A nurse is assessing a client diagnosed with dysthymic disorder (persistent depressive disorder). Which of the following is a characteristic feature of dysthymic disorder?

Choice A reason: Buspirone is a non-benzodiazepine anxiolytic that takes weeks to achieve therapeutic effects, making it ineffective for acute panic attacks. It does not provide immediate relief, so administering it during a panic attack does not promote safety or address the client’s acute distress.

Choice B reason: Offering therapy during a panic attack may be overwhelming, as the client’s heightened anxiety impairs their ability to engage in therapeutic dialogue. Safety-focused interventions, like reducing stimuli or staying with the client, are more effective in managing acute panic and ensuring immediate safety.

Choice C reason: Turning off televisions or music reduces environmental stimuli, which can exacerbate a panic attack by overwhelming the client’s heightened sympathetic nervous system response. Minimizing sensory input helps de-escalate anxiety, creating a calmer environment and promoting safety during the acute episode.

Choice D reason: Remaining with the client during a panic attack provides reassurance and ensures safety by monitoring for escalating symptoms or self-harm risks. The nurse’s presence helps stabilize the client emotionally and physically, reducing feelings of isolation and supporting de-escalation of the panic state.

Choice E reason: A calm nursing approach prevents further escalation of the client’s panic by modeling stability and reducing perceived threats. A calm demeanor lowers the client’s sympathetic arousal, fostering a sense of safety and helping to de-escalate the acute anxiety episode effectively.

Choice A reason: An untidy house and yard may indicate poor organization or neglect but is not specific to hoarding. It could result from various factors, such as depression or physical limitations, and does not inherently pose a dangerous safety risk associated with hoarding behaviors.

Choice B reason: A single path through the yard and house indicates severe accumulation of items, characteristic of hoarding disorder. This creates significant safety hazards, such as fire risks, tripping hazards, or blocked exits, which can impede emergency access and pose immediate dangers to the client’s well-being.

Choice C reason: Neighbor complaints about cats may suggest pet hoarding, a subtype of hoarding disorder. However, without evidence of excessive clutter or unsafe living conditions, this alone is less indicative of dangerous hoarding compared to physical obstructions like a single path through the home.

Choice D reason: A collection of scattered magazines may suggest early hoarding tendencies but does not necessarily indicate a dangerous level of hoarding. It lacks the severity of safety risks, such as blocked pathways or fire hazards, associated with a single path through the home.