A nurse is reviewing the medical record for a client who has generalized anxiety disorder. Which of the following manifestations should the nurse expect to see included in the client's medical record?

The client is preoccupied with a supposed body defect.

The client compulsively bites fingernails.

The client exhibits hoarding behaviors.

The client puts off making decisions.

Answer and Explanation

The Correct Answer is D

A. "The client is preoccupied with a supposed body defect.": This manifestation is more characteristic of body dysmorphic disorder rather than generalized anxiety disorder (GAD).

B. "The client compulsively bites fingernails.": Nail-biting is often associated with obsessive-compulsive disorder (OCD) or other stress-related behaviors rather than GAD.

C. "The client exhibits hoarding behaviors.": Hoarding is typically associated with obsessive-compulsive disorder (OCD) and not generalized anxiety disorder.

D. "The client puts off making decisions.": Individuals with generalized anxiety disorder often experience indecisiveness and procrastination due to excessive worry and fear of making the wrong choice. This is a common manifestation of GAD

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Correct Answer is A

Explanation

A) Help the client role play alternative solutions to identified problems: Role-playing can be a highly effective intervention for clients with generalized anxiety disorder (GAD). It allows clients to practice and develop problem-solving skills in a safe and supportive environment. By simulating different scenarios, clients can explore various responses and coping mechanisms, which can help reduce anxiety by increasing their confidence and preparedness for real-life situations.

B) Have the client write a list of personal characteristics they feel need improvement: This approach may inadvertently increase a client's anxiety by focusing on perceived personal shortcomings. It is more beneficial to focus on strengths and positive attributes to build self-esteem and resilience. Encouraging self-criticism can exacerbate feelings of inadequacy and contribute to a negative self-concept.

C) Give the client detailed instructions when providing teaching about ways to cope: While providing information is important, detailed instructions can sometimes overwhelm clients with GAD, leading to increased anxiety. It is more effective to offer clear, concise, and manageable steps and to ensure that the client fully understands and feels comfortable with each coping strategy before moving on to the next one.

D) Give the client an alternative interpretation of the client's perception of a situation: Offering alternative interpretations can be helpful, but it must be done cautiously. Clients with GAD may feel invalidated if their perceptions are dismissed or challenged too directly. It is more supportive to guide clients to explore and consider different perspectives on their own, fostering a sense of autonomy and self-efficacy in managing their anxiety.

A. Offer the client a small meal if she is not nauseated. B. Administer 1 mg of glucagon intramuscularly to the client. C. Contact the client's provider for further instructions D. Transport the client to an emergency department for treatment.

Correct Answer is B

Explanation

A) Offer the client a small meal if she is not nauseated:
While eating a small meal can help raise blood glucose levels, it is not the immediate priority in a severe hypoglycemia situation. The client might be unconscious or unable to swallow safely, making this action inappropriate as a first step.

B) Administer 1 mg of glucagon intramuscularly to the client:
Administering glucagon intramuscularly is the most crucial initial action. Glucagon rapidly increases blood glucose levels by stimulating glycogen breakdown in the liver. This is vital for quickly reversing severe hypoglycemia, especially if the client is unconscious or unable to ingest carbohydrates orally.

C) Contact the client's provider for further instructions:
Contacting the provider is essential, but it should occur after addressing the immediate hypoglycemic episode. Once the client's condition stabilizes, further guidance can be sought from the healthcare provider.

D) Transport the client to an emergency department for treatment:
Transporting the client to the emergency department is necessary if the hypoglycemia does not improve after administering glucagon or if the client remains unresponsive. However, it is not the first action; immediate glucagon administration takes precedence to stabilize the client's condition before considering transportation.

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A nurse is reviewing the medical record for a client who has generalized anxiety disorder. Which of the following manifestations should the nurse expect to see included in the client's medical record?

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