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.