a nurse is caring for a client who has been diagnosed with generalized anxiety disorder the client states i cant stop worrying about my job my family

ATI RN

ATI Mental Health Practice B

1. A client has been diagnosed with generalized anxiety disorder and expresses worrying about their job, family, and health, feeling a loss of control. What should the nurse do first?

A. Administer a prescribed antianxiety medication.
B. Encourage the client to attend a support group.
C. Identify triggers of the client's anxiety.
D. Teach the client deep breathing techniques.

Correct answer: D

Rationale: The initial step for the nurse is to teach the client deep breathing techniques to aid in managing anxiety symptoms. Deep breathing exercises can help the client relax, reduce anxiety levels, and regain a sense of control. This intervention is non-invasive, empowering the client to develop a coping strategy for immediate use when feeling overwhelmed by anxiety. Administering medication (Choice A) should not be the first action unless the client is in severe distress. Encouraging attendance at a support group (Choice B) and identifying triggers of anxiety (Choice C) are important but teaching coping strategies like deep breathing comes first to help the client feel more in control of managing their anxiety.

2. Which statement indicates an understanding of the DSM-5 diagnosis?

A. The DSM-5 includes information on cultural considerations.
B. The DSM-5 is a tool for healthcare providers.
C. The DSM-5 is not used for legal purposes.
D. The DSM-5 includes information on the prevalence of mental disorders.

Correct answer: A

Rationale: Option A is the correct answer as the DSM-5 not only provides specific criteria for diagnosing mental disorders but also includes information on cultural considerations. Understanding cultural factors is crucial in making accurate diagnoses and providing appropriate care, highlighting the comprehensive nature of the DSM-5 for healthcare providers. Choices B, C, and D are incorrect because while the DSM-5 is indeed a tool for healthcare providers, it is also used in legal settings, and it focuses on diagnostic criteria and not just the prevalence of mental disorders.

3. A client with schizophrenia is experiencing delusions. Which of the following interventions should the nurse implement?

A. Agree with the client's delusions to avoid confrontation.
B. Challenge the client's delusions directly.
C. Encourage the client to discuss their delusions in detail.
D. Present reality and offer reassurance without reinforcing the delusions.

Correct answer: D

Rationale: When caring for a client with schizophrenia experiencing delusions, the nurse should present reality and offer reassurance without reinforcing the client's delusions. This approach helps the client maintain a connection to reality while feeling supported. Agreeing with the delusions may perpetuate false beliefs, while directly challenging them can lead to increased distress for the client. Encouraging the client to discuss their delusions in detail may further exacerbate their symptoms or reinforce their false beliefs. Therefore, the most therapeutic intervention is to gently present reality and provide reassurance to the client.

4. Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select one that doesn't apply.

A. Monitor the patient's vital signs frequently.
B. Keep the patient distracted with group-oriented activities.
C. Provide the patient with frequent milkshakes and protein drinks.
D. Reduce the volume on the television and dim bright lights in the environment.

Correct answer: B

Rationale: When caring for a patient demonstrating manic behavior, it is crucial to monitor vital signs frequently to ensure the patient's physical health is stable. Providing nutrition, such as milkshakes and protein drinks, is essential to meet the patient's dietary needs. Diminishing environmental stimuli by reducing the volume on the television and dimming bright lights can help create a calmer environment. However, keeping the patient distracted with group-oriented activities may not be the most appropriate intervention as it could potentially exacerbate the manic behavior by overstimulating the patient. Therefore, this choice is the one that doesn't apply in managing manic behavior effectively.

5. Which statement demonstrates a well-structured attempt at limit setting?

A. Hitting me when you are angry is unacceptable.
B. I expect you to behave yourself during dinner.
C. Come here, right now!
D. Good boys don't bite.

Correct answer: A

Rationale: Choice A, 'Hitting me when you are angry is unacceptable,' demonstrates a well-structured attempt at limit setting because it clearly defines the unacceptable behavior without ambiguity. This statement sets a clear boundary and clearly communicates the consequence for the behavior. In contrast, choices B, C, and D are less effective in setting limits as they are either vague expectations or commands without specific consequences for crossing the limit.