A 32-year-old patient arrives at the emergency department complaining of palpitations, shortness of breath, and chest pain. The patient reports feeling a sense of impending doom for the past hour. The nurse assesses the patient and notes diaphoresis and trembling. Vital signs reveal tachycardia and elevated blood pressure. Which assessment finding supports the nurse’s suspicion of acute anxiety?
A. Bradycardia
B. Hypotension
C. Increased respiratory rate
D. Constricted pupils
E. Cool and clammy skin
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Rationale: In acute anxiety, the sympathetic nervous system is activated, leading to increased respiratory rate due to hyperventilation. This response aims to take in more oxygen and expel carbon dioxide, preparing the body for a fight-or-flight response. The other options, such as bradycardia, hypotension, constricted pupils, or cool/clammy skin, are not typically associated with acute anxiety.
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A 25-year-old client diagnosed with generalized anxiety disorder (GAD) seeks guidance on coping mechanisms. The nurse suggests progressive muscle relaxation. Which rationale best explains the benefit of this technique for managing anxiety?
A. Decreases blood pressure
B. Reduces muscle tension
C. Slows down heart rate
D. Enhances cognitive function
E. Increases adrenaline secretion
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Rationale: Progressive muscle relaxation involves systematically tensing and relaxing muscle groups, reducing physical tension associated with anxiety. While anxiety can impact blood pressure, heart rate, and cognitive function, the primary benefit of this technique is the direct reduction of muscle tension, contributing to overall relaxation.
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A 40-year-old patient is prescribed buspirone for the management of anxiety. The nurse educates the patient on the medication’s action. What teaching point should the nurse include about the mechanism of action of buspirone?
A. Increases GABA levels in the brain
B. Blocks dopamine receptors
C. Stimulates serotonin release
D. Antagonizes beta-adrenergic receptors
E. Modulates glutamate receptors
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Rationale: Buspirone acts as a partial agonist at serotonin receptors, specifically 5-HT1A receptors, leading to an increase in serotonin release. This mechanism differs from medications that directly impact GABA, dopamine, beta-adrenergic, or glutamate receptors. Understanding the specific action of buspirone is crucial for patient education and understanding its therapeutic effects.
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A 28-year-old client with a history of panic disorder arrives at the clinic, reporting frequent panic attacks. During the assessment, the nurse observes the client clutching their chest, hyperventilating, and expressing fear of impending death. The nurse recognizes the client’s symptoms as consistent with a panic attack. Which neurotransmitter is primarily implicated in the pathophysiology of panic disorder?
A. Dopamine
B. Serotonin
C. Norepinephrine
D. Acetylcholine
E. Gamma-aminobutyric acid (GABA)
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Rationale: Panic disorder involves dysregulation in the noradrenergic system, leading to increased release and sensitivity to norepinephrine. This hyperactivity contributes to the physiological manifestations observed during panic attacks. While serotonin and GABA abnormalities are also associated with anxiety disorders, norepinephrine plays a more prominent role in panic disorder.
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NCLEX Practice Questions: Understanding Anxiety Causes and Symptoms
A 40-year-old client is prescribed lorazepam for acute anxiety. The nurse provides education regarding the medication. What should the nurse emphasize about the administration of lorazepam to manage acute anxiety?
A.Take with food to enhance absorption
B. Administer on an empty stomach for rapid effect
C. Avoid driving or operating heavy machinery
D. Expect peak effect in 30 minutes
E. Combine with alcohol for enhanced efficacy
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Rationale: Lorazepam is a benzodiazepine used for acute anxiety; however, it can cause sedation and impair motor skills. Patients should be advised to avoid activities requiring mental alertness, such as driving or operating machinery, to prevent accidents. The medication is usually absorbed well regardless of food intake, has a rapid onset (not necessarily 30 minutes), and should never be combined with alcohol due to increased CNS depression risk.
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A 50-year-old client diagnosed with post-traumatic stress disorder (PTSD) experiences flashbacks and nightmares related to a traumatic event. The nurse plans interventions to assist in reducing the client’s symptoms. Which therapeutic approach is most appropriate for managing PTSD flashbacks and nightmares?
A. Cognitive-behavioral therapy (CBT)
B. Eye movement desensitization and reprocessing (EMDR)
C. Psychodynamic therapy
D. Dialectical behavior therapy (DBT)
E. Solution-focused therapy
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Rationale: EMDR is a specialized therapy recommended for managing PTSD symptoms, including flashbacks and nightmares. This therapy involves a structured approach using bilateral stimulation (eye movements, tapping) to help the client process traumatic memories. While other therapies might have some efficacy, EMDR is specifically designed for PTSD symptom management.
Understanding Anxiety: NCLEX Priority Questions
A 35-year-old client is receiving paroxetine for the treatment of generalized anxiety disorder (GAD). The nurse monitors the client for potential side effects of the medication. Which common side effect should the nurse prioritize when assessing this client?
A. Weight gain
B. Hypotension
C. Insomnia
D. Bradycardia
E. Diarrhea
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Rationale: Paroxetine, a selective serotonin reuptake inhibitor (SSRI), commonly causes gastrointestinal disturbances such as diarrhea, nausea, or vomiting. While SSRIs can also lead to weight changes, insomnia, or even sexual dysfunction, diarrhea is a more immediate concern due to its potential to cause dehydration and electrolyte imbalances.
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NCLEX Questions: Focus on Medications for Anxiety
A 22-year-old college student visits the campus health clinic reporting persistent feelings of restlessness, difficulty concentrating, and muscle tension for the past six months. The student mentions being constantly on edge and worries about academic performance. The nurse suspects generalized anxiety disorder (GAD). Which neurotransmitter imbalance is often associated with the pathophysiology of GAD?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Glutamate
E. Gamma-aminobutyric acid (GABA)
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Rationale: GAD is often linked to a deficiency in GABA, the primary inhibitory neurotransmitter in the brain. Decreased GABA levels contribute to increased neuronal excitability, leading to symptoms of anxiety, restlessness, and muscle tension. While other neurotransmitters like serotonin are implicated in anxiety disorders, GABA dysregulation is particularly associated with GAD.
NCLEX Focus Exploring Anxiety: Causes and Diagnosis
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A 45-year-old client with a history of panic attacks is receiving cognitive-behavioral therapy (CBT). During a session, the client describes an overwhelming fear of enclosed spaces and expresses difficulty in coping with crowded elevators. Which CBT technique is most appropriate for addressing this specific phobia?
A. Exposure therapy
B. Mindfulness-based stress reduction
C. Dialectical behavior therapy
D. Relaxation techniques
E. Assertiveness training
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Rationale: Exposure therapy, a cornerstone of CBT, involves gradually exposing the individual to feared situations or stimuli. In the case of the client’s fear of enclosed spaces, exposure therapy would involve systematically and progressively confronting these situations to reduce fear and anxiety responses. While other CBT techniques may be beneficial for anxiety management, exposure therapy is specifically designed to address phobias.
NCLEX Questions Critical Thinking: Anxiety Symptoms
A 30-year-old client is prescribed venlafaxine for the management of social anxiety disorder. The nurse provides education regarding the medication. What should the nurse emphasize about the mechanism of action of venlafaxine for treating anxiety?
A. Increases dopamine release
B. Blocks serotonin receptors
C. Inhibits norepinephrine reuptake
D. Enhances GABA activity
E. Modulates glutamate receptors
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NCLEX Review: Anxiety Treatments
Rationale: Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that primarily inhibits the reuptake of serotonin and norepinephrine. By preventing their reuptake, it increases the availability of these neurotransmitters in the synaptic space, thereby modulating mood and reducing anxiety. Understanding the specific action of venlafaxine helps in educating the client about the medication’s therapeutic effects.
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