A client with generalized anxiety disorder does not want to communicate with friends, smokes 2 to 3 packages of cigarettes a day, and describes difficulty concentrating at work. Which coping strategy should the nurse include in the plan of care?
Focus on small achievable tasks, not taxing problems.
Relax and reduce the amount of effort to solve the problem.
Analyze past hurts and resentments to identify the source.
Concentrate on and ventilate emotions when distressed.
The Correct Answer is A
Choice A reason: Focusing on small achievable tasks helps the client experience a sense of accomplishment and reduce anxiety. It provides structure and manageable goals, which can improve concentration and reduce overwhelming feelings.
Choice B reason: Relaxing and reducing the effort to solve the problem may help to some extent, but it is not a comprehensive coping strategy and does not address the client's avoidance behaviors and concentration difficulties.
Choice C reason: Analyzing past hurts and resentments is more aligned with psychotherapy rather than an immediate coping strategy for generalized anxiety disorder.
Choice D reason: Concentrating on and ventilating emotions when distressed might provide temporary relief but does not address the broader issue of managing anxiety and improving function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Holding urine for at least 10 minutes does not dilute bacteria and can actually increase the risk of infection.
Choice B reason: Emptying the bladder before and after sexual intercourse helps flush out bacteria that may have been introduced during intercourse, reducing the risk of UTI.
Choice C reason: Drinking large amounts of fluids before bedtime is not specific to preventing UTIs and may lead to nighttime urination, disrupting sleep.
Choice D reason: Cleansing the perineal area in a circular motion is not the recommended method. The recommended practice is to wipe from front to back to prevent the spread of bacteria from the rectal area to the urethra.
Correct Answer is C
Explanation
Choice A reason: Intubation is not the first step in managing COPD exacerbation unless the client is in severe respiratory failure (e.g., unresponsive, unable to protect airway, pH severely low). This client is alert, able to maintain vitals, so less invasive interventions should be tried first.
Choice B reason: High-flow oxygen at 100% can eliminate the hypoxic drive to breathe in COPD patients, leading to CO₂ retention and respiratory acidosis. Controlled oxygen therapy (e.g., nasal cannula or Venturi mask at 1–2 L/min or FiO₂ 24–28%) is preferred.
Choice C reason: This "tripod" position reduces work of breathing by optimizing diaphragmatic expansion and helping accessory muscles function more effectively. It is an evidence-based immediate nursing intervention for acute dyspnea in COPD.
Choice D reason: Obtaining a sputum sample for culture and sensitivity is important for identifying the cause of the infection but is not the immediate priority.
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