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 C
Explanation
Rationale:
A. Monitor the client for hypertension: Epidural anesthesia commonly causes hypotension due to sympathetic nervous system blockade, not hypertension. Monitoring for hypotension is more appropriate.
B. Have protamine sulfate available at the bedside: Protamine sulfate is the antidote for heparin, not epidural anesthesia. It has no relevance in managing epidural-related effects during labor.
C. Reposition the client side-to-side each hour: Changing positions frequently helps promote venous return, enhance placental perfusion, and reduce the risk of pressure injuries and aortocaval compression from a supine position.
D. Decrease the maintenance infusion rate of IV fluid: IV fluids are typically increased before and during epidural anesthesia to prevent or manage hypotension, not decreased. Reducing the rate could worsen hypotension.
Correct Answer is B
Explanation
Rationale:
A. Provide frequent stimulation for the newborn: Newborns with neonatal abstinence syndrome (NAS) are often hypersensitive to stimuli. Excessive stimulation can worsen symptoms such as tremors, irritability, and sleep disturbances.
B. Decrease the lighting levels in the nursery: Reducing environmental stimuli such as bright lights and loud noises helps soothe infants with NAS. A calm, low-stimulation setting promotes comfort and minimizes overstimulation.
C. Wrap the newborn loosely in a blanket: Tight swaddling not loose wrapping is recommended for NAS to provide a sense of security and decrease tremors and agitation. Loose wrapping can increase distress and reduce effectiveness.
D. Encourage frequent eye contact with the newborn during feedings: Direct eye contact can be overstimulating for infants experiencing NAS. Instead, feedings should be calm and gentle, with minimal stimulation to reduce stress and improve tolerance.
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