A nurse in the emergency department is caring for a client who is exhibiting manifestations of a panic level of anxiety. Which of the following interventions should the nurse initiate?

Encourage the client to reframe their perception of stress

Guide the client to a location that is quiet and stay with the client.

Help the client identify factors that are contributing to the anxiety

Ask questions to clarify how the client feels and what they are thinking.

Answer and Explanation

The Correct Answer is B

A. Encourage the client to reframe their perception of stress: Reframing can be a helpful strategy for less severe anxiety, but during a panic attack, the client may be too overwhelmed to engage in cognitive techniques like reframing. Immediate support is needed first.

B. Guide the client to a location that is quiet and stay with the client: This is the best intervention. A quiet environment helps reduce external stimuli, and staying with the client provides reassurance and safety, helping to calm the overwhelming anxiety during a panic attack.

C. Help the client identify factors that are contributing to the anxiety: While identifying triggers is important for long-term management, during a panic attack, the priority is immediate relief and safety. The client may not be able to engage in reflection during peak anxiety.

D. Ask questions to clarify how the client feels and what they are thinking: During a panic attack, the client is likely to be too overwhelmed to respond meaningfully to questions. The priority is to offer comfort and a calm presence rather than focusing on understanding their thoughts at that moment.

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Correct Answer is C

Explanation

A. Intellectualization: Intellectualization involves using logic or reasoning to avoid emotional response to stress, but it is not the defense mechanism demonstrated here. The client is not using abstract thinking to avoid feelings but justifying behavior.

B. Introjection: Introjection involves internalizing the beliefs or values of others, which is not what is happening in this scenario. The client is not adopting someone else’s values but rationalizing their own actions.

C. Rationalization: Rationalization is the defense mechanism the client is using. The client is justifying their drinking as a way to cope with stress, making the behavior seem reasonable or acceptable even though it may be harmful.

D. Repression: Repression involves unconsciously blocking out uncomfortable thoughts or feelings, but the client is not denying their emotions or thoughts about stress. Instead, they are justifying their behavior, which aligns more with rationalization.

A. Fatigue B. Hand tremors C. Rapid speech D. Seizures

Correct Answer is A

Explanation

A. Fatigue: Fatigue is a common symptom of cocaine withdrawal, as the body adjusts to the absence of the stimulant. Clients often feel extremely tired or lethargic during this phase. Depressive symptoms that accompany withdrawal can also contribute to feelings of exhaustion.

B. Hand tremors: Hand tremors are more often seen with alcohol withdrawal or neurological disorders. While tremors can occur in some cases, they are not a typical manifestation of cocaine withdrawal. The focus is more on mood and energy changes.

C. Rapid speech: Rapid speech is a sign of cocaine intoxication, not withdrawal. During withdrawal, clients tend to experience slowed speech and cognitive dulling, not the heightened energy associated with the drug.

D. Seizures: Seizures are more related to cocaine overdose or intoxication, not withdrawal. Withdrawal typically involves mood changes and fatigue rather than physical manifestations like seizures.

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A nurse in the emergency department is caring for a client who is exhibiting manifestations of a panic level of anxiety. Which of the following interventions should the nurse initiate?

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