A nurse is providing information to a client about risk factors for developing an anxiety-related disorder. Which of the following clients is at greatest risk for developing an anxiety-related disorder?
A client who has a family history of anxiety disorders and several positive childhood experiences (PCEs)
A client who had multiple adverse childhood experiences and whose parents both have a history of anxiety disorder
A client who has a family history of cancer and is recently unemployed
A client who did not graduate from high school or complete their general education development (GED) test
The Correct Answer is B
Choice A reason: A family history of anxiety disorders increases risk via genetic predisposition (e.g., serotonin transporter gene variants), but positive childhood experiences (PCEs) build resilience, reducing risk. This client has a moderate risk but is less vulnerable than one with adverse experiences and genetic predisposition.
Choice B reason: Multiple adverse childhood experiences (ACEs), like abuse or neglect, elevate anxiety risk by increasing stress hormone dysregulation (e.g., cortisol) and altering brain development (e.g., amygdala hyperactivity). Combined with a parental history of anxiety disorders, indicating genetic risk, this client faces the greatest risk for developing an anxiety-related disorder.
Choice C reason: A family history of cancer and recent unemployment are stressors but not specific risk factors for anxiety disorders. Unemployment may increase stress, but without genetic or trauma-related predispositions, this client’s risk is lower than one with ACEs and family history.
Choice D reason: Not graduating high school or completing a GED may limit opportunities, increasing stress, but is not a direct risk factor for anxiety disorders. Genetic predisposition and adverse childhood experiences have stronger links to anxiety development, making this client less at risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: A dose of 0.2 g (200 mg) requires 2 capsules of 100 mg each, not 3. Administering 3 capsules would deliver 300 mg, exceeding the prescribed dose, potentially causing toxicity due to phenytoin’s narrow therapeutic index, making this choice incorrect.
Choice B reason: “None of the above” is incorrect, as the calculation for 0.2 g (200 mg) divided by 100 mg per capsule yields exactly 2 capsules. A precise dose is possible with the available capsules, so this option does not apply to the scenario.
Choice C reason: Converting 0.2 g to 200 mg and dividing by 100 mg per capsule results in 2 capsules per dose. This matches the prescription exactly, ensuring therapeutic levels of phenytoin, an anticonvulsant, are administered safely, making this the correct choice.
Choice D reason: One 100 mg capsule provides only half the prescribed 0.2 g (200 mg) dose. This underdosing could lead to subtherapeutic phenytoin levels, risking seizures in a patient dependent on this anticonvulsant, making this choice incorrect.
Correct Answer is B
Explanation
Choice A reason: Taking art lessons to relieve stress suggests a healthy coping mechanism, not a substance use disorder. Alcohol use disorder involves impaired functioning, like work performance, not positive activities like art, which indicates adaptive behavior rather than addiction.
Choice B reason: Loss of appetite can indicate alcohol use disorder, as chronic alcohol consumption disrupts appetite-regulating hormones (e.g., ghrelin) and causes gastrointestinal irritation, reducing desire to eat. Combined with work reprimands from drinking, this suggests impaired functioning, a hallmark of substance use disorder.
Choice C reason: Being focused with many goals does not indicate a substance use disorder, which typically impairs concentration and goal-directed behavior due to alcohol’s neurotoxic effects. This statement suggests intact functioning, inconsistent with the negative consequences described in the scenario.
Choice D reason: Having supportive friends is a positive factor, not indicative of substance use disorder. Alcohol use disorder often leads to social isolation or strained relationships, not reliance on a support system, making this statement unrelated to addiction criteria.
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