How should a nurse best describe the major maladaptive client response to panic disorder?

Correct Answer: D

Rationale: The major maladaptive client response to panic disorder is clients developing compulsions to deal with anxiety. Panic disorder is a type of anxiety disorder characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms such as heart palpitations, shortness of breath, and dizziness. In an attempt to cope with the overwhelming anxiety associated with panic attacks, individuals may develop compulsions or rituals. These compulsions can vary widely and often serve as a way for the individual to try and regain a sense of control or alleviate their anxiety. This response is maladaptive because while the compulsions may provide temporary relief, they do not address the root cause of the anxiety and can contribute to the cycle of panic attacks.

Correct Answer: B

Rationale: This statement suggests that the physical symptoms Carly is experiencing may be serving as a secondary gain for her. Despite medical tests showing no evidence of a brain tumor, Carly's continued belief that her headaches are due to a serious condition could be providing her with a sense of significance or attention. This belief may also help her avoid dealing with underlying emotional issues or stressors, providing a psychological benefit as well. This points towards secondary gains related to the somatic symptom disorder.

Correct Answer: B

Rationale: Dissociative fugue is a subtype of dissociative amnesia and is characterized by sudden, unexpected travel or bewildered wandering during which the person is unable to recall some or all of their past. This dissociative disorder is typically triggered by extreme psychological stress or trauma. Unlike the other choices, dissociative fugue is intrinsically linked to memory loss and a specific behavior pattern of travel or wandering coupled with amnesia, making choice B the accurate description of dissociative fugue.

Correct Answer: A

Rationale: In confirming a diagnosis of generalized amnesia, the nurse should ask the client questions that assess their ability to recall personal information. Option A, "Can you tell me your name and where you live?" is the correct choice as it directly evaluates the client's ability to remember basic personal details, which is a key feature of generalized amnesia. Option B, "Have you ever traveled suddenly or unexpectedly away from home?" is incorrect as it pertains more to dissociative fugue rather than generalized amnesia. Option C, "Have you recently experienced any traumatic event?" is incorrect as it focuses on potential triggers for memory loss rather than assessing the memory loss itself. Option D, "Have you ever felt detached from your environment?" is incorrect as it pertains more to depersonalization rather than memory loss. Educationally, understanding the specific types of amnesia and related conditions is crucial for nurses to accurately assess and care for clients with memory disturbances. By differentiating between the types of memory loss and knowing the appropriate assessment questions, nurses can provide targeted care and support to individuals experiencing these conditions.