Question 1

The nurse's primary intervention for a client who is experiencing a panic attack is to?

Accepted Answer

Answer reason: During an acute panic attack, the client is at risk of injury or impulsive behavior. The immediate priority is to ensure and maintain safety; exploration, relationship-building, and teaching are addressed after the crisis subsides.

Question 2

A client firmly believes she has serious liver disease despite no symptoms or evidence of liver disease; what is this condition called?

Accepted Answer

Answer reason: Preoccupation with having a serious illness despite medical reassurance and minimal/no symptoms is characteristic of hypochondriasis (illness anxiety disorder).

Question 3

What is an appropriate nursing intervention for a client experiencing an anxiety attack?

Accepted Answer

Answer reason: During an anxiety/panic attack, the priority is to remain with the client and communicate calmly with short, simple sentences to reduce anxiety and ensure safety. Leaving the client alone is unsafe; music may increase stimulation; environmental changes like opening windows are not the primary intervention.

Question 4

Which is the most common clinical syndrome of OCD?

Accepted Answer

Answer reason: Contamination fears with compulsive washing are the most common presentation subtype of obsessive–compulsive disorder.

Question 5

While assessing an out-patient with a panic disorder, the nurse completes a thorough health history and physical exam. Which of the following is MOST significant for this client?

Accepted Answer

Answer reason: A sudden overwhelming sense of impending doom is a hallmark symptom of panic attacks. Compulsions suggest OCD, fear of flying is a specific phobia, and panic episodes are typically unpredictable.

Question 6

The nurse recognizes which of these symptoms as characteristic of a panic attack?

Accepted Answer

Answer reason: Panic attacks typically feature palpitations, sweating, narrowed perceptual field, and fear of losing control or going crazy. Other options include findings inconsistent with panic attacks (e.g., decreased blood pressure, bradycardia, increased concentration).

Question 7

The nurse is observing a client with an obsessive-compulsive disorder in an in-patient setting. Which of the following behaviors is consistent with this diagnosis?

Accepted Answer

Answer reason: Obsessive-compulsive disorder involves obsessions and compulsions, commonly repetitive checking or washing behaviors. Repeatedly checking a locked door is a classic compulsion.

Question 8

Which client statement is MOST characteristic of generalized anxiety disorder (GAD)?

Accepted Answer

Answer reason: Generalized anxiety disorder is defined by persistent, excessive worry occurring more days than not across multiple life domains. Sudden waves suggest panic disorder, avoidance of places suggests phobia, and intrusive thoughts with rituals indicate obsessive-compulsive disorder.

Question 9

A client with panic disorder arrives at the emergency department during an acute panic attack. Which nursing action is MOST appropriate initially?

Accepted Answer

Answer reason: During an acute panic attack, immediate interventions focus on reducing physiologic arousal and promoting a sense of safety. Calm presence and guided breathing help decrease hyperventilation and sympathetic overactivation.

Question 10

When planning care for a client with social anxiety disorder, which outcome BEST indicates effective treatment?

Accepted Answer

Answer reason: Effective treatment does not require elimination of all anxiety but improved functioning and reduced avoidance. Gradual participation with manageable anxiety reflects therapeutic progress.

Question 11

Which finding BEST differentiates panic disorder from generalized anxiety disorder?

Accepted Answer

Answer reason: Panic disorder is characterized by abrupt episodes of intense fear accompanied by physical symptoms such as palpitations, shortness of breath, and chest discomfort. GAD involves chronic, diffuse worry rather than sudden attacks.

Question 12

A client with social anxiety disorder is beginning cognitive-behavioral therapy (CBT). Which client behavior BEST indicates early therapeutic progress?

Accepted Answer

Answer reason: Early CBT progress is reflected by reduced avoidance and increased engagement despite residual anxiety. Total symptom elimination is unrealistic early in treatment, and reliance on avoidance or PRN medication indicates limited progress.

Question 13

A client with generalized anxiety disorder is prescribed an SSRI. Which teaching is MOST appropriate to include?

Accepted Answer

Answer reason: SSRIs require time to achieve therapeutic effect, often several weeks. They are taken daily, not PRN, and should not be stopped abruptly due to risk of withdrawal and symptom recurrence.

Question 14

OCD is classified under which category in ICD-10?

Accepted Answer

Answer reason: In ICD-10, obsessive-compulsive disorder is coded as F42 within the section "Neurotic, stress-related and somatoform disorders" (F40–F48). This places OCD under neurotic disorders, not psychotic disorders (which involve loss of reality testing) and not mood or personality disorders. Clinically, OCD is also conceptualized within anxiety-related disorders due to prominent obsessions/compulsions and associated distress.

Question 15

The commonest obsession seen in OCD is?

Accepted Answer

Answer reason: In obsessive-compulsive disorder, the most common obsessional theme is contamination (e.g., fear of germs, dirt, or illness), often linked with cleaning/washing compulsions. Religious thoughts can occur but are less common as the predominant obsessional category. Counting is more characteristic as a compulsion/ritual rather than the most common obsession. Gambling is not an OCD obsessional theme and is more consistent with gambling disorder (impulse-control/addictive behavior).

Question 16

Phobia is a type of _?

Accepted Answer

Answer reason: A phobia is characterized by a marked, persistent fear of a specific object or situation that leads to avoidance and significant distress or impairment. In standard psychiatric classifications, specific phobia is grouped under anxiety disorders. Mood disorders primarily involve disturbances in mood (e.g., depression, mania), and psychotic disorders are defined by delusions, hallucinations, or disorganized thought. Therefore, the best answer is anxiety disorder.

Question 17

A nurse is caring for a client experiencing a panic attack. Which of the following is the priority nursing action?

Accepted Answer

Answer reason: During a panic attack, the priority is to reduce anxiety and promote safety by staying with the client and communicating in a calm, simple, reassuring manner. Severe anxiety impairs the client’s ability to process complex questions or engage in extensive discussion, so short, simple phrases are most therapeutic. Leaving the client alone can increase fear and risk of escalation, and distraction with food/water is not a priority and may be unsafe if the client is hyperventilating or nauseated.

Question 18

The nurse is observing a staff member caring for a client with generalized anxiety disorder. The nurse should intervene if the staff member is observed?

Accepted Answer

Answer reason: Requesting a prescription for lithium to treat acute symptoms of anxiety Lithium is a mood stabilizer primarily used for bipolar disorder and is not indicated for acute anxiety symptom relief. Acute anxiety is typically managed with nonpharmacologic techniques (eg, breathing/relaxation) and, when needed, anxiolytics such as SSRIs/SNRIs for long-term control or short-term benzodiazepines in select situations. The other observed actions (identifying triggers, deep breathing, limiting caffeine) are appropriate evidence-based interventions for generalized anxiety disorder.

Question 19

A client is experiencing acute anxiety. Which intervention should the nurse implement first?

Accepted Answer

Answer reason: Reducing environmental stimuli is the safest immediate first step in acute anxiety because it helps decrease escalating arousal and supports the client’s ability to regain control. Once stimulation is minimized and the client is calmer, coaching in slow breathing or other coping skills can be more effective. PRN medication may be appropriate if anxiety remains severe, but it is not the first-line immediate intervention when nonpharmacologic measures can promptly improve safety and engagement.

Question 20

Sign and symptoms of obsessive compulsive disorder include all, except?

Accepted Answer

Answer reason: Thought broadcasting is a psychotic symptom (a delusion of control) more characteristic of schizophrenia-spectrum disorders, not OCD. OCD is defined by intrusive, recurrent obsessions and/or compulsions performed to reduce distress, commonly presenting as ritualistic behaviors and persistent obsessive thoughts. Feelings of guilt can occur secondary to distress about obsessions or inability to control compulsions, but they are not the key differentiator compared with psychotic features like thought broadcasting.

Question 21

A patient was admitted with a diagnosis of agoraphobia with panic attacks. Which of the following symptoms would the nurse expect the patient to experience during a panic attack?

Accepted Answer

Answer reason: Hyperventilation during panic can lower carbon dioxide and cause respiratory alkalosis, leading to tingling/numbness in the hands, feet, or around the mouth. Panic attacks also typically produce sympathetic activation (e.g., palpitations, sweating, tremors), making hypotension unlikely. Constipation is not an acute panic symptom, and “frequent fears” is nonspecific compared with a classic physiologic manifestation during an attack.

Question 22

Housebound housewife syndrome is associated with?

Accepted Answer

Answer reason: The “housebound” pattern is characteristic of this avoidance behavior and can become severe enough that the person rarely leaves the home. While depression can cause low motivation and social withdrawal, it does not specifically produce fear-driven avoidance of leaving the home. OCD and somatoform disorders may coexist with anxiety but do not classically define a syndrome centered on being unable to go out due to escape/embarrassment fears.

Question 23

The recently discharged veteran who served in active combat reports symptoms of recurring intrusive thoughts, insomnia, and hyper vigilance. Which question would be most helpful in establishing a diagnosis?

Accepted Answer

Answer reason: ” Posttraumatic stress disorder is suggested by trauma exposure plus intrusion symptoms and sleep-related re-experiencing. Nightmares are a classic intrusion symptom that directly supports PTSD in a combat veteran with intrusive thoughts, insomnia, and hypervigilance. This question targets a core diagnostic feature and helps differentiate PTSD from nonspecific insomnia or occupational sleepiness. Asking about hair pulling points toward trichotillomania, and asking about OCD history does not address the trauma-linked re-experiencing pattern central to the presentation.

Question 24

A client has been unemployed related to frequent absences due to an anxiety disorder and informs the nurse that they would like to have a job working alone without someone evaluating their performance. How will the nurse interpret this comment?

Accepted Answer

Answer reason: Wanting to work alone to avoid being observed or judged reflects a fear of negative evaluation, which is the defining feature of social anxiety disorder. The client’s absences can be driven by avoidance of performance situations or social scrutiny rather than lack of need for supervision. Obsessive-compulsive symptoms would more typically involve time-consuming obsessions/compulsions interfering with punctuality, not specifically avoidance of evaluation. Agoraphobia centers on fear of being unable to escape or get help in certain places, not primarily fear of being evaluated at work.

Question 25

Which is the most common neurotic disorder?

Accepted Answer

Answer reason: Among anxiety-spectrum conditions, specific phobias are highly prevalent in the general population and are often cited as the most common neurotic disorder in older psychiatric classifications. The option best matching that high-prevalence category is the one naming the disorder directly rather than a narrower diagnostic label. Compared with OCD or generalized anxiety disorder, phobias generally have a higher population prevalence despite many cases going unreported due to avoidance.

Question 26

Which disease process is characterized by anxiety about and avoidance of places or situations in which the ability to escape is limited or embarrassing?

Accepted Answer

Answer reason: Agoraphobia is defined by marked fear/anxiety about situations where escape might be difficult or help might not be available if panic-like or other embarrassing symptoms occur. This leads to avoidance of places such as crowds, public transportation, open/enclosed spaces, or being outside alone. The stem’s emphasis on limited escape and potential embarrassment aligns directly with this diagnostic concept. A common distractor is social phobia (social anxiety), which centers on fear of negative evaluation in social/performance situations rather than fear of being unable to escape. Specific phobias like fear of spiders or needles do not primarily involve escape/entrapment concerns.

Question 27

Which statement made by a client best meets the diagnostic criteria for pain disorder?

Accepted Answer

Answer reason: " Pain disorder (a somatic symptom–related condition) is characterized by pain as the predominant complaint that causes significant distress/impairment and is not better explained by a medical condition alone, often occurring across multiple sites. This statement presents pain as the primary symptom and in more than one body area, which aligns best with the diagnostic focus on pain. Option A is more consistent with a neurologic-type functional symptom (motor deficit) rather than pain-predominant presentation. Option D describes classic acute coronary syndrome features requiring emergent medical evaluation and does not fit a primary psychiatric pain-disorder pattern.

Question 28

Which of the following nursing diagnoses would be appropriate for a client with an obsessive-compulsive disorder?

Accepted Answer

Answer reason: A nursing diagnosis focused on maladaptive coping and functional impairment best captures this pattern because it targets the anxiety-driven behaviors and their impact on daily living. The other choices describe problems more consistent with psychosis (disturbed perception), self-harm with recent self-mutilation, or impulse-control/anger-related injury risk, which are not core expected findings in OCD. Prioritizing coping also aligns with nursing interventions such as anxiety reduction strategies, response prevention support, and promoting adaptive decision-making.

Question 29

The client with an anxiety disorder tells the nurse that being in crowds creates thoughts of losing control and the need to hurriedly leave. What should the nurse recommend as an effective , nonpharmacological therapy for managing the client's symptoms of anxiety?

Accepted Answer

Answer reason: CBT directly targets these maladaptive thoughts and teaches coping skills (e.g., cognitive restructuring, relaxation, and graded exposure) to reduce panic and avoidance in triggering situations. It is a first-line, evidence-based nonpharmacologic treatment for many anxiety disorders, especially those involving situational triggers and catastrophic thinking. Family systems therapy is more appropriate when dysfunctional family dynamics are the primary driver, and ECT is not a standard treatment for anxiety disorders.

Question 30

The recently discharged veteran who served in active combat reports symptoms of recurring intrusive thoughts, insomnia, and hyper vigilance. Which question would be most helpful in establishing a diagnosis?

Accepted Answer

Answer reason: " The symptom cluster after combat exposure suggests post-traumatic stress disorder, an anxiety-related disorder characterized by intrusion symptoms, hyperarousal, sleep disturbance, and avoidance. Nightmares and distressing dreams related to the traumatic event are a core intrusion feature and help confirm the PTSD pattern rather than nonspecific insomnia alone. Asking about nightmares directly links the patient’s sleep problem to trauma re-experiencing and increases diagnostic specificity. Falling asleep at work points more toward hypersomnolence/narcolepsy, hair pulling suggests trichotillomania, and past OCD diagnosis does not establish the current trauma-linked syndrome.

Question 31

The client tells the nurse about an intense fear of dogs that causes the client to avoid visiting others unless it is continued that there are no dogs on the premises. The client further explains that these fears seem unreasonable, but the fear continues in spite of this acknowledgment. Which conclusion by the nurse is accurate?

Accepted Answer

Answer reason: Specific phobia is characterized by marked fear of a specific object or situation that is out of proportion to actual danger and leads to avoidance and functional impairment. The client’s insight that the fear is unreasonable, along with persistent fear and avoidance of situations where dogs may be present, matches this diagnostic feature. Option A is incorrect because the avoidance behavior and distress indicate clinically significant anxiety rather than a normal fear. Option B is inaccurate because phobias are generally more common in women, and age-of-onset details do not address the key diagnostic criterion described in the stem.

Question 32

Nurse Penny is aware that the symptoms that distinguish post-traumatic stress disorder from other anxiety disorders would be?

Accepted Answer

Answer reason: g., recurrent distressing memories, nightmares, and flashbacks) that directly re-live the traumatic event. This re-experiencing cluster is not a defining feature of other anxiety disorders such as GAD or panic disorder, which are characterized by excessive worry or panic episodes without a required traumatic trigger. Avoidance can occur in PTSD but can also be seen across other conditions (e.g., phobias), making it less distinctive. Depressive symptoms, blunted affect, and social withdrawal may accompany PTSD but are nonspecific and overlap with depressive disorders and other trauma-related presentations.

Question 33

The nurse is observing a client with obsessive-compulsive disorder (OCD) in an inpatient setting. Which behavior is consistent with this diagnosis?

Accepted Answer

Answer reason: Obsessive-compulsive disorder is characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to reduce anxiety. Repeated checking behaviors, such as ensuring a door is locked multiple times, are classic examples of compulsions seen in OCD. The other options reflect paranoia, preference, or neurological symptoms rather than OCD.

Question 34

Which term describes a feeling of being disconnected from oneself, as may occur during a panic attack?

Accepted Answer

Answer reason: Depersonalization refers to a sense of detachment or disconnection from one’s own body or self. It is commonly experienced during severe anxiety or panic attacks. Derealization, in contrast, involves a sense that the external environment is unreal.

Question 35

The school nurse is planning a community education program about childhood mental health problems that appear to be genetically transmitted. While conducting the program, the nurse will emphasize information about which problem?

Accepted Answer

Answer reason: Childhood anxiety commonly clusters in families due to inherited temperament (e.g., behavioral inhibition) and shared vulnerability pathways, so it best matches a “genetically transmitted” focus. In contrast, sleepwalking and enuresis are typically categorized as sleep/arousal and elimination disorders and are not primarily taught as genetically transmitted mental health problems in NCLEX-style mental health teaching. ODD is more strongly associated with environmental/parenting factors and comorbid ADHD/conduct problems, with genetics playing a less central, less emphasized role for basic community teaching.

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The nurse's primary intervention for a client who is experiencing a panic attack is to?

A client firmly believes she has serious liver disease despite no symptoms or evidence of liver disease; what is this condition called?

What is an appropriate nursing intervention for a client experiencing an anxiety attack?

Which is the most common clinical syndrome of OCD?

While assessing an out-patient with a panic disorder, the nurse completes a thorough health history and physical exam. Which of the following is MOST significant for this client?

The nurse recognizes which of these symptoms as characteristic of a panic attack?

The nurse is observing a client with an obsessive-compulsive disorder in an in-patient setting. Which of the following behaviors is consistent with this diagnosis?

Which client statement is MOST characteristic of generalized anxiety disorder (GAD)?

A client with panic disorder arrives at the emergency department during an acute panic attack. Which nursing action is MOST appropriate initially?

When planning care for a client with social anxiety disorder, which outcome BEST indicates effective treatment?

Which finding BEST differentiates panic disorder from generalized anxiety disorder?

A client with social anxiety disorder is beginning cognitive-behavioral therapy (CBT). Which client behavior BEST indicates early therapeutic progress?

A client with generalized anxiety disorder is prescribed an SSRI. Which teaching is MOST appropriate to include?

OCD is classified under which category in ICD-10?

The commonest obsession seen in OCD is?

Phobia is a type of _?

A nurse is caring for a client experiencing a panic attack. Which of the following is the priority nursing action?

The nurse is observing a staff member caring for a client with generalized anxiety disorder. The nurse should intervene if the staff member is observed?

A client is experiencing acute anxiety. Which intervention should the nurse implement first?

Sign and symptoms of obsessive compulsive disorder include all, except?

A patient was admitted with a diagnosis of agoraphobia with panic attacks. Which of the following symptoms would the nurse expect the patient to experience during a panic attack?

Housebound housewife syndrome is associated with?

The recently discharged veteran who served in active combat reports symptoms of recurring intrusive thoughts, insomnia, and hyper vigilance. Which question would be most helpful in establishing a diagnosis?

A client has been unemployed related to frequent absences due to an anxiety disorder and informs the nurse that they would like to have a job working alone without someone evaluating their performance. How will the nurse interpret this comment?

Which is the most common neurotic disorder?

Which disease process is characterized by anxiety about and avoidance of places or situations in which the ability to escape is limited or embarrassing?

Which statement made by a client best meets the diagnostic criteria for pain disorder?

Which of the following nursing diagnoses would be appropriate for a client with an obsessive-compulsive disorder?

The client with an anxiety disorder tells the nurse that being in crowds creates thoughts of losing control and the need to hurriedly leave. What should the nurse recommend as an effective , nonpharmacological therapy for managing the client's symptoms of anxiety?

The recently discharged veteran who served in active combat reports symptoms of recurring intrusive thoughts, insomnia, and hyper vigilance. Which question would be most helpful in establishing a diagnosis?

Nurse Penny is aware that the symptoms that distinguish post-traumatic stress disorder from other anxiety disorders would be?

The nurse is observing a client with obsessive-compulsive disorder (OCD) in an inpatient setting. Which behavior is consistent with this diagnosis?

Which term describes a feeling of being disconnected from oneself, as may occur during a panic attack?

The school nurse is planning a community education program about childhood mental health problems that appear to be genetically transmitted. While conducting the program, the nurse will emphasize information about which problem?

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