and respiratory rate, worsening symptoms during a panic attack. It may also be unsafe if the client is disoriented, dizzy, or hyperventilating.

B. While distractions can be helpful after symptoms reduce, during a panic attack, cognitive overload limits the ability to focus. Distractions may be ineffective or confusing in the acute phase.

D. Teaching requires concentration and cognitive engagement, which are compromised during a panic episode. This intervention is better suited for a later stage once the client is calm.

Take Home Points

During a panic attack, safety and presence are the most immediate nursing priorities.
Clients in acute distress cannot learn or process complex information effectively.
Physical activity and distraction are better suited for anxiety prevention, not acute panic.
Panic attacks must be differentiated from life-threatening conditions like cardiac events.

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A nurse is assessing a client with anxiety. When assessing a client with anxiety, the nurse’s questions should be:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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