The nurse is caring for a patient preparing for surgery. Which finding would concern the nurse?

Choice A reason: Cool, dry skin is not typically associated with a panic attack, which often involves symptoms like sweating due to the fight-or-flight response.

Choice B reason: Chest pain is a common symptom of panic attacks, often leading individuals to believe they are having a heart attack.

Choice C reason: Pallor, or paleness, may occur during a panic attack, but it is not as common as other symptoms like chest pain.

Choice D reason: Bradycardia, or slow heart rate, is not characteristic of a panic attack; tachycardia, or fast heart rate, is more common.

Choice A: "I’m sorry if I upset you. I just wanted to make sure you’re aware of the day’s schedule."

This response may seem empathetic, but it could potentially reinforce the client's aggressive behavior. The nurse is apologizing, which might give the impression that the client's rude behavior is acceptable¹.

Choice B: "Well, if you can read it yourself, then why don’t you?"

This response is confrontational and could escalate the situation. It's important for the nurse to maintain a neutral and respectful manner.

Choice C: "You don’t have to be so rude. I’m just doing my job."

This response is defensive and could provoke further aggression from the client. It's not recommended to respond defensively to clients with borderline personality disorder¹.

Choice D: "I didn’t mean to offend you. I’ll leave the schedule here for you to review."

This is the most appropriate response. The nurse acknowledges the client's feelings without reinforcing the aggressive behavior. The nurse also respects the client's autonomy by leaving the schedule for the client to review¹.