1. Maria Torres is a 23-year-old Hispanic single mother of two and is enrolled as a

student at the local community college. She works 30 hours a week as a

waitress at a local restaurant in addition to her course work. Maria states that

she is “excited about her future career as a computer programmer.” She

manages her living expenses marginally, but states that she is reasonably happy

and satisfied with her life. She states that she is getting good grades in her

college courses. Her mother helps care for her two small children when Maria is

at school, studying, or working. (Learning Objectives: 1 and 4)

a. Based on this information, what personal factors or characteristics would

reflect Maria’s current state of mental health or illness according to the

information in Chapter 1?

b. What if Maria’s situation suddenly changed and she lost her housing? What

concerns would you, as the nurse, have for Maria and her children now? How

would you counsel Maria to obtain the needed assistance and support she

requires in the face of her new situation?

2. The student nurse is accompanying the psychiatric nurse in a nursing

assessment of a newly admitted client. The psychiatric nurse tells the student nurse

that the client is profoundly depressed and has refused to bathe or eat for the past

one week. The psychiatric nurse stressed that all clients admitted to a hospital for

psychiatric treatment will have a diagnosis from the DSM stated on the chart by the

psychiatrist. The nurse explains that the nursing diagnosis will consider past and

present responses to actual mental health problems and provide a conceptual

framework for identifying interventions for the abnormality the client is

experiencing. (Learning Objective: 2)

a. What would the psychiatric nurse’s reply be if the student nurse asked him or

her what type of client information the DSM is associated with?

b. How does the DSM diagnosis affect client care?

c. What information do the DSM criteria impart to the 

multidisciplinary team

members?

Suggested Answers to Case Study, Chapter 14, Anxiety and

Anxiety Disorders

1.

a. The nursing diagnosis of anxiety related to recent difficulty at work, concerns

about her brother’s health and placement, and irritability with

apprehension/helplessness is appropriate in Penny’s situation.

b. The signs/symptoms Penny is experiencing are associated with severe or

panic levels of anxiety.

c. The nurse should provide calm, brief, directive communication to help Penny

to regain control of overwhelming impulses that escalate into a panic attack.