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

Clonazepam and buspironeare commonly used together in the initial management of generalized anxiety disorder (GAD). Clonazepam is a benzodiazepinethat provides rapid relief of anxiety symptoms by enhancing GABA activity, but it carries risks of sedation, dependence, and tolerance. Buspirone is a non-benzodiazepine anxiolyticthat acts as a partial agonist at serotonin 5-HT1A receptors. It has a delayed onset of action, typically requiring 2–4 weeks for full therapeutic effect, and is preferred for long-term management due to its low abuse potentialand lack of sedation.

Rationale for correct answers

3.Clonazepam is used short-termto manage acute anxiety symptoms while waiting for buspirone’s delayed onsetto take effect. This approach minimizes benzodiazepine dependenceand supports transition to safer long-term therapy.

Rationale for incorrect answers

1.Long-term use of clonazepam is discouraged due to risk of tolerance, dependence, and withdrawal. It is not recommended as a sustained therapy alongside buspirone.

2.Buspirone does not cause sedationand is typically taken consistently, not necessarily at night. It lacks the sedative properties of benzodiazepines.

4.Buspirone does not lead to tolerancewith long-term use. It is considered safe for chronic anxiety management without risk of physical dependence.

Take Home Points

• Clonazepam is used short-term for acute anxiety relief while buspirone builds therapeutic effect.
• Buspirone is non-sedating and preferred for long-term GAD management due to low abuse potential.
• Benzodiazepines like clonazepam carry risks of dependence and are not suitable for chronic use.
• Buspirone does not cause tolerance or sedation, making it ideal for sustained anxiety control.

Panic anxietyis 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 perceptionsand 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 anxietyand tracking symptom change are measurableand achievablewithin 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 goalrequiring 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 functioningand 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 functioningand 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.