During a therapy session, a nurse is speaking with a client who has a phobia of public speaking. The client expresses, "I'm so afraid that I'll embarrass myself in front of others. I can't even imagine giving a presentation without feeling intense fear." Based on the client's statement, the nurse identifies that the client is most likely experiencing:

Choice A rationale:

This statement accurately captures the key features of phobias. Phobias involve intense, irrational fear reactions to specific objects or situations that persist over time. The fear is often excessive in relation to the actual threat posed by the phobic stimulus.

Choice B rationale:

The statement "Phobias can be caused by biological factors only" (choice B) is not accurate. While biological factors like genetics and brain chemistry can contribute to the development of phobias, they are not the sole cause. Psychological and environmental factors also play significant roles.

Choice C rationale:

The statement "Phobias can be diagnosed based on physical symptoms" (choice C) is incorrect. Phobias are diagnosed based on psychological symptoms, such as intense fear, avoidance behavior, and distress. Physical symptoms may accompany the fear response but are not the primary diagnostic criteria.

Choice D rationale:

The statement "Phobias can be managed with medication alone" (choice D) is not entirely accurate. While medication can help alleviate symptoms of anxiety associated with phobias, the most effective treatments often involve psychotherapy, particularly exposure therapy, to address the underlying fear response and promote lasting change.

Choice C rationale:

Collaborating with the client to set realistic and achievable goals for overcoming phobias (Choice C) is an example of a nursing intervention for phobias. This empowers the client to actively participate in their treatment, fostering a sense of control and motivation to confront their fears.

Choice A rationale:

Providing a safe and supportive environment for the client (Choice A) is important, but it is a more general intervention that doesn't specifically address the process of overcoming phobias.

Choice B rationale:

Encouraging the client to avoid situations that trigger phobic responses (Choice B) is counterproductive, as mentioned earlier. It reinforces avoidance behaviors rather than helping the client confront their fears.

Choice D rationale:

Referring the client to other health care professionals as needed (Choice D) is a potential step in the treatment process, but it doesn't exemplify a direct nursing intervention for phobias. It's more about coordinating care if specialized help is required.