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 ["A","B"]

Explanation

A. History of hypertension: Although the client’s current blood pressure is controlled with atenolol, the need for medication confirms a history of hypertension. Hypertension is a major modifiable risk factor for coronary artery disease and warrants ongoing assessment.

B. Family health history: A strong family history of heart disease and diabetes, particularly in first-degree relatives, significantly increases the client’s risk for cardiovascular events. The genetic predisposition should be explored to assess early markers and implement prevention strategies.

C. Vegetarian diet: A vegetarian diet is generally associated with lower cardiovascular risk due to reduced intake of saturated fats and cholesterol. Unless the diet is poorly balanced or nutrient-deficient, it does not constitute a risk factor that requires further evaluation here.

D. Sexual history: Sexual history may be relevant in certain clinical contexts, such as evaluating HIV risk or sexually transmitted infections, but it is not directly related to the client's cardiac symptoms or concern about hereditary heart disease.

E. Excessive aerobic exercise: The client’s activity level (jogging) is not excessive and is generally healthy, unless it is associated with overtraining or extreme exertion. There is no indication here that excessive exercise is a concern, so further exploration is not needed based on this information.

A. Her fourth child weighed 9 pounds (4.08 kg) at 41 weeks gestation B. Client is at 28 weeks. She has been receiving prenatal care since 8 weeks gestation C. Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dL (9.1 mmol/L) D. Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 (9.3 mmol/L) and a two-hour postprandial of 220 mg/dL (12.2 mmol/L)

Correct Answer is ["A","C","D"]

Explanation

Rationale for correct findings:

Fasting 1-hour glucose screen: 164 mg/dL (9.1 mmol/L): The fasting glucose of 164 mg/dL is elevated, indicating impaired glucose metabolism, which suggests the possibility of gestational diabetes.
3-hour glucose tolerance test: Fasting blood sugar 168 mg/dL (9.3 mmol/L): The fasting blood sugar of 168 mg/dL is above the normal threshold of 140 mg/dL, reinforcing the suspicion of gestational diabetes.
2-hour postprandial glucose: 220 mg/dL (12.2 mmol/L): A postprandial glucose level of 220 mg/dL is significantly above the normal limit of 140 mg/dL, further indicating gestational diabetes.
Fourth child with macrosomia: 9 pounds (4.08 kg) at 41 weeks gestation: Macrosomia is often associated with gestational diabetes. The fourth child weighing 9 pounds suggests the possibility of undiagnosed gestational diabetes during the previous pregnancy, which could be recurring in the current pregnancy.

Rationale for incorrect Findings:

Client is at 28 weeks and has been receiving prenatal care since 8 weeks gestation: The client’s consistent prenatal care since 8 weeks indicates early and regular monitoring, reducing the likelihood of other major complications.

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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

Correct Answer is ["A","B"]

Explanation

Correct Answer is ["A","C","D"]

Explanation

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