A mental health nurse is assessing a client who has generalized anxiety disorder. Which of the following findings should the nurse expect?

Obsession over a fictitious defect in physical appearance.

Constant worry about the undiagnosed presence of an illness.

Sudden unexplained loss of vision without a physical medical explanation.

Prior physical health followed by the need for two surgeries within the last three months.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Obsession over a fictitious defect in physical appearance is characteristic of body dysmorphic disorder, not generalized anxiety disorder (GAD).

Individuals with body dysmorphic disorder become preoccupied with an imagined or slight defect in their appearance, often to the point of significant distress and impairment in functioning.

They may engage in excessive grooming behaviors, repeatedly check their appearance in mirrors, or avoid social situations due to their appearance concerns.

While individuals with GAD may also experience concerns about their physical appearance, these concerns are typically not as severe or pervasive as those seen in body dysmorphic disorder.

Choice B rationale:

Constant worry about the undiagnosed presence of an illness is a hallmark feature of GAD.

Individuals with GAD often experience excessive worry about a variety of things, including health, finances, relationships, and work.

This worry is often accompanied by physical symptoms such as restlessness, fatigue, difficulty concentrating, and muscle tension.

The worry is typically difficult to control and can significantly interfere with daily life.

Choice C rationale:

Sudden unexplained loss of vision without a physical medical explanation is not a common symptom of GAD. It may be indicative of a more serious medical condition, such as a stroke or a neurological disorder.

It is important to rule out any potential medical causes before attributing a symptom like this to GAD.

Choice D rationale:

Prior physical health followed by the need for two surgeries within the last three months may be a stressful life event that could contribute to the development of GAD.

However, it is not a specific symptom of GAD.

Many people experience stressful life events without developing GAD.

The presence of other symptoms, such as excessive worry and physical symptoms, is necessary for a diagnosis of GAD.

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Correct Answer is A

Explanation

Choice A rationale:

Anger is a common and expected response to trauma, including sexual assault. It can stem from various sources, including:

Feelings of violation and powerlessness: Survivors may feel intense anger towards the perpetrator for taking control of their bodies and lives.

Betrayal: If the assault was committed by someone they knew or trusted, survivors may feel intense anger towards that person for breaking their trust.

Frustration and injustice: Survivors may feel angry at the injustice of the situation, the lack of control they had, and the ongoing impact of the trauma.

Difficulty processing other emotions: Anger can sometimes mask other emotions that are difficult to deal with, such as fear, sadness, or guilt.

Anger can manifest in various ways, including:

Irritability and outbursts: Survivors may have a short temper, snap at others easily, or have difficulty controlling their anger. Aggression: In some cases, anger can lead to physical or verbal aggression towards others or self-harming behaviors.

Withdrawal and isolation: Some survivors may withdraw from social interactions and relationships to avoid potential triggers for their anger.

Substance abuse: Some survivors may turn to alcohol or drugs to numb their feelings or cope with their anger.

Choice B rationale:

Sleeping 12 hours or more each day can be a symptom of PTSD, but it is not a specific indicator of anger. It can also be a sign of depression, anxiety, or hypersomnia, a sleep disorder characterized by excessive daytime sleepiness.

Choice C rationale:

PTSD can sometimes lead to an increased sense of detachment from others, rather than attachment. Survivors may feel emotionally numb, have difficulty trusting others, or withdraw from relationships.

Choice D rationale:

While some survivors of sexual assault may feel a need to talk about the event, it is not a universal symptom of PTSD. Some survivors may avoid talking about the event altogether due to the distress it causes.

A. Explain to the client that the behavior was unacceptable. B. Set behavioral limits for the client. C. Explore the truth of the client's statements. D. Establish a client relationship.

Correct Answer is D

Explanation

Rationale for Choice A:

While it is important to address the client's behavior, simply explaining that it was unacceptable is unlikely to be effective in this situation. Clients with antisocial personality disorder often have difficulty understanding and accepting responsibility for their actions. They may lack empathy for others and may not see their behavior as problematic. Confronting the client about their behavior too early in the therapeutic relationship could lead to defensiveness, hostility, or even aggression. It is important to first establish a rapport with the client and build a foundation of trust before addressing difficult topics.

Rationale for Choice B:

Setting behavioral limits is an important aspect of treatment for clients with antisocial personality disorder. However, it is not the first priority in this situation. Before setting limits, the nurse needs to establish a relationship with the client and assess their individual needs and level of functioning. Attempting to set limits without first establishing a rapport could lead to power struggles and further resistance from the client.

Rationale for Choice C:

Exploring the truth of the client's statements may be necessary at some point in the treatment process. However, it is not the first priority in this situation. The nurse's initial focus should be on establishing a relationship with the client and assessing their immediate needs. Focusing on the accuracy of the client's statements too early in the therapeutic process could derail the development of a trusting relationship.

Rationale for Choice D:

Establishing a client relationship is the first and most important step in the treatment of any client, but it is especially crucial for clients with antisocial personality disorder. These clients often have difficulty trusting others and forming close relationships. By establishing a rapport with the client, the nurse can begin to build trust and create a safe and supportive environment. This foundation is essential for any further therapeutic interventions to be successful.

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A mental health nurse is assessing a client who has generalized anxiety disorder. Which of the following findings should the nurse expect?

Nursing Test Bank

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