A client in the psychiatric unit is experiencing severe anxiety—they are trembling, pacing, and saying, "I can’t think straight. I feel like something terrible is going to happen." Which of the following is the most therapeutic response by the nurse?

"You need to stop thinking this way. Nothing bad is going to happen."

"Let’s sit together here quietly. I’ll stay with you until you feel more in control."

"Try to calm down. You're safe here, so there’s nothing to worry about."

"Why are you so anxious? Can you tell me what triggered this feeling?"

Answer and Explanation

The Correct Answer is B

Choice A reason: Telling the patient to stop thinking a certain way invalidates their feelings and is not therapeutic.

Choice B reason: Offering presence and calm support provides safety and helps reduce anxiety. It is the most therapeutic intervention for severe anxiety.

Choice C reason: Telling the patient not to worry may feel dismissive, and in severe anxiety the patient may not be able to process reassurance.

Choice D reason: Asking "why" is not effective when the patient is overwhelmed by severe anxiety, as they cannot engage in rational discussion at that moment.

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Correct Answer is A

Explanation

Choice A reason: This response acknowledges the patient’s feelings without confirming or denying the delusion. It helps establish trust while maintaining therapeutic communication. By focusing on the patient’s underlying concern, it avoids reinforcing the delusional content.

Choice B reason: Stating that the CIA is prohibited in health care facilities engages with the delusion, which is non-therapeutic because it validates the false belief.

Choice C reason: Redirecting away from the delusion may seem dismissive and does not address the patient’s immediate feelings of fear or concern. This could cause the patient to feel unheard.

Choice D reason: Telling the patient they have “lost touch with reality” is confrontational and could increase defensiveness. It is not supportive or therapeutic in building rapport.

A. A 28-year-old client who exhibits odd beliefs, magical thinking, social anxiety, and eccentric behavior. B. A 34-year-old client who is dramatic, attention-seeking, and frequently exaggerates emotions in social situations. C. A 45-year-old client who avoids close relationships due to fear of criticism and feelings of inadequacy, yet desires connection. D. A 39-year-old client who is arrogant, lacks empathy, and shows a strong sense of entitlement in interactions with staff.

Correct Answer is A

Explanation

Choice A reason: Odd beliefs, magical thinking, social anxiety, and eccentric behaviors are characteristic of schizotypal personality disorder, which belongs to Cluster A (odd and eccentric disorders).

Choice B reason: Dramatic, exaggerated emotional expression and attention-seeking behavior reflect histrionic personality disorder, which is classified under Cluster B (dramatic, emotional, or erratic disorders).

Choice C reason: Avoidance of relationships due to fear of rejection and inadequacy, despite desiring connection, is typical of avoidant personality disorder, which falls under Cluster C (anxious or fearful disorders).

Choice D reason: Arrogance, lack of empathy, and entitlement describe narcissistic personality disorder, which is in Cluster B.

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A client in the psychiatric unit is experiencing severe anxiety—they are trembling, pacing, and saying, "I can’t think straight. I feel like something terrible is going to happen." Which of the following is the most therapeutic response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient diagnosed with schizophrenia tells the nurse, "The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say." Which response by the nurse would be most therapeutic?

Correct Answer is A

Explanation

A psychiatric nurse is caring for several clients with personality disorders. The nurse understands that the DSM-5 groups these disorders into clusters based on characteristic behaviors. Which of the following client presentations is most consistent with a Cluster A personality disorder?

Correct Answer is A

Explanation

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