A client who has coronary artery disease tells the nurse he is afraid of dying from a heart attack. Which of the following responses should the nurse make?

Choice A rationale: Agoraphobia is a type of anxiety disorder where the person fears and avoids places or situations that might cause them to panic, feel trapped, or helpless. The goal of treatment for agoraphobia is to help the person feel less anxious and fearful about being in places or situations that they perceive as difficult to escape from. This is often achieved through a combination of cognitive-behavioral therapy (CBT) and medication. In CBT, the person learns to understand and change thought patterns that lead to troublesome feelings, behaviors, and symptoms.

Gradual exposure to the feared situation, under controlled conditions, can help the person gain better control over their anxiety. Therefore, the statement “I plan to sit on a park bench for a few minutes each day” indicates an understanding of the goals of treatment as it suggests a willingness to gradually expose oneself to feared situations.

Choice B rationale: The statement “I can try participating in group therapy every week” does not necessarily indicate an understanding of the goals of treatment for agoraphobia. While group therapy can be beneficial for many mental health conditions, it is not specific to the treatment of agoraphobia. In the context of agoraphobia, the focus of treatment is more on individual cognitive-behavioral therapy and gradual exposure to feared situations.

Choice C rationale: The statement “I will join a book club in my neighborhood” does not necessarily indicate an understanding of the goals of treatment for agoraphobia. Joining a book club could potentially provide social support and a sense of community, which can be beneficial for mental health in general. However, it does not specifically address the fears and avoidance behaviors associated with agoraphobia.

Choice D rationale: The statement “I should avoid entering elevators and other closed spaces” indicates a misunderstanding of the goals of treatment for agoraphobia. Avoidance of feared situations is a common symptom of agoraphobia, and treatment aims to reduce this avoidance behavior, not reinforce it. Therefore, this statement suggests a need for further education about the goals of treatment.

Choice A rationale: Providing privacy when friends visit is a general good practice in nursing. However, it may not be the most effective intervention for a client with anorexia nervosa. Anorexia nervosa is characterized by a distorted body image and an intense fear of gaining weight. While privacy is important, it is not directly related to the management of anorexia nervosa.

Choice B rationale: Scheduling regular weigh-in times is a key intervention for clients with anorexia nervosa. Regular weigh-ins help monitor the client’s progress and any potential complications related to weight loss. This intervention is directly related to the management of anorexia nervosa and is therefore the correct answer.

Choice C rationale: Complimenting the client for weight gain can be a sensitive issue for individuals with anorexia nervosa. While it might seem like a positive reinforcement, it could potentially trigger anxiety and fear in the client, as individuals with anorexia nervosa have an intense fear of gaining weight. Therefore, this intervention should be handled with care and is not the best choice in this scenario.

Choice D rationale: Allowing the client to eat at any time might seem like a good idea, but it is not the most effective intervention for a client with anorexia nervosa. Individuals with anorexia nervosa often have strict rituals and rules around eating. Allowing them to eat at any time might not address these underlying issues and could potentially enable their disordered eating habits.