A client relates the following history: the presence of intrusive ...

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A client relates the following history: the presence of intrusive thoughts that her hands are con-taminated by illness-producing bacteria and the uncontrollable urge to scrub her hands and any-thing she has touched.
 
  The nurse will plan to access and modify the standard care plan for:
  1. Generalized anxiety disorder
  2. Panic disorder
  3. Obsessive-compulsive disorder
  4. Posttraumatic stress disorder

Question 2

A client comes to the ED for the fifth time in 2 weeks with severe physical and emotional symp-toms: She is diaphoretic, her heart is racing (124 bpm), she states she cannot breathe, and she is experiencing chest pain.
 
  Her BP is 148/90, and she tells the nurse she is afraid she is going to die. On all five visits, no physical cause for the symptoms could be determined. The nurse analyzes the history and symp-toms as being most consistent with the medical diagnosis:
  1. Phobia
  2. Panic disorder
  3. Generalized anxiety disorder
  4. Anxiety trait problem

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Answer to Question 1

ANS: 3
These symptoms are consistent with DSM-IV-TR criteria for obsessive-compulsive disorder. This clinical picture is neither suggestive of nor consistent with DSM-IV-TR criteria for generalized anxiety disorder (option 1), panic disorder (option 2), or posttraumatic stress disorder (option 4).

Answer to Question 2

ANS: 2
The symptoms are consistent with those of panic disorder. 1. There is no mention of an object of fear. 3. The symptoms are more acute than for generalized anxiety disorder. 4. Anxiety trait problem is not a medical diagnosis.

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