Which of the following symptom assessments would validate the diagnosis of generalized anxiety disorder? Select all that apply.

Excessive worry about items difficult to control.

Muscle tension.

Hypersomnia.

Excessive amounts of energy.

Feeling “keyed up” or “on edge.”

Answer and Explanation

Correct Answer : A,B,E

Generalized anxiety disorder is a chronic psychiatric condition marked by excessive worry, muscle tension, and autonomic hyperarousal. According to DSM-5, symptoms must persist for at least six months and include difficulty controlling worry, restlessness, fatigue, irritability, sleep disturbance, and somatic complaints. Feeling “keyed up” or “on edge” reflects persistent sympathetic activation. Muscle tension is a hallmark physical symptom. Hypersomnia and excessive energy are not typical features and may suggest alternative diagnoses like depression or bipolar disorder.

Rationale for correct answers

1. Excessive worry is the core diagnostic feature of generalized anxiety disorder. It must be present most days for at least six months and be difficult to control.

2. Muscle tension is one of the six DSM-5 physical symptoms used to validate the diagnosis. It reflects chronic somatic arousal and is commonly reported.

5. Feeling “keyed up” or “on edge” indicates autonomic hyperactivity and is part of the DSM-5 criteria. It reflects the persistent restlessness and arousal seen in GAD.

Rationale for incorrect answers

3. Hypersomnia is more characteristic of depressive disorders. GAD typically presents with insomnia or restless, unsatisfying sleep.

4. Excessive energy is not a symptom of GAD. It may suggest manic or hypomanic episodes seen in bipolar spectrum disorders.

Take Home Points

Generalized anxiety disorder requires excessive, uncontrollable worry lasting at least six months.
DSM-5 criteria include restlessness, fatigue, irritability, muscle tension, sleep disturbance, and difficulty concentrating.
Feeling “keyed up” and muscle tension are hallmark signs of autonomic arousal in GAD.

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Correct Answer is B

Explanation

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.

A. Long-term treatment of posttraumatic stress disorder, convulsive disorder, and alcohol withdrawal. B. Short-term treatment of generalized anxiety disorder, alcohol withdrawal, and preoperative sedation. C. Short-term treatment of obsessive-compulsive disorder, skeletal muscle spasms, and essential hypertension. D. Long-term treatment of panic disorder, alcohol dependence, and bipolar affective disorder: manic episode.

Correct Answer is B

Explanation

Benzodiazepinesare central nervous system depressants that enhance the effect of gamma-aminobutyric acid (GABA), producing sedative, anxiolytic, anticonvulsant, and muscle relaxant effects. They are indicated for short-termmanagement of anxiety, alcohol withdrawal, and procedural sedation. Long-term use is discouraged due to risks of dependence, tolerance, and cognitive impairment. Common side effects include drowsiness, confusion, and respiratory depression. Contraindications include sleep apnea, substance use disorders, and concurrent use with opioids or alcohol due to synergistic CNS depression.

Rationale for correct answers

2.Benzodiazepines are appropriate for short-term treatment of generalized anxiety disorder, alcohol withdrawal, and preoperative sedationdue to their rapid onset and calming effects. These uses align with their pharmacologic profile and safety guidelines for limited duration.

Rationale for incorrect answers

1.Long-term use for PTSD and convulsive disorders is discouraged due to risk of dependenceand tolerance. While benzodiazepines may be used acutely in alcohol withdrawal, chronic use is not recommended.

3.Benzodiazepines are not first-line for obsessive-compulsive disorder or essential hypertension. They may relieve muscle spasms but are not indicated for long-termmanagement of these conditions.

4.Long-term treatment of panic disorder and bipolar mania with benzodiazepines is not standard due to risk of addiction. Alcohol dependence requires structured withdrawal protocols, not maintenance benzodiazepine therapy.

Take Home Points

Benzodiazepines are best suited for short-term use in anxiety, alcohol withdrawal, and procedural sedation.
Long-term use increases risk of dependence, tolerance, and cognitive decline.
They are contraindicated in patients with substance use disorders or respiratory compromise.
SSRIs and other non-addictive agents are preferred for chronic anxiety and mood disorders.

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Which of the following symptom assessments would validate the diagnosis of generalized anxiety disorder? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with generalized anxiety disorder has a nursing diagnosis of panic anxiety related to altered perceptions. Which of the following short-term outcomes is most appropriate for this client?

Correct Answer is B

Explanation

In which situation would benzodiazepines be prescribed appropriately?

Correct Answer is B

Explanation

A nurse is admitting a client diagnosed with generalized anxiety disorder. During the client’s assessment, the nurse determines that which findings would be consistent with generalized anxiety disorder? Select all that apply.

A client diagnosed with generalized anxiety disorder is getting ready for discharge. Which statement evaluates the client’s cognitive response to nursing interventions?

A client recently diagnosed with generalized anxiety disorder is prescribed clonazepam (Klonopin), buspirone (BuSpar), and citalopram (Celexa). Which assessment related to the concurrent use of these medications is most important?

During an assessment, a client diagnosed with generalized anxiety disorder rates anxiety as 9/10 and states, “I have thought about suicide because nothing ever seems to work out for me.” Based on this information, which nursing diagnosis takes priority?

Which assessment information would be evaluated as objective data?

After a nurse teaches a client with generalized anxiety disorder some strategies for coping with stressors, another goal for the client would be to:

A client with a history of generalized anxiety disorder enters the emergency department complaining of restlessness, irritability, and exhaustion. Vital signs are blood pressure 140/90 mm Hg, pulse 96, and respirations 20. Based on this assessed information, which assumption would be correct?

The nurse has received an evening report. Which client would the nurse need to assess first?