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Mental Health
Anxiety Disorders
| Question | Answer |
|---|---|
| Individuals with anxiety disorders use rigid, repetitive, and ineffective behaviors to | Try to control anxiety. |
| Anxiety disorders tend to be | persistent and often disabling |
| Major depression and substance abuse are frequently encountered with | anxiety disorders |
| Anxiety disorders tend to cluster in | families |
| Panic disorders are 2-3x more frequent in | women |
| Generalized anxiety disorder is 2x more frequent in | women |
| Phobias are 2x more frequent in | women |
| Social anxiety disorder is _______in prevelance when comparing women and men. | equal |
| OCD is _______in prevalence when comparing women and men. | equal |
| PTSD is more likely to affect | women |
| Abnormalities of the benzodiazepine receptors leading to the unregulated anxiety levels of a patient is what theory? | GABA benzodiazepine theory |
| Studies suggest that a stress response of the hypothalamus-pituitary-adrenal system is abnormal in these individuals. | Patients with PTSD |
| This person taught that anxiety resulted from the threatened breakthrough of repressed ideas or emotions from the unconscious. | Freud |
| Freud suggested that ego defense mechanisms are used by an individual to | keep anxiety at manageble levels |
| This person felt that anxiety experienced early in life becomes the prototype for that experienced when unpleasant events occur later in life. | Sullivan |
| Behavioral psychologists conceptualize anxiety as a | learned response that can be unlearned |
| Cognitive theorists take the position that anxiety disorders are caused by | distortions in an individual's thinking and perceiving. |
| Panic attacks in Latin Americans and Northern Europeans often involve sensations of | Choking, smothering, numbness, or tingling as well as fear of dying. |
| Blusing, eye contact or body is offensive to others in what culture? | Japanese and Korean cultures |
| Minority groups have a much higher rates of | PTSD |
| List the disorders that are considered anxiety disorders: | Panic disorders, Phobias, OCD, GAD, PTSD, acute stress disorder, anxiety due to substance use, anxiety due to medical condition, and anxiety not otherwise specified. |
| The key feature of panic disorder is | the panic attack |
| This anxiety disorder is characcterized by recurrent unexpected panic attacks, about which the individual is persistently concerned. | Panid Disorder without agoraphobia |
| The sudden onset of extreme apprehansion or fear, usually associated with feelings of impending doom. | panic attack |
| People experiencing _____ may believe that they are losing their minds or tare having a heart attack. | panic attack |
| Palpitations, chest pain, breathing difficulties, nausea, feelings of choking, chills, and hot flashes are physical symptoms of | panic attacks |
| Typically panic attacks occur _______ and not in response to stress. | suddenly |
| Intense, excessive anxiety or fear about being in places or situations from which escape might be difficult or embarassing, or which help might not be abailable if a panic attack occured. | agoraphobia |
| Examples of situations that are commonly avoided by clients with agoraphobia are: | Being alone outside; being alone at home; traveling in a car, bus, or airplane; being on a bridge; ridign in an elevator. |
| Avoiding behaviors can be | debilitating and life constricting. |
| Recurrent episodes of panic attacks, and at least one of the attacks has been followed by 1 month of either persisten concern about having the attacks, worry about aconsequences, or significant change in behavior. | Panic Disorder |
| Irrational fear of an object or situation that persists although the person may recognize it as unreasonable. | Phobia |
| Fear of being along in open or public places where escape might be difficult, may not leave home. | agoraphobia |
| Fear of situations where one might be seen and embarrassed or criticized. | Social phobia |
| Fear of a single object, activity, or situation. | Specific phobia |
| In a person with a phobia, anxiety is severe if the object, situation or activity | cannot be avoided |
| Preoccupation with persisten intrusive thoughts, impulses, or images or repetitive behaviors or mental acts that the person feels driven to perform in order to reduce distress or prevent a dreaded event or situation. | OCD |
| With OCD the person knows the obsessions/compulsions are | excessive and unreasonable |
| This anxiety disorder can caus increased distress and is timeconsuming. | OCD |
| Excessice anxiety or worry more days than not over 6 months and an inability to control the worrying. | GAD |
| GAD is anxiety and worry associated with three or more of the following symptoms: | Restlless or keyed up;easily fatigued;difficulty concentrating, mind goes blank;irritability; muscle tension;sleep disturbance. |
| With this anxiety disorder, anxiety or worry or hysical symptoms cause siginificant impairment in social, occupational or other areas of important functioning. | GAD |
| _______ without a history of panic disorder occurs only rarely, and it occurs early in the clients history. | agoraphobia |
| Specific phobias are common and usually do not cause much difficulty because | People can contrive to avoid the feared object. |
| A ritualistic behavior that in individual feels driven to perform in an attempt to reduce anxiety. | compulsion |
| Common obsessions and compulsions are: | Doubt, need to check; sexual imagery or ideation; need for order; violence;germs or dirt. |
| What are the symptoms a person with GAD may exhibit? | Restlessness, fatigue, poor concentration, irritability, tension, sleep disturbance. |
| Examples of worries typical in GAD are: | Inadequacy in interpersonal relationships, job responsibilities, finances, health of family members, household chores, and lateness for appointments. |
| In GAD, decision making is | difficult, owing to poor concentration and dread of making a mistake. |
| Nurses need to teach clients with GAD that there are | effective psychotherapy treatments for this disorder. |
| This disorder is characterized by repeated reexperiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others. | PTSD |
| PTSD symptoms often begin _____ after the trauma. | 3 months |
| Dissociative experiences during which the event is relived and the person behaves as though he or she is experiencing the event at that time. | flashbacks |
| The major features of PTSD are: | Persistant reexperiencing of the trauma, perisitant avoidance of stimuli associated with the trauma, experience of persistent numbness of general responsiveness, persistent symptoms of increased arousal. |
| Difficulty with interpersonal, social, or occupational relationships nearly always accompanies | PTSD |
| This anxiety disorder occurs within 1 month after exposure to a highly traumatic event. | Acute Stress Disorder |
| Acute stress disorder resolves within | 4 weeks |
| This anxiety disorder is characterized by symptoms of anxiety, panic attacks, obsessions, and compulsions that develop with the use of a substance or within a month of stopping use of the substance. | Substance-Induced Anxiety Disorder |
| Chronic PTSD has a duration of ________ or longer. | 3 months |
| Acute stress disorder is no due to | drug/medication or medical condition. |
| Acute stress disorder occurs within _____ of the traumatic event. | 4 weeks |
| In this anxiety disorder, the individual's symptoms of anxiety are a direct physiological result of a medical condition, such as hyperthyroidism, pulmonary embolism, or cardiac dysrhythmias. | Anxiety due to medical condition |
| This anxiety disorder is a diagnosis used for disorders in which anxiety or phobic aboidance predominates but the symptoms do not meet full diagnostic criteria for a specific anxiety disorder. | Anxiety Disorder Not Otherwise Specified |
| People with anxiety disorders rarely need ______ unless they are suicidal or have compulsions causing injury. | hospitalization |
| The main symptoms of anxiety disorders are: | panic attacks, excessive anxiety, severe reactions to stress or trauma, phobias, obsessions, and compulsions. |
| What defense is used by a patient who has a phobia? | displacement |
| What defense is used by a patient who has a compulsion? | undoing |
| What defenses are used by a patient who has an obsession? | reaction-formation and intellectualization |
| What defenses are used by a patient who has PTSD? | Isolation and repression |
| Basic level psychiatric mental health nurses use ________ to assist clients with anxiety disorders to reduce anxiety, enhance coping and communication skills, and intervene in crises. | counseling |
| Advanced nurses use treatment approaches that include: | Cognitive or cognitive behavioral therapy, relaxation training, and the behavioral techniques of modeling, systematic desensitization, flooding, and response prevention. |
| If a patient with anxiety does have to be hospitalized, what features of atherapeutic mileu can be especcially helpful to the patient? | Structure of the daily routine, providing daily activities to promote sharing and cooperation, provide therapeutic interactions, including client in decisions about his or her own care. |
| What self-care activities are most likely to be affected with an anxiety disorder? | Nutrition and fluid intake, personal hygiene and grooming, elimination, and sleep. |
| Weighing anxiety disorder clients frequently is a useful tool for assessing | nutrition |
| Why might maintenanc of skin integrity become a problem for a client with an anxiety disorder? | Excessive washing of the skin. |
| Patients with GAD, PTSD, and acute stress disorder often experience sleep disturbances from | nightmares |
| These intervention include the use of simple relaxation exercises and administration of medications. | Psychobiological Interventions |
| What medications are the first line treatment for anxiety disorders? | SSRI's (antidepressants) |
| Why are SSRI's preferable to the tricyclic antidepressants (TCA's)? | Because they have a more rapid onset of action and fewer problematic side effects. |
| Why are MAOI's reserved for treatment-resistant conditions? | Because of the risk of life-threatening hypertensive crisis if the client does not gollow dietary restrictions (tyramine). |
| Antidepressants have the secondary benefit of treating | comorvid depressive disorders in clients |
| When antidepressant therapy is started, why is it important to start with low doses of SSRI's? | Because of the activating effect, which temporarily increases anxiety symptoms. |
| What may use of an antidepressant do in a client with co-occuring bipolar disorder? | It may cause a manic episode which will require the addition of mood stabilizers or even antipsychotic agents. |
| Use of MAOI's is contraindicated clients with comorbid substance abuse because | There is a risk of hypertensive crisis with the use of stimulant drugs. |
| These drugs are often used to treat the somatic and psychological symptoms of anxiety disorders. | anxiolytic drugs |
| Why are benzodiazepines the most common form of anxiolytic drugs used? | Because they have a quick onset of action. |
| What are the side effects of benzodiazepine? | Sedation, ataxia, and decreased cognitive function,. |
| An alternative anxiolytic drug that does not cause dependence is | Buspirone |
| How long does it take for Buspirone to reach its full effects? | 2-4 weeks |
| What anxiolyic drug would be used for long term treatment? | Buspirone |
| Aside from antidepressants and anyiolytics what are the other classes of medications that may be used to treat anxiety disorders? | Beta blockers, antihistamines, and anticonvulsants. |
| _______ have shown some benefit in management of GAD, SAD, and comorbid depression with SAD or panic disorder. | anticonvulsants |
| Because benzodiazepine is discouraged for patients with comorbid substance dependence, _____ are a safe nonaddictive alternative. | antihistamines |
| Problems that can occur with the use of psychotropic herbs include: | Toxic side effects and herb drug interactions |
| Inhibition of GABA may cause | increased anxiety |
| Among the suggested effective treatments for panic disorder is participation in ______ ______ therapy to gain mastery over panic episodes. | cognitive-behavioral |
| Assisting a client to increase his or her personal judgment of self-worth. | self esteem enhancement |
| The age of onset of most anxiety disorders is | before 40 years |
| Studies of clients with posttraumatic stress disorder suggest that the stress response of what is considered abnormal? | Hypothalamus-pituitary-adrenal system |
| A recurrent, persistent thought or impulse. | obsession |
| Fear and impending doom is a symptom associated with | panic attacks |
| Working with a client to help the client view an occurrence in a more positive light is called | cognitive restructuring |
| The primary purpose of performing a physical examination before beginning treatment for any anxiety disorder is | to determine if the anxiety is of primary or secondary origin |
| The treatment for secondary anxiety is | treatment of the underlying cause. |
| Inability to leave one's home because of avoidance of severe anxiety suggests the anxiety disorder of | panic attacks with agoraphobia |
| Panic attacks in Latin American individuals often involve | fear of dying |
| The nurse caring for a client with a panic attack might anticipate that the psychiatrist would order a stat dose of | a short-acting benzodiazepine |
| The physician orders lorazepam 1 mg po qid for 1 week for a client with generalized anxiety disorder. What should the nurse caution the patient to limit intake of? | caffeine |
| Anxiety disorders often interfere with the usual _________ of clients | role performance |
| Sleep disturbances is a potential problem that should be investigated for a client with | severe obsessive-compulsive disorder |
| What therapeutic intervention can the nurse independently use with a client with anxiety disorder? | modeling |
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