A nurse is caring for a client who reports acute, moderate anxiety. Which of the following is the priority nursing action?

Instruct the client to remember past coping mechanisms.

Provide a diverting activity.

Encourage verbalization of feelings.

Remain with the client.

Answer and Explanation

The Correct Answer is D

By remaining with the client, the nurse provides a sense of support and security. This presence can help alleviate the client's anxiety and provide reassurance. It also ensures that the nurse is available to assess the client's condition, offer therapeutic communication, and intervene if the anxiety escalates or the client becomes overwhelmed.

While the other options are also beneficial interventions for managing anxiety, they are not the priority in this situation. Instructing the client to remember past coping mechanisms (Option A) can be helpful, but the immediate presence of the nurse is more important to provide immediate support.

Providing a diverting activity (Option B) can be beneficial to distract the client from their anxiety, but it does not address the underlying anxiety or provide direct support.

Encouraging verbalization of feelings (Option C) is important for therapeutic communication, but it may not be the initial priority when the client is experiencing acute anxiety.

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Correct Answer is C

Explanation

Diazepam belongs to the benzodiazepine class of drugs and is commonly used to manage the symptoms of alcohol withdrawal. It helps alleviate anxiety, agitation, tremors, and seizures that can occur during alcohol withdrawal. Diazepam has sedative effects and helps prevent and treat alcohol withdrawal seizures by acting on the central nervous system.

Incorrect:

A- Disulfiram is a medication used to support alcohol abstinence by creating unpleasant reactions if alcohol is consumed. It is not typically administered during acute alcohol withdrawal.

B- Naltrexone is used to help individuals with alcohol dependence reduce their alcohol cravings and drinking behavior. It is not typically used during the acute phase of alcohol withdrawal.

D- Acamprosate is a medication used to maintain abstinence from alcohol in individuals who have already stopped drinking. It is not typically used during the acute phase of alcohol withdrawal.

A. Recognizing the warning signs of suicide B. Identifying individuals who are at higher risk for attempting suicide C. Performing life-saving measures following a suicide attempt D. Providing support for family and friends following a suicide

Correct Answer is C

Explanation

Secondary interventions are aimed at reducing the harm or preventing further complications in individuals who have already engaged in suicidal behavior. In this case, performing life-saving measures after a suicide attempt, such as cardiopulmonary resuscitation (CPR) or administering first aid, falls under the category of secondary intervention.

The other options are examples of primary and tertiary interventions:

A- Recognizing the warning signs of suicide: This is an example of primary intervention, which focuses on preventing suicidal behavior before it occurs by raising awareness, promoting mental health, and identifying risk factors and warning signs.

B- Identifying individuals who are at higher risk for attempting suicide: This is also an example of primary intervention, as it involves assessing and identifying individuals who may be at greater risk for suicidal behavior and implementing preventive measures.

D- Providing support for family and friends following a suicide: This is an example of tertiary intervention, which aims to provide support and care to those who have been affected by a suicide, including family and friends. Tertiary interventions focus on postvention, addressing the aftermath and providing support for survivors.

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A nurse is caring for a client who reports acute, moderate anxiety. Which of the following is the priority nursing action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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