A nurse on an inpatient mental health unit is assisting with the care of a client who is experiencing panic level anxiety. Which of the following findings should the nurse expect?
Voice tremors
Depersonalization
Shakiness
Poor concentration
The Correct Answer is B
A. Voice tremors are associated with moderate anxiety, where the individual begins to exhibit physical signs of distress but still retains some level of focus. At panic-level anxiety, communication becomes severely impaired, often resulting in unintelligible speech or complete loss of verbal ability.
B. Depersonalization, a dissociative symptom in which individuals feel detached from their own body or reality, is a hallmark of panic-level anxiety. During this state, individuals may experience a sense of unreality, feel as though they are outside their body, or believe that their surroundings are distorted, contributing to a profound sense of fear and disorientation.
C. Shakiness is a physiological response observed in moderate to severe anxiety due to increased autonomic arousal. However, at panic-level anxiety, the body is in a state of extreme crisis, often leading to more severe symptoms such as hyperventilation, loss of motor control, and derealization rather than mere shakiness.
D. Poor concentration is characteristic of moderate to severe anxiety, where cognitive function begins to decline due to excessive worry. However, in panic-level anxiety, cognitive function is severely impaired, and the individual may be unable to process information coherently, often leading to complete disorganization of thought.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Tell the client that there is nothing there. Dismissing the client's perception may increase distress and reduce trust in the nurse-client relationship. A therapeutic approach acknowledges the client’s experience without reinforcing or denying hallucinations.
B. Ask the client to describe what is being seen. Encouraging the client to describe the hallucination helps assess its nature and severity. Understanding the content allows the nurse to provide appropriate support, ensure safety, and guide interventions.
C. Touch the client's arm reassuringly. Touching the client without consent, especially during a distressing hallucination, may escalate fear or agitation. Maintaining a calm and non-threatening presence is more appropriate.
D. Remove the client from the room. Relocating the client without assessing the hallucination may not address the underlying distress. Identifying triggers and using therapeutic communication are more effective initial interventions.
Correct Answer is D
Explanation
A. Diagnosis typically occurs after 40 years of age. Diagnosis typically occurs in late adolescence to early adulthood, not after 40 years of age. While late-onset schizophrenia can occur, it is less common. The disorder usually manifests in the late teens to early 30s, with males often presenting earlier than females.
B. Life expectancy is greater than the general population. Life expectancy is lower than the general population due to factors such as increased risk of suicide, cardiovascular disease, and reduced access to healthcare. The presence of comorbid conditions and lifestyle factors, including smoking and poor diet, further contribute to a shorter lifespan.
C. Co-occurring mental health illnesses are rarely diagnosed. Co-occurring mental health illnesses are frequently diagnosed in individuals with schizophrenia. Conditions such as depression, anxiety disorders, and substance use disorders are common. These comorbidities can complicate treatment and impact overall prognosis.
D. The need for resources increases as the disease progresses into adulthood. The need for resources increases as the disease progresses into adulthood due to worsening functional impairment. Individuals with schizophrenia often require long-term support, including medication management, social services, and rehabilitation programs to maintain stability and quality of life.
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