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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
The correct answer/s is Choices A, B, and C.
Choice A Rationale:
Recent or impending moves can be a significant stressor for adolescents, disrupting their social networks, routines, and sense of belonging. This disruption can exacerbate existing mental health problems or trigger new ones, increasing the risk of suicidal ideation or behavior. Studies have shown that adolescents who relocate are more likely to experience depression, anxiety, and substance abuse, all of which are risk factors for suicide. Additionally, the feeling of loss and displacement associated with moving can lead to feelings of isolation and hopelessness, further increasing the risk.
Choice B Rationale:
A sudden decline in school performance can be a sign of underlying emotional distress in adolescents. This decline may be due to depression, anxiety, or other mental health problems that can impede concentration, motivation, and overall academic functioning. Suicidal ideation or behavior can also lead to a decline in school performance as the adolescent withdraws from their usual activities and struggles to cope with their emotions. Therefore, a sudden drop in grades or academic engagement should raise a red flag for the nurse and warrant further investigation into the adolescent's emotional well-being.
Choice C Rationale:
The death of a parent at a young age is a major life event that can have a profound impact on an adolescent's emotional and psychological development. This loss can lead to feelings of grief, sadness, anger, and isolation, all of which are risk factors for suicide. Additionally, adolescents who lose a parent may be more likely to experience depression, anxiety, and substance abuse, further increasing their vulnerability to suicidal thoughts and behaviors. The nurse should be particularly concerned if the death of the parent was recent or if the adolescent has not adequately processed their grief.
Choice D Rationale:
While low parental expectations can be a negative influence on an adolescent's self-esteem and motivation, it is not directly linked to an increased risk of suicide. In fact, some studies have suggested that high parental expectations can be equally detrimental to adolescent mental health. Therefore, while low parental expectations may not be a standalone risk factor for suicide, it is important to consider this factor in the context of the adolescent's overall psychosocial assessment.
Summary:
A recent or impending move, a sudden decline in school performance, and the death of a parent at a young age are all significant stressors that can increase the risk of suicidal ideation or behavior in adolescents. The nurse should be alert to these warning signs and conduct a thorough psychosocial assessment to identify any underlying mental health issues or risk factors. Early intervention and support can significantly reduce the risk of suicide and help adolescents cope with these challenging life events.
Correct Answer is B
Explanation
Choice A rationale: The statement “My arms often feel weak and spastic” does not indicate obsessive-compulsive disorder (OCD). This could be a symptom of a physical condition or a different mental health disorder, but it does not align with the common symptoms of OCD. OCD is characterized by unwanted, recurring thoughts and repetitive behaviors.
Choice B rationale: The statement “I check where my car keys are ten times” is indicative of OCD. One of the key symptoms of OCD is the need to check things repeatedly due to persistent, unwanted thoughts and fears. The individual may check something over and over again, such as whether the door is locked or where their car keys are, even if they know they’ve already checked. This behavior is a compulsion - an act the person feels compelled to perform to alleviate the distress caused by the obsessive thought.
Choice C rationale: The statement “I’m embarrassed to go out and speak in public” could be indicative of social anxiety disorder, not OCD. Social anxiety disorder is characterized by a fear of social situations and interactions, particularly those involving the possibility of scrutiny or judgment by others. While people with OCD can also have social anxiety disorder, embarrassment about going out and speaking in public is not a typical symptom of OCD12.
Choice D rationale: The statement “I keep reliving a car accident almost every day” is more indicative of post- traumatic stress disorder (PTSD) than OCD. PTSD is a mental health disorder that can develop after experiencing or witnessing a traumatic event, such as a car accident. Symptoms of PTSD include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event. While people with OCD can have intrusive thoughts, these thoughts are typically related to themes like contamination or orderliness, rather than reliving past traumas.
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