A nurse is caring for a client who has moderate anxiety disorder. The client is pacing in the hallway and states, "I am at the end of my rope, I can't take it anymore." Which of the following responses should the nurse make?

"Providers usually recommend relaxation exercises for clients who are as upset as you are."

"Walk with me to an area where we can talk about how you're feeling."

"An antianxiety pill works best for situations like this. Let me get you one."

"Most clients with anxiety issues benefit from lying down."

Answer and Explanation

The Correct Answer is B

A. "Providers usually recommend relaxation exercises for clients who are as upset as you are.": Too impersonal and not immediately helpful.

B. "Walk with me to an area where we can talk about how you're feeling.": Therapeutic, supportive, and helps de-escalate anxiety by providing a safe environment.

C. "An antianxiety pill works best for situations like this. Let me get you one.": Premature medication use; verbal de-escalation is preferred first.

D. "Most clients with anxiety issues benefit from lying down.": Not appropriate; may not meet the client’s needs and dismisses the emotion.

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Correct Answer is D

Explanation

A. "I will avoid crossing my legs at the knees.":
Crossing legs can impair circulation and should be avoided in PVD.

B. "I will not go barefoot and wear proper fitted shoes.":
Clients with PVD are at high risk for injury and infection, so proper foot protection is important.

C. "I will use a thermometer to check the temperature of my bath water.":
Clients with PVD may have decreased sensation and should check water temperature to avoid burns.

D. "I will wear stockings with tight elastic tops.":
Tight elastic can constrict circulation. Compression stockings may be used, but not ones with tight bands that can impair venous return.

A. Instructing the patient to fast for at least 12 hours before the procedure B. Ensuring the skin is clean and dry where electrodes will be placed C. Using a higher room temperature to keep the patient warm D. Applying electrodes directly over bony prominences

Correct Answer is B

Explanation

A. Instructing the patient to fast for at least 12 hours before the procedure: Fasting is not required for an ECG. It is a non-invasive test that doesn’t involve food interactions.

B. Ensuring the skin is clean and dry where electrodes will be placed: This ensures good electrode contact and accurate readings. Oils, lotions, or moisture can interfere with signal transmission.

C. Using a higher room temperature to keep the patient warm: While comfort is important, this is not a primary preparation step. ECG accuracy is not dependent on room temperature.

D. Applying electrodes directly over bony prominences: Electrodes should be placed on flat, muscular areas to ensure proper contact, not over bones.

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A nurse is caring for a client who has moderate anxiety disorder. The client is pacing in the hallway and states, "I am at the end of my rope, I can't take it anymore." Which of the following responses should the nurse make?

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