A nurse is assisting with planning care for a client who has been brought to the inpatient mental health unit by law enforcement officers after becoming aggressive in a local bar. The nurse should identify that this finding is consistent with which of the following disorders?

A. Voice tremors are associated with moderate anxiety, where the individual begins to exhibit physical signs of distress but still retains some level of focus. At panic-level anxiety, communication becomes severely impaired, often resulting in unintelligible speech or complete loss of verbal ability.
B. Depersonalization, a dissociative symptom in which individuals feel detached from their own body or reality, is a hallmark of panic-level anxiety. During this state, individuals may experience a sense of unreality, feel as though they are outside their body, or believe that their surroundings are distorted, contributing to a profound sense of fear and disorientation.
C. Shakiness is a physiological response observed in moderate to severe anxiety due to increased autonomic arousal. However, at panic-level anxiety, the body is in a state of extreme crisis, often leading to more severe symptoms such as hyperventilation, loss of motor control, and derealization rather than mere shakiness.
D. Poor concentration is characteristic of moderate to severe anxiety, where cognitive function begins to decline due to excessive worry. However, in panic-level anxiety, cognitive function is severely impaired, and the individual may be unable to process information coherently, often leading to complete disorganization of thought.

A. Although you have mentioned wanting to talk today about your past abuse, let's discuss this handout I have with new coping skills. Redirecting the client away from their chosen topic disregards their needs and autonomy. Patient-centered care involves respecting the client’s concerns and prioritizing what is most meaningful to them.
B. I am going to have to change our meeting time because I need to go get lunch. Changing the meeting time based on the nurse’s personal needs rather than the client’s schedule does not align with patient-centered care. The focus should remain on the client's well-being and therapeutic relationship.
C. Let's review the goals you set today and see what your priority is this week. Reviewing client-established goals and prioritizing their needs aligns with patient-centered care. This approach fosters collaboration and empowers the client to take an active role in their recovery.
D. I would like to focus on what I believe are the best goals for you to work on. Imposing the nurse’s priorities over the client’s goals does not support patient-centered care. Instead, care should be tailored to the client's preferences, values, and recovery journey.