a nurse is assessing a client who is experiencing severe anxiety which symptom should the nurse expect to observe
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Nursing Elites

ATI RN

ATI Mental Health Proctored Exam 2019

1. When assessing a client experiencing severe anxiety, which symptom should the nurse expect to observe?

Correct answer: B

Rationale: When a client is experiencing severe anxiety, a rapid heart rate is a common physiological response. This increased heart rate is due to the body's fight-or-flight response, where adrenaline is released, causing the heart to beat faster. Monitoring the client's heart rate is crucial in assessing and managing their anxiety. Restlessness (choice A) can also be present in anxiety but is more of a behavioral manifestation rather than a physiological symptom. Sweating (choice C) can occur in anxiety, but it is not as specific or consistent as a rapid heart rate. Dry mouth (choice D) is associated with anxiety but is not as immediate or directly linked to the body's physiological response to stress as a rapid heart rate.

2. When assessing a client with bipolar disorder who is experiencing a depressive episode, which of the following findings should the nurse not expect?

Correct answer: D

Rationale: In a client experiencing a depressive episode in bipolar disorder, common findings include low energy, feelings of hopelessness, insomnia or hypersomnia, and decreased appetite. Difficulty concentrating is more indicative of attention deficit disorders or cognitive impairment rather than a typical presentation of a depressive episode in bipolar disorder.

3. A client with generalized anxiety disorder is prescribed buspirone (Buspar). Which statement by the client indicates a need for further teaching?

Correct answer: B

Rationale: The correct answer is B. Clients should not stop taking buspirone (Buspar) abruptly as it may cause withdrawal symptoms. Choice A is correct as buspirone can cause dizziness and drowsiness, so avoiding driving is important. Choice C is also accurate because buspirone may take several weeks to reach its full effectiveness. Choice D is valid as buspirone is not recommended during pregnancy due to potential risks to the fetus.

4. When an individual's stress response is sustained over a long period of time, which physiological effect of the endocrine system should one anticipate?

Correct answer: A

Rationale: When stress is prolonged, the body reaches the stage of exhaustion in the general adaptation syndrome, where compensatory mechanisms fail, and diseases of adaptation may occur. One physiological effect includes a decreased immune response, leading to decreased resistance to disease. Therefore, the correct answer is A. Increased libido (choice B) is not a typical physiological effect related to prolonged stress. Decreased blood pressure (choice C) is not commonly associated with sustained stress. Increased inflammatory response (choice D) may occur in the short term due to stress, but over a prolonged period, the immune system's function weakens, leading to decreased resistance to disease.

5. A client with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

Correct answer: A

Rationale: In cognitive-behavioral therapy, identifying and challenging negative thoughts is a fundamental aspect of the treatment process. This cognitive restructuring helps individuals with major depressive disorder to develop healthier thinking patterns and cope more effectively with their emotions, which ultimately leads to improvement in their mental health. Therefore, when a client is able to identify and challenge negative thoughts, it indicates that they are actively engaging in the therapeutic process and making progress towards better mental well-being.

Similar Questions

A healthcare provider is assessing a client with suspected post-traumatic stress disorder (PTSD). Which of the following findings should the provider expect? Select one that does not apply.
A client has been diagnosed with generalized anxiety disorder. Which of the following findings should the nurse expect?
When caring for a client with major depressive disorder, what is the most appropriate short-term goal for the client?
Which of the following is a hallmark symptom of generalized anxiety disorder (GAD)?
Which should the individual recognize as an example of the defense mechanism of repression?

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