Which client would the charge nurse assign to an agency nurse who is new to a psychiatric setting?

Generalized anxiety disorder (GAD)is a chronic psychiatric condition marked by excessive, uncontrollable worry occurring more days than not for at least 6 months. It involves both psychological distressand somatic symptomssuch as restlessness, fatigue, and muscle tension. Management includes pharmacologic and non-pharmacologic interventions, with emphasis on early recognitionof symptom escalation and implementation of coping strategies to prevent functional impairment.

Rationale for correct answers

2.Learning to obtain assistance when anxiety increases reflects insight and self-monitoring, which are essential for relapse prevention. It promotes adaptive copingand timely intervention before symptoms escalate.

Rationale for incorrect answers

1.Recognizing signs of elevated mood is relevant to bipolar disorder, not GAD. GAD is characterized by persistent worry, not mood elevation or pressured speech.

3.Decreasing manipulative peer behavior is unrelated to GAD. This goal aligns more with personality disorders or conduct-related interventions.

4.Facilitating self-care participation is more applicable to depressive disordersor severe psychosis where motivation and functioning are impaired. GAD clients typically maintain self-care but struggle with excessive worry.

Take Home Points

• GAD clients benefit from learning to recognize symptom escalation and seek support proactively.
• Elevated mood and pressured speech are features of bipolar disorder, not GAD.
• Goals should align with the client’s diagnosis and functional challenges specific to anxiety.
• Self-care deficits are not primary in GAD unless comorbid depression is present.

Algophobiais an irrational and persistent fear of pain that may lead to avoidance behaviors and heightened anxiety. It is classified under specific phobias and typically does not involve acute psychiatric instability. Clients with algophobia are often cognitively intact and oriented, and their care focuses on gradual exposure therapy, reassurance, and anxiety-reducing techniques. Unlike disorders with active psychosis or medication initiation, algophobia rarely requires complex psychiatric interventions

Rationale for correct answers

3.Stable conditionand low riskmake this client appropriate for a nurse new to psychiatric care. The client has been admitted for several days, reducing the likelihood of unpredictable behavior or urgent needs. Care involves routine monitoring and supportive communication.

Rationale for incorrect answers

1.Flashbacksin posttraumatic stress disorder may involve dissociation, aggression, or re-experiencing trauma. These episodes require skilled de-escalation techniques and familiarity with trauma-informed care, which may overwhelm a new psychiatric nurse.

2.Initiating benzodiazepinesrequires close monitoring for sedation, paradoxical reactions, and respiratory depression. A newly admitted client also presents with unknown behavioral patterns, increasing the complexity of care.

4.Obsessive-compulsive disorderoften involves compulsions that interfere with daily functioning. A newly admitted client may exhibit rituals, anxiety, or resistance to care, requiring experienced psychiatric assessment and intervention strategies.

Take Home Points

• Algophobia is a specific phobia characterized by fear of pain, typically managed with reassurance and exposure therapy.
• Clients with PTSD experiencing flashbacks may require trauma-informed care and advanced psychiatric skills.
• Benzodiazepine initiation demands close monitoring for adverse effects and behavioral changes.
• Newly admitted psychiatric clients often present with unpredictable symptoms requiring experienced nursing judgment.