A client who has agoraphobia is beginning desensitization with the therapist, and the nurse is reinforcing the process. Which intervention has the highest priority for this client's plan of care?

Establish trust by providing a calm, safe environment.

Encourage deep breathing when anxiety escalates in a crowd.

Progressively expose the client to larger crowds.

Encourage substitution of positive thoughts for negative ones.

Answer and Explanation

The Correct Answer is A

A.   Establishing trust by providing a calm, safe environment is crucial for clients with agoraphobia, as it lays the foundation for effective therapeutic interventions and supports the client's sense of safety and security.
B.   Encouraging deep breathing is a helpful coping strategy, but it may not be the highest priority compared to establishing trust and safety.
C.   Progressively exposing the client to larger crowds is part of desensitization therapy, but it should be done gradually and only after trust and rapport have been established.
D.   Encouraging substitution of positive thoughts for negative ones is a valuable cognitivebehavioral technique, but it may be more effective once the client feels safe and supported in the therapeutic environment.

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Correct Answer is A

Explanation

A. Nausea and vomiting could indicate potential lithium toxicity, which requires immediate medical attention to prevent serious complications.
B. Short-term memory loss is a known side effect of lithium therapy but may not require immediate medical attention unless severe or persistent.
C. Weight gain is a common side effect of lithium, but a five-pound (2.3 kg) gain may not be considered significant enough to warrant immediate medical attention unless it occurs rapidly or is accompanied by other symptoms.
D. Depressed affect is a symptom of depression and may be related to the client's underlying condition but may not require immediate medical attention unless it poses a risk to the client's safety.

A. Administer the prescribed anticholinergic benztropine for dystonia. B. Offer the client a prescribed physical therapy hot pack for muscle spasms. C. Direct the client to occupational therapy to distract him from somatic complaints. D. Medicate the client with the prescribed antipsychotic thioridazine.

Correct Answer is A

Explanation

A. The client's symptoms, including a laterally contracted position and perception of body contortion, suggest acute dystonia, a known side effect of antipsychotic medications like risperidone. Administering an anticholinergic such as benztropine can help alleviate these symptoms.
B. Offering a hot pack for muscle spasms may provide some relief for generalized muscle discomfort but would not specifically address the dystonic reaction.
C. Directing the client to occupational therapy may be beneficial for overall treatment but does not address the immediate need to alleviate acute dystonic symptoms.
D. Thioridazine is an antipsychotic medication but is not typically used as a first-line treatment for acute dystonia. Administering benztropine, an anticholinergic, would be more appropriate for dystonia associated with risperidone use.

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A client who has agoraphobia is beginning desensitization with the therapist, and the nurse is reinforcing the process. Which intervention has the highest priority for this client's plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is A

Explanation

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