A client returns to the mental health clinic for assistance with an anxiety reaction that is manifested by a rapid heartbeat, sweating, shaking, and nausea while driving over the bay bridge. Which action in the treatment plan should the nurse implement?

Recommend that the client avoid driving over the bridge.

Teach the client to listen to music or audio books while driving.

Tell the client to drive over the bridge until fear is manageable.

Encourage the client to have the spouse drive in stressful places.

Answer and Explanation

The Correct Answer is B

A. Recommend that the client avoid driving over the bridge: Avoidance reinforces the anxiety and prevents the client from developing effective coping mechanisms. Over time, this may worsen the phobia and reduce the client’s functional independence and quality of life.

B. Teach the client to listen to music or audio books while driving: Calming distractions can help reduce anxiety symptoms and promote gradual exposure to the feared situation. This approach supports desensitization while helping the client stay in control and manage symptoms.

C. Tell the client to drive over the bridge until fear is manageable: Flooding, or forced prolonged exposure, may overwhelm the client and worsen anxiety. A more gradual, supportive approach is generally safer and more effective in treating specific and anxiety.

D. Encourage the client to have the spouse drive in stressful places: Delegating driving to someone else may provide short-term relief, but it limits the client’s independence and does not promote long-term coping or resolution of the anxiety trigger.

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Correct Answer is C

Explanation

A. Electromyography: Electromyography assesses electrical activity in muscles and is used to diagnose neuromuscular disorders. It is not relevant to evaluating bleeding tendencies or pinpoint skin spots, which suggest a hematologic issue like thrombocytopenia.

B. Skin biopsy: A skin biopsy might help diagnose dermatologic conditions, but it is invasive and not the initial step when systemic drug side effects like petechiae are suspected. The presence of red spots suggests a possible blood disorder requiring laboratory confirmation first.

C. Complete blood count: A CBC is essential to evaluate for thrombocytopenia, a known adverse effect of zidovudine. Pinpoint red spots, or petechiae, are often linked to low platelet counts, which require prompt detection and management to prevent serious complications.

D. Allergy test: Allergy testing identifies hypersensitivity reactions, typically associated with rashes or itching. Petechiae are not commonly caused by allergic reactions but are more indicative of blood abnormalities, making this test less immediately relevant.

A. 0800: Heart rate 130 beats/minute, blood pressure 190/90 mm Hg; 1200: heart rate 136 beats/minute, blood pressure 200/100 mm Hg, Kussmaul respirations. B. 0800: Heart rate 55 beats/minute, blood pressure 160/70 mm Hg; 1200: heart rate 50 beats/minute, blood pressure 194/70 mm Hg, irregular respirations. C. 0800: Heart rate 110 beats/minute, blood pressure 130/70 mm Hg; 1200: heart rate 100 beats/minute, blood pressure 110/70 mm Hg, shallow respirations. D. 0800: Heart rate 70 beats/minute, blood pressure 120/60 mm Hg; 1200: heart rate 100 beats/minute, blood pressure 90/60 mm Hg, rapid respirations.

Correct Answer is B

Explanation

A. Elevated heart rate and BP may indicate stress or pain, but Kussmaul respirations are more typical of metabolic acidosis (e.g., DKA), not increased ICP.

B. Bradycardia, widening pulse pressure (increased systolic with stable diastolic), and irregular respirations are signs of Cushing’s triad, a late but classic indicator of increased ICP requiring immediate reporting.

C. Vital signs here are stable and within expected ranges; shallow respirations may be related to sedation or fatigue but not increased ICP.

D. This pattern suggests hypotension and compensatory tachycardia, more consistent with hypovolemia or shock than increased ICP.

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A client returns to the mental health clinic for assistance with an anxiety reaction that is manifested by a rapid heartbeat, sweating, shaking, and nausea while driving over the bay bridge. Which action in the treatment plan should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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