Anxiety Disorder NCLEX Questions 11-20

The following are anxiety disorder NCLEX questions

Situation: F. the nurse-manager in the cardiac clinic, notes that many patients seem confused and overwhelmed by the number of medications prescribed for their heart conditions. She suggests implementing medication management groups. The idea is well received by the treatment team. Anxiety Disorder NCLEX Questions are:

11. F. should begin planning for the groups by carefully assessing:

a) the nature of the problems that patients are having with their medications
b) which patients would be interested in joining such a group
c) which staff members are prepared to be leaders or co-leaders of the groups
d) the best time of day to offer such groups

12. F. consults the hospital's clinical nurse specialist in psychiatric nursing about group size. The nurse specialist will most likely say that the optimal number of patients in each group is:

a) 5
b) 10
c) 20
d) unlimited

13. The nurse specialist recommends forming three medication management groups with F. as leader and another nurse as co-leader. Each group meets once a week for 30 minutes in 4 week cycles. What is the best approach to establishing membership in each group?

a) require all cardiac clinic patients to attend
b) assign patients to groups that are offered on their clinic visit days
c) permit patients to join any group or attend any session
d) screen patients, and explain the group's goals and purposes to them

14. Anxiety Disorder NCLEX Questions: F. and her co-leader plan to meet weekly with the clinical nurse specialist for supervision and review of group progress. To facilitate these sessions, the nurse specialist should:

a) ask the leader and co-leader to keep a log or journal of each group session
b) review each group member's chart weekly
c) ask the patients how they feel about the group and its progress
d) meet with the leader and co-leader separately for supervision

15. During the group sessions, F. identifies several patients who demonstrate anxiety, ineffective coping, and hopelessness related to the impact of adjusting to serious cardiac illness. The most beneficial form of group therapy for these patients is likely to be led by:

a) F. and another nurse
b) a psychiatric clinical nurse specialist
c) a cardiology resident
d) other cardiac patients who have coped successfully with similar problems

Anxiety Disorder NCLEX Questions Situation: T., a 44 year old married woman with one son, was referred to the mental health clinic by her family physician after he ruled out any physical basis for her complaints of insomnia, anxiety, fatigue, and loss of interest in her usual activities. On arrival at the clinic, T. sates that her symptoms have increased over the last few weeks to the point that she feels "too tired" most of the time to take care o her home or leave the house.

16. During the initial assessment, the nurse suspects that T. may be having a situational crisis. Which question is most effective in beginning to explore this possibility?

a) what has changed in your life recently?
b) do you think your symptoms are related to a recent event in your life
c) what do you think is causing your symptoms
d) tell me all about yourself

17. T. relates that her father died 7 years ago and that her mother is extremely lonely and misses her father very much. While listening to T., the nurse should further assess for:

a) the patient's feelings about her mother
b) the patient's feelings about her father
c) any recent losses in the patient's life
d) the patient's relationships with relatives and friends

18. Anxiety Disorder NCLEX Questions: During the assessment interview, T. reveals that her only son moved to another state 2 months ago and that her husband has been traveling frequently on business lately. The nurse inquires about the patient's close relatives and friends. These inquiries should be directed at:

a) encouraging the patient to form closer relationships with others to replace those with her son and husband
b) identifying the patient's available support systems
c) helping the patient to realize she is not alone
d) helping the patient to develop new coping mechanisms

19. The treatment team determines that T. is in a situational crisis. Which nursing diagnostic category is most applicable at this time?

a) dysfunctional grieving
b) altered thought processes
c) adjustment disorder
d) ineffective individual coping

20. All of the following therapeutic approaches are appropriate for counseling T. except:

a) ventilation
b) clarification
c) support of defense
d) interpretation




Anxiety Disorder NCLEX Questions
ANSWERS AND RATIONALE

11) A

- when planning groups, the nurse must begin by assessing the patient's needs and resources. Ascertaining the nature of the patient's medication problem is crucial. Once this is accomplished, the nurse can select the leaders and co-leaders who are best able to meet the identified patient needs. Establishing the level of patient interest in a group and determining the best time to meet are part of later planning.

12) B
- Anxiety Disorder NCLEX Questions Rationale: although there is no hard and fast agreement, 10 patients usually is considered an ideal size for therapeutic group. A group of this size permits opportunities for maximum therapeutic exchange and participation. With 5 or fewer members, participation often is inhibited by self-consciousness. In groups or more than 15 members, overall participation may be inhibited by the formation of smaller patient subgroups. Permitting an unlimited number of members in a group is unwise. Part of the therapeutic benefit is lost if there is no consistency of membership or if the group becomes too large to permit therapeutic interaction.

13) D
- group leaders should meet before the group sessions to screen and orient prospective members. At this time, the leader can determine a patient's appropriateness for the group -- for example, a patient with a serious hearing problem may benefit more from an individual approach. The screening period also provides the leaders with an opportunity to explain the purpose and goals of the group and to clarify patient expectations. Requiring or assigning patients to groups limits their participation in treatment planning and may result in inappropriate group membership that could be non-therapeutic for other patients. Because consistent group membership encourages attainment of the therapeutic goals, planned patient selection is important.

14) A
- Anxiety Disorder NCLEX Questions Rationale: using a log or journal to follow and review group progress is an important supervisory aid. The log should document group themes, individual patient responses. and interventions and their effect. The co-leader can keep the log during the group meeting or write it as soon as possible after the session ends. The leaders and supervisor can use the log to review group progress and to analyze interventions and strategies. (Other effective methods of tracking group sessions include audiotaping, audiovisual recording, and inviting outsiders to record their observations; however, these methods usually require the patient's consent.) Although patient's records and interviews are useful part of the group's overall evaluation and effectiveness, they are not helpful in reviewing group progress during supervisory sessions; supervisory sessions should focus on the group leaders and their feelings about the progress of sessions. Having the leader and co-leader attend supervisory sessions together allows them to discuss their perceptions of events and enables the supervisor to pursue conflicting statements while the leaders are together.

15) B
- the psychiatric clinical nurse specialist is an appropriate leader for group therapy with cardiac patients who demonstrate anxiety, ineffective individual coping, and hopelessness. A psychiatric clinical nurse specialist with a master's degree who has been supervised in group therapy has the knowledge and experience necessary for this level of nursing intervention. F., as nurse-manager, might be asked to participate as a co-leader but does not have the expertise to lead on her own. A cardiology resident has expertise in medical management but not in group therapy. After the patients have been assisted to develop more effective coping skills, a self-help group composed of other cardiac patients is a means of maintaining these skills.

16) A
- Anxiety Disorder NCLEX Questions Rationale: crisis intervention focuses on identifying and solving the patient's immediate presenting problem. By asking about recent changes in the patient's life, the nurse tries to identify factors related to the problem. It is too early in the therapeutic relationship to ask the patient to link her present symptoms to recent life changes. Such analysis needs further exploration and should be based on trust established in the nurse-patient relationship. Because the patient is seeking an answer to her problem, asking her to identify what is causing the symptoms is not helpful. Complete diagnostic assessments typically include extensive explorations of the past and are not done in crisis intervention.

17) C
- identifying underlying themes is an important part of the assessment process in crisis intervention. In this situation, the nurse identifies a theme of loss or abandonment and seeks further clues to recent losses that may have activated the patient's anxiety. The patient's feelings about her mother and father are less important than recent events and her response to them. Once the stressors and the patient's needs are identified, the nurse can assist the patient in identifying positive relationships with friends and relatives.

18) B
- Anxiety Disorder NCLEX Questions Rationale: during a crisis, a patient typically has difficulty dealing realistically with events, plans, and decisions. Identifying available support networks is an essential part of crisis intervention. The nurse tries to foster adaptive coping and encourage the use of available support systems to help the patient reestablish equilibrium. The nurse should never imply that relationships are replaceable, which belittles the patient's feelings. The nurse may find that the patient has no readily available support system. In this case, the nurse should direct the patient to a crisis group that can provide the needed support. Developing new coping mechanisms is not a primary goal of crisis intervention, which focuses on short-term solutions and is directed toward supporting previous healthy coping mechanisms. Some patients, however, do develop new coping mechanisms in times of crisis.

19) D
- Anxiety Disorder NCLEX Questions Rationale: the most appropriate nursing diagnostic category for T. is Ineffective individual coping. In a crisis, a patient's coping skills are compromised or overwhelmed and become ineffective; equilibrium is typically upset by external events, such as T.'s son moving away and her husband's increased travel. Because the onset of symptoms is clearly related to these events and not to her father's death, the nursing diagnostic category of Dysfunctional grieving is unsupported. No evidence supports the diagnostic category of Altered thought processes, and Adjustment disorder is a medical diagnosis, not a nursing diagnostic category.

20) D
- the therapeutic technique of interpretation rarely is used in crisis counseling. Interpretation, which is directed at helping a patient link unconscious factors with present behaviors, is more appropriate in long-term therapy. Ventilation encourages the patient to talk about pent-up feelings to relieve tension. Clarification, a process of verbalizing relationships between events, helps the patient link events in a crisis and understand their relationship; if the patient cannot see the relationships, the nurse may need to point them out. Crisis intervention seeks to support healthy, adaptive defenses rather than develop new ones.


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Anxiety Disorder NCLEX Questions 1-10


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Anxiety Disorder NCLEX Questions 21-30

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Depression NCLEX Questions 1-10

Accomplish this 5-item Depression NCLEX Questions and do good in your NCLEX!

1. The home health nurse visits a client at home and determines that the client is dependent on drugs. During the assessment, which action should the nurse take to plan appropriate nursing care?

a) Ask the client why he started taking illegal drugs.
b) Ask the client about the amount of drug use and its effect.
c) Ask the client how long he thought that he could take drugs without someone finding out.
d) Not ask any questions for fear that the client is in denial and will throw the nurse out of the home. 

2. Depression NCLEX Questions about which interventions are most appropriate for caring for a client in alcohol withdrawal? Select all that apply.

a) Monitor vital signs.
b) Maintain NPO status.
c) Provide a safe environment.
d) Address hallucinations therapeutically.
e) Provide stimulation in the environment.
f) Provide reality orientation as appropriate.

3. The nurse determines that the wife of an alcoholic client is benefiting from attending an Al-Anon group if the nurse hears the wife make which statement?

a) “I no longer feel that I deserve the beatings my husband inflicts on me.”
b) “My attendance at the meetings has helped me to see that I provoke my husband’s violence.”
c) “I enjoy attending the meetings because they get me out of the house and away from my husband.” d) “I can tolerate my husband’s destructive behaviors now that I know they are common with alcoholics.”

4. Depression NCLEX Questions about a hospitalized client with a history of alcohol abuse tells the nurse, “I am leaving now. I have to go. I don’t want any more treatment. I have things that I have to do right away.” The client has not been discharged and is scheduled for an important diagnostic test to be performed in 1 hour. After the nurse discusses the client’s concerns with the client, the client dresses and begins to walk out of the hospital room. What action should the nurse take?

a) Call the nursing supervisor.
b) Call security to block all exit areas.
c) Restrain the client until the health care provider (HCP) can be reached.
d) Tell the client that the client cannot return to this hospital again if the client leaves now.

5. The nurse is preparing to perform an admission assessment on a client with a diagnosis of bulimia nervosa. Which assessment findings does the nurse expect to note? Select all that apply.

a) Dental decay
b) Moist oily skin
c) Loss of tooth enamel
d) Electrolyte imbalances
e) Body weight well below ideal range

6. Depression NCLEX Questions about which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal?

a) The adolescent gives away a DVD and a cherished autographed picture of a performer.
b) The adolescent runs out of the therapy group, swearing at the group leader, and runs to her room.
c) The adolescent becomes angry while speaking on the telephone and slams down the receiver.
d) The adolescent gets angry with her roommate when the roommate borrows the client’s clothes without asking.

7. The police arrive at the emergency department with a client who has lacerated both wrists. What is the initial nursing action?

a) Administer an antianxiety agent.
b) Examine and treat the wound sites.
c) Secure and record a detailed history.
d) Encourage and assist the client to ventilate feelings.

8. Depression NCLEX Questions about a moderately depressed client who was hospitalized 2 days ago suddenly begins smiling and reporting that the crisis is over. The client says to the nurse, “I’m finally cured.” How should the nurse interpret this behavior as a cue to modify the treatment plan?

a) Suggesting a reduction of medication
b) Allowing increased “in-room” activities
c) Increasing the level of suicide precautions
d) Allowing the client off-unit privileges as needed

9. Low doses of central nervous system (CNS) depressants produce an initial excitatory response. This reaction is caused by:

a) a stimulating effect on the CNS
b) the depression of acetylcholine
c) the stimulation of dopamine by depressant drugs
d) inhibitory synapses in the brain being depressed before excitatory synapses.

10. A client with borderline personality disorder dramatically expresses feelings about each nurse on the staff, stating that only one nurse is understanding and trustworthy - namely, the nurse the client is talking to at the time. This client is demonstrating which behavior?

a) confidentially
b) splitting
c) empathy
d) gnawing

Depression NCLEX Questions
Answers and Rationale

1) B
- Rationale: Whenever the nurse carries out an assessment for a client who is dependent on drugs, it is best for the nurse to attempt to elicit information by being nonjudgmental and direct. Option A is incorrect because it is judgmental and off-focus, and reflects the nurse’s bias. Option C is incorrect because it is judgmental, insensitive, and aggressive, which is nontherapeutic. Option D is incorrect because it indicates passivity on the nurse’s part and uses rationalization to avoid the therapeutic nursing intervention.

- Depression NCLEX Questions Test-Taking Strategy: Focus on the subject, providing appropriate nursing care. Use of therapeutic communication techniques will assist in directing you to the correct option. 

2) A, C, D, F
- Depression NCLEX Questions Rationale: When the client is experiencing withdrawal from alcohol, the priority for care is to prevent the client from harming self or others. The nurse would provide a low-stimulation environment to maintain the client in as calm a state as possible. The nurse would monitor the vital signs closely and report abnormal findings. The nurse would reorient the client to reality frequently and would address hallucinations therapeutically. Adequate nutritional and fluid intake need to be maintained.

- Test-Taking Strategy: Note the strategic words most appropriate. Use therapeutic communication techniques to assist in selecting the correct interventions. Also, recalling the characteristics associated with alcohol withdrawal will assist in answering correctly.

3) A
- Rationale: Al-Anon support groups are a protected, supportive opportunity for spouses and significant others to learn what to expect and to obtain excellent pointers about successful behavioral changes. The correct option is the healthiest response because it exemplifies an understanding that the alcoholic partner is responsible for his behavior and cannot be allowed to blame family members for loss of control. Option B is incorrect because the nonalcoholic partner should not feel responsible when the spouse loses control. Option C indicates that the group is viewed as an escape, not as a place to work on issues. Option D indicates that the wife remains codependent.

- Depression NCLEX Questions Test-Taking Strategy: Focus on the subject, the therapeutic effect of attending an Al-Anon group. Noting the words benefiting from attending an Al-Anon group will direct you to the correct option.

4) A
- Rationale: Most health care facilities have documents that the client is asked to sign relating to the client’s responsibilities when the client leaves against medical advice. The client should be asked to wait to speak to the HCP before leaving and to sign the “against medical advice” document before leaving. If the client refuses to do so, the nurse cannot hold the client against the client’s will. Therefore, in this situation, the nurse should call the nursing supervisor. The nurse can be charged with false imprisonment if a client is made to believe wrongfully that he or she cannot leave the hospital. Restraining the client and calling security to block exits constitutes false imprisonment. All clients have a right to health care and cannot be told otherwise.

- Test-Taking Strategy: Keeping the concept of false imprisonment in mind, eliminate options B and C because they are comparable or alike. Eliminate option D, knowing that all clients have a right to health care. From the options presented, the best action is presented in the correct option.

5) A, C, D
- Depression NCLEX Questions Rationale: Clients with bulimia nervosa initially may not appear to be physically or emotionally ill. They are often at or slightly below ideal body weight. On further inspection, a client exhibits dental decay and loss of tooth enamel if the client has been inducing vomiting. Electrolyte imbalances are present. Dry, scaly skin (rather than moist, oily skin) is present.

- Test-Taking Strategy: Focus on the subject, assessment findings in bulimia nervosa. It is necessary to recall that in anorexia nervosa the body weight is normally well below ideal body weight and that clients with bulimia nervosa are often at or slightly below ideal body weight. Also, remember that skin texture will be dry and scaly.

6) A
- Rationale: A depressed suicidal client often gives away that which is of value as a way of saying goodbye and wanting to be remembered. Options B, C, and D deal with anger and acting-out behaviors that are often typical of any adolescent.

- Test-Taking Strategy: Eliminate options B, C, and D because they are comparable or alike. The correct option is different and is an action that could indicate that the client may be “saying goodbye.”

7) B
- Rationale: The initial nursing action is to assess and treat the self-inflicted injuries. Injuries from lacerated wrists can lead to a life-threatening situation. Other interventions, such as options A, C, and D, may follow after the client has been treated medically.

- Test-Taking Strategy: Note the strategic word initial. Use Maslow’s Hierarchy of Needs theory to prioritize. Physiological needs come first. The correct option addresses the physiological need.

8) C
- Rationale: A client who is moderately depressed and has only been in the hospital 2 days is unlikely to have such a dramatic cure. When a depression suddenly lifts, it is likely that the client may have made the decision to harm himself or herself. Suicide precautions are necessary to keep the client safe. The remaining options are therefore incorrect interpretations.

- Depression NCLEX Questions Test-Taking Strategy: Focus on the subject, suicide precautions. Options A and D support the client’s notion that a cure has occurred. Option B allows the client to increase self-isolation self-isolation and would present a threat to the client’s safety. Knowing that safety is of the utmost importance will direct you to the correct option.

9) D
- Excitation can occur when inhibitory synapses are depressed. The other options are incorrect because depressants don't stimulate the CNS or dopamine and don't depress acetylcholine.

10) B
- In splitting, or primitive dissociation, the client categorizes people as good or bad and tries to keep the bad from contaminating the good. Such a client may view a staff member is ideal and then devalue that person. Confidentially is the protection of client information. Empathy is the nurse's attempt to understand and respond to a client's needs and feelings. Gnawing isn't a term used in psychiatric nursing.


Proceed to the next set of questions:

Depression NCLEX Questions 11-20

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RN Comprehensive Online Practice (NCLEX 6-10)

Nurses who will be taking the NCLEX exam should take our RN Comprehensive Online Practice quizzes. These free questions will help you enhance your critical thinking skills and make you more prepared for the actual exam. 
6. The nurse is preparing a plan of care for a client in skin traction. The nurse should monitor for which priority finding in this client?
a) Urinary incontinence
b) Signs of skin breakdown
c) The presence of bowel sounds
d) Signs of infection around the pin sites

7. RN Comprehensive Online Practice question about the home care nurse who is visiting a client who is in a body cast. While performing an assessment, the nurse plans to evaluate the psychosocial adjustment of the client to the cast. What is the most appropriate assessment for this client?

a) The need for sensory stimulation
b) The amount of home care support available
c) The ability to perform activities of daily living
d) The type of transportation available for follow-up care

8. What action should the nurse consider when counseling a client of the Amish tradition?

a) Speak only to the husband.
b) Use complex medical terminology.
c) Avoid using scientific or medical jargon.
d) Stand close to the client and speak loudly.

9. A client has refused to eat more than a few spoonfuls of breakfast. The health care provider has prescribed that tube feedings be initiated if the client fails to eat at least half of a meal because the client had been losing weight for the previous 2 months. The nurse enters the room, looks at the tray, and states, “If you don’t eat any more than that, I’m going to have to put a tube down your throat and get a feeding in that way.” The client begins crying and tries to eat more. Based on the nurse’s actions, the nurse may be accused of which violation?

a) Assault
b) Battery
c) Slander
d) Invasion of privacy

10. When making assignments to a team consisting of a registered nurse (RN), one licensed practical nurse (LPN), and two unlicensed assistive personnel (UAP), which is the best client for the LPN?

a) A client requiring frequent temperature checks
b) A client requiring assistance with ambulation every 4 hours
c) A client on a mechanical ventilator requiring frequent assessment and suctioning
d) A client with a spinal cord injury requiring urinary catheterization every 6 hours as prescribed






RN Comprehensive Online Practice
Answers and Rationale

6) B
- Rationale: Skin traction is achieved by Ace wraps, boots, and slings that apply a direct force on the client’s skin. Traction is maintained with 5 to 8 lb of weight, and this type of traction can cause skin breakdown. Urinary incontinence is not related to the use of skin traction. Although constipation can occur as a result of immobility and monitoring bowel sounds may be a component of the assessment, this intervention is not the priority assessment. There are no pin sites with skin traction.

- RN Comprehensive Online Practice Test-Taking Strategy: Note the strategic word priority. Eliminate option D first because there are no pin sites with skin traction. Visualizing the traction setup and knowledge of the complications associated with this type of traction will direct you to the correct option.

7) A
- Rationale: A psychosocial assessment of a client who is immobilized would most appropriately include the need for sensory stimulation. This assessment should also include such factors as body image, past and present coping skills, and coping methods used during the period of immobilization. Although home care support, the ability to perform activities of daily living, and transportation are components of an assessment, they are not as specifically related to psychosocial adjustment as is the need for sensory stimulation.

- Test-Taking Strategy: Focus on the strategic words most appropriate and note the subject, psychosocial adjustment. Option C can be eliminated first because it relates to physiological integrity rather than psychosocial integrity. Next, eliminate options B and D because they are most closely related to physical supports, rather than psychosocial needs of the client.

8) C
- Rationale: Complex scientific or medical terminology should be avoided when counseling an Amish client (or any client). When counseling a female Amish client, most often the husband and wife will want to discuss health care options together. Standing close and speaking loudly is inappropriate in most counseling situations.

- RN Comprehensive Online Practice Test-Taking Strategy: Use knowledge of the Amish society and therapeutic communication techniques to answer this question. Options B and D can be eliminated first because option D is inappropriate and option B is not a therapeutic intervention. In addition, note that options B and C are opposite, which may indicate that one of these options is correct. Option A can be eliminated because of Amish cultural habits.

9) A
- Rationale: Assault occurs when a person puts another person in fear of harmful or offensive contact and the victim fears and believes that harm will result as a result of the threat. In this situation, the nurse could be accused of the tort of assault. Battery is the intentional touching of another’s body without the person’s consent. Slander is verbal communication that is false and harms the reputation of another. Invasion of privacy is committed when the nurse intrudes into the client’s personal affairs or violates confidentiality.

- Test-Taking Strategy: Note the subject, legal implications for nursing care. Focusing on the words used by the nurse and noting that the nurse threatens the client will direct you to the correct option.

10) D
- Rationale: When delegating nursing assignments, the nurse needs to consider the skills and educational level of the nursing staff. Frequent temperature checks and ambulation can most appropriately be provided by the UAP, considering the clients identified in each option. The client on the mechanical ventilator requiring frequent assessment and suctioning should most appropriately be cared for by the RN. The LPN is skilled in urinary catheterization, so the client in option D would be assigned to this staff member.

- Test-Taking Strategy: Focus on the subject, the principles related to delegations and assignments, and consider the education and job position as described by the nurse practice act and employee guidelines. Note the word assessment in option C. This should alert you that this client should be assigned to the registered nurse. Options A and B can be eliminated because a UAP can perform these tasks.


After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

RN Comprehensive Online Practice (NCLEX 1-5)


Or proceed to the next set of questions:

RN Comprehensive Online Practice (NCLEX 11-15)

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