A client with a phobia is experiencing physiological symptoms such as palpitations, sweating, and shortness of breath. These symptoms are most likely due to:

Choice A rationale:

The client reporting decreased fear and anxiety related to phobias (Choice A) is a subjective outcome that might not accurately reflect the effectiveness of the nursing interventions. It relies solely on the client's self-report and might not provide an objective measure of improvement.

Choice B rationale:

The client demonstrating increased avoidance behavior (Choice B) is not an outcome aimed at reducing fear and anxiety. Increased avoidance behavior would actually indicate a worsening of the phobia-related symptoms, as the client is avoiding the feared stimulus more.

Choice C rationale:

The client engaging in exposure therapy without excessive distress (Choice C) is a desired outcome for interventions targeting phobias. Exposure therapy involves gradually exposing the client to the feared stimulus in a controlled manner. If the client can tolerate exposure without excessive distress, it indicates a positive response to the intervention and a reduction in fear and anxiety over time.

Choice D rationale:

The client applying cognitive-behavioral techniques ineffectively (Choice D) is not a desirable outcome. The goal of cognitive-behavioral techniques is to equip the client with effective coping strategies to manage their phobias. If the client is applying these techniques ineffectively, it indicates a need for further intervention or adjustment of the therapeutic approach.

Choice B rationale:

The client's intense fear of embarrassing themselves in front of others and the specific fear related to giving a presentation are indicative of social phobia (social anxiety disorder) Social phobia involves an excessive fear of social situations where the individual fears negative evaluation or judgment by others, leading to avoidance of such situations.

Choice A rationale:

While the client's fear is related to public speaking, the emphasis is on the fear of embarrassment and negative evaluation rather than a fear of a specific object or situation, which aligns more with social phobia.

Choice C rationale:

Agoraphobia does not align with the client's fear of public speaking. Agoraphobia involves the fear of situations where escape might be difficult or help might not be available if a panic attack occurs, often leading to avoidance of various places or situations.

Choice D rationale:

Panic disorder involves recurrent and unexpected panic attacks, which are not explicitly mentioned in the client's statement. The focus of the client's fear is on the social aspect of giving a presentation rather than on panic attacks.