RN Nursing · Anxiety Disorders · Practice question
A nurse is providing information to a client about risk factors for developing an anxiety-related disorder. Which of the following clients is at greatest risk for developing an anxiety-related disorder?
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A client who has a family history of anxiety disorders and several positive childhood experiences (PCES).
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A client who has a family history of cancer and is recently unemployed.
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A client who had multiple adverse childhood experiences and whose parents both have a history of anxiety disorder.
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A client who did not graduate from high school or complete their general education development (GED) test.
Answer & explanation
Correct: A client who had multiple adverse childhood experiences and whose parents both have a history of anxiety disorder.
Anxiety disorders have a well-established multifactorial etiology involving genetic predisposition, early life experiences, and environmental stressors. The client at greatest risk is the one who has multiple adverse childhood experiences (ACEs) combined with a family history of anxiety disorder in both parents. This person carries a significant genetic loading — having both parents with anxiety disorder substantially increases inherited vulnerability — and also has multiple environmental risk factors from early life adversity. Research consistently shows that ACEs, such as abuse, neglect, or household dysfunction, are strongly associated with anxiety disorders in adulthood, especially when combined with genetic susceptibility. A client with a family history of anxiety but positive childhood experiences has the genetic risk partially buffered by protective factors. A client with cancer family history and recent unemployment has stressors but lacks the specific genetic predisposition for anxiety disorders specifically. A client who did not complete high school has a socioeconomic risk factor but no family history of anxiety or documented early adversity in this scenario. The combination of genetic vulnerability plus multiple ACEs represents the highest cumulative risk, making option C the correct answer, which aligns with the keyed response.
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