A client who has agoraphobia is beginning desensitization with the therapist, and the nurse is reinforcing the process. Which intervention has the highest priority for this client's plan of care?
Establish trust by providing a calm, safe environment.
Encourage deep breathing when anxiety escalates in a crowd.
Progressively expose the client to larger crowds.
Encourage substitution of positive thoughts for negative ones.
The Correct Answer is A
A. Establishing trust by providing a calm, safe environment is crucial for clients with agoraphobia, as it lays the foundation for effective therapeutic interventions and supports the client's sense of safety and security.
B. Encouraging deep breathing is a helpful coping strategy, but it may not be the highest priority compared to establishing trust and safety.
C. Progressively exposing the client to larger crowds is part of desensitization therapy, but it should be done gradually and only after trust and rapport have been established.
D. Encouraging substitution of positive thoughts for negative ones is a valuable cognitivebehavioral technique, but it may be more effective once the client feels safe and supported in the therapeutic environment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Clients taking disulfiram must completely avoid alcohol, as even small amounts can cause severe reactions (e.g., nausea, vomiting, flushing, hypotension). There is no safe amount of alcohol to consume while on this medication.
B. Alcohol consumption must be completely avoided, not just limited, while taking disulfiram, as the drug works by causing an aversive reaction when alcohol is ingested.
C. Disulfiram should not be started immediately if alcohol is still in the system. It must be initiated at least 12–48 hours after the last drink to prevent severe reactions.
D. The client should begin taking disulfiram at least 48 hours after the last alcohol intake to reduce the risk of adverse effects. The medication is taken daily, and alcohol must be strictly avoided, including in hidden sources like mouthwash and cooking extracts.
Correct Answer is A
Explanation
A. Caring for an older parent and her own children simultaneously can lead to significant caregiver role strain due to the increased responsibilities and demands on the client's time and energy.
B. Feeling anxious to leave for personal appointments may indicate stress but does not specifically address caregiver role strain.
C. Taking naps in her car during lunch hour may suggest fatigue or exhaustion but does not directly relate to caregiver role strain.
D. Working an average of 60 hours per week may contribute to overall stress and fatigue but does not specifically address the client's role as a caregiver for her parent and children.
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