Persistent, uncontrollable worry about multiple everyday concerns is the central feature.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A client with generalized anxiety disorder is hyperventilating and pacing, stating they feel like they are losing control. Which nursing intervention is most appropriate first?
Answer: B. During acute anxiety the client's ability to process is reduced; the nurse should remain with the client and use a calm voice with simple, clear directions, such as slow breathing. Leaving the client alone, providing detailed teaching, or demanding the client calm down all increase anxiety.
Question 2 of 5
A client with generalized anxiety disorder is started on buspirone. The nurse teaches that buspirone:
Answer: B. Buspirone is non-sedating, non-addictive, and takes 2–4 weeks for full effect (not for acute panic). It is taken consistently, not PRN for immediate relief.
Question 3 of 5
A client with obsessive-compulsive disorder performs lengthy hand-washing rituals. Early in treatment the nurse should:
Answer: B. Allow time for the ritual initially (preventing it abruptly raises anxiety) while setting reasonable limits and building trust; gradually reduce with the treatment plan.
Question 4 of 5
A client repeatedly checks that the door is locked dozens of times, distressed but unable to stop. This compulsion is most associated with:
Answer: B. Repetitive behaviors performed to reduce anxiety from obsessions characterize obsessive-compulsive disorder (OCD).
Question 5 of 5
A client with severe COPD expresses anxiety and fear during episodes of dyspnea. Which nursing intervention is most appropriate to help reduce the client's anxiety?
Answer: B. Staying with the client and coaching slow, pursed-lip breathing provides reassurance and helps break the cycle of anxiety and dyspnea that can worsen breathlessness. Leaving the client alone, dismissing the fear, or telling the client to simply calm down would increase anxiety and is not therapeutic.
Keep the streak going with more questions like these, each with a full rationale.
What is generalized anxiety disorder?
It causes physical and cognitive symptoms that impair functioning. SSRIs/SNRIs and buspirone are first-line; benzodiazepines are for short-term use only due to dependence risk.
Key points to remember
- Persistent, uncontrollable worry about multiple everyday concerns is the central feature.
- Physical symptoms include restlessness, muscle tension, fatigue, irritability, and sleep disturbance.
- Anxiety narrows perceptual field; severe and panic levels impair the ability to learn or problem-solve.
- Buspirone is non-addictive but takes 1 to 2 weeks to work, so it is not for acute attacks.
- Benzodiazepines act quickly but carry tolerance, dependence, and sedation risk.
- Caffeine and stimulants worsen anxiety symptoms.
Signs & symptoms
- Uncontrollable worry, restlessness
- Muscle tension, fatigue, irritable
- ↓ concentration, sleep trouble
Nursing priorities
- Stay with the anxious client and remain calm; use short simple sentences during high anxiety.
- Reduce environmental stimuli and provide a quiet, safe space.
- Teach and coach relaxation techniques such as deep breathing and grounding.
- Help the client identify triggers and effective coping strategies once anxiety lowers.
- Encourage gradual problem-solving only after anxiety is reduced to a moderate level.
Labs & values
Patient teaching
- Buspirone must be taken regularly and takes 1-2 weeks for effect; it does not work on demand.
- Avoid caffeine, nicotine, and other stimulants that heighten anxiety.
- Do not stop benzodiazepines abruptly; practice relaxation skills daily.
Red flags: report now
- Escalation to panic level with chest pain or hyperventilation requires immediate calm presence and assessment to rule out medical causes.
- Abrupt benzodiazepine withdrawal can cause seizures and must be tapered.
- Combining benzodiazepines with alcohol or opioids risks fatal respiratory depression.
References
Clinical references for this topic
