A nurse is assessing a client who is experiencing anxiety. Which of the following findings should the nurse expect?

Choice A reason: Financial difficulties are a significant psychosocial stressor, activating the hypothalamic-pituitary-adrenal axis, increasing cortisol, and contributing to chronic stress responses. Economic instability can lead to anxiety, sleep disturbances, and cardiovascular strain, as individuals worry about meeting basic needs, making this a primary source of stress in the psychological and physiological context.

Choice B reason: A wrist fracture causes physical pain and temporary disability but is not a primary source of stress unless it leads to prolonged financial or functional issues. Acute injuries trigger short-term stress responses, but their impact is less chronic compared to ongoing psychosocial stressors like financial difficulties, making this incorrect.

Choice C reason: Hypothermia is a physiological condition, not a direct source of stress. It triggers compensatory responses like shivering to maintain body temperature but is not a psychosocial or chronic stressor. Stress is more associated with psychological or environmental factors, making hypothermia an incorrect choice for a primary stress source.

Choice D reason: Burn injuries cause acute physical stress and pain, activating the body’s stress response temporarily. However, they are not a chronic psychosocial stressor like financial difficulties. Their impact is more immediate and physical, with stress subsiding post-recovery, making this a less relevant source compared to ongoing financial concerns.

Choice A reason: Using gestures to communicate is less effective for a client with moderate vision impairment, as they may not clearly see hand movements. Visual cues are unreliable, and verbal communication is more effective. Gestures could lead to miscommunication or frustration, making this an inappropriate action for effective interaction.

Choice B reason: Facing the client when speaking enhances communication for those with moderate vision impairment, as it allows them to see lip movements and facial expressions, aiding comprehension. This approach leverages residual vision and supports clear verbal exchange, making it the most effective and appropriate action for the nurse to take.

Choice C reason: Speaking loudly is unnecessary unless the client has a hearing impairment, which is not indicated. Moderate vision impairment affects sight, not hearing, and loud speech may be perceived as condescending or disruptive, potentially hindering effective communication and rapport with the client.

Choice D reason: Opening shades to provide natural light may improve visibility but risks causing glare, which can worsen visual clarity for clients with moderate vision impairment. Controlled lighting, such as soft artificial light, is preferred to avoid discomfort, making this an inappropriate primary action compared to facing the client during communication.