A nurse in a mental health facility is caring for a client who is experiencing a panic level of anxiety. Which of the following actions should the nurse take?
Tell the client to sit alone in a private place and reflect on the situation.
Use short sentences when communicating with the client
Have the client journal about what is happening to him
Encourage the client to talk about his feelings.
The Correct Answer is B
Rationale:
A. Tell the client to sit alone in a private place and reflect on the situation: Clients in a panic state are overwhelmed, disorganized, and unable to focus. Leaving them alone can increase feelings of isolation and fear, worsening the anxiety.
B. Use short sentences when communicating with the client: During panic-level anxiety, the client's ability to process information is impaired. Clear, concise communication helps reduce confusion and provides a sense of control and safety.
C. Have the client journal about what is happening to him: Journaling requires introspection and cognitive organization, which are not possible when a client is in a panic state. This intervention is more appropriate once anxiety levels have decreased.
D. Encourage the client to talk about his feelings: While verbalizing emotions is therapeutic, a client in panic may not be able to articulate thoughts. The priority is to first reduce the anxiety to a manageable level using calm, simple guidance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Apply the largest cuff available: Using a cuff that is too large for the client can yield inaccurately low readings. Cuff size should match the client’s arm circumference, not be chosen randomly or for convenience.
B. Use the palpatory method to determine blood pressure: When auscultation is difficult, the palpatory method helps estimate the systolic pressure by palpating the radial pulse. This guides proper cuff inflation and avoids missing the auscultatory gap.
C. Place the arm above the level of the client's heart: Elevating the arm above heart level can result in falsely low readings. The arm should be supported at heart level to obtain accurate results.
D. Deflate the cuff quickly: Rapid deflation can cause the nurse to miss key Korotkoff sounds, leading to an inaccurate measurement. Cuff deflation should be slow and controlled (2–3 mm Hg/sec).
Correct Answer is C
Explanation
Rationale:
A. Fibrinogen level: Fibrinogen is a clotting factor that can reflect coagulation activity, but it is not used to monitor warfarin therapy. It is more relevant in conditions like DIC or liver disease, not for warfarin dose adjustments.
B. aPTT: Activated partial thromboplastin time (aPTT) is used to monitor heparin therapy. Warfarin, which affects the extrinsic pathway of coagulation, does not significantly impact aPTT levels.
C. INR: The international normalized ratio (INR) is the standard test used to monitor warfarin therapy. It reflects the effect of warfarin on prothrombin time and guides safe and effective dosing to maintain therapeutic anticoagulation.
D. Platelet count: While platelet count helps evaluate bleeding risk and detect thrombocytopenia, it is not used to guide warfarin dosing. Warfarin works by inhibiting vitamin K–dependent clotting factors, not by affecting platelet production.
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