A nurse is contributing to the plan of care for a client who experiences panic attacks.
Which of the following strategies should be included for implementation during an attack?
Assist the client with evaluating their coping mechanisms.
Explore with the client what precipitates an attack.
Minimize environmental stimuli.
Encourage the client to set goals.
The Correct Answer is C
Choice A rationale
Assisting the client with evaluating their coping mechanisms is a helpful strategy for preventing future panic attacks and managing anxiety in the long term. However, during an acute panic attack, the client's ability to think rationally and evaluate their coping skills is significantly impaired. The immediate focus should be on reducing overwhelming stimuli.
Choice B rationale
Exploring with the client what precipitates an attack is crucial for identifying triggers and developing preventative strategies. However, during an active panic attack, the client is experiencing intense anxiety and may not be able to effectively process or articulate potential triggers. This intervention is more appropriate for periods between attacks.
Choice C rationale
Minimizing environmental stimuli is a key intervention during a panic attack. Panic attacks involve a surge of intense fear and anxiety, often accompanied by sensory overload. Reducing noise, bright lights, and excessive activity in the immediate surroundings can help decrease the client's distress and promote a sense of calm and safety.
Choice D rationale
Encouraging the client to set goals is a therapeutic strategy aimed at promoting a sense of control and accomplishment, which can be beneficial for overall mental health and managing anxiety in the long term. However, during an acute panic attack, the client is likely overwhelmed and unable to focus on goal setting. The immediate priority is to reduce their acute anxiety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Respecting the client's autonomy is paramount in nursing practice. If a client explicitly states they do not want visitors, the nurse should communicate this directly to the sibling. This upholds the client's right to make decisions about their care and interactions.
Choice B rationale
While the provider may be involved in the client's overall care, directly referring the sibling regarding visitation preferences bypasses the nurse's role in communicating the client's wishes. The nurse has a responsibility to act on the client's stated preferences.
Choice C rationale
Encouraging the client to see the sibling might undermine the client's expressed wishes and feelings. The nurse should first respect the client's decision and explore the reasons behind it before suggesting a visit.
Choice D rationale
Arranging a visit in the dayroom without the client's consent disregards their autonomy and right to privacy. The client has the right to decide who they interact with and where those interactions occur.
Correct Answer is D
Explanation
Choice A rationale
Restraint prescriptions for adults typically need to be renewed every 24 hours, according to most healthcare facility policies and regulatory guidelines, not every 48 hours. This frequent review ensures ongoing assessment of the client's need for restraints.
Choice B rationale
Attaching restraints to the side rail of the client's bed is dangerous because the side rail can move independently of the bed frame. This can cause injury to the client if they try to move or reposition themselves, potentially leading to strangulation or other harm. Restraints should be secured to a stable part of the bed frame.
Choice C rationale
Maintaining 2 fingerbreadths between the restraint and the client's skin is the standard to ensure proper circulation and prevent skin breakdown. One fingerbreadth would be too tight and could compromise blood flow and nerve function.
Choice D rationale
Using a quick-release tie is essential for safety when applying restraints. This allows for rapid removal of the restraints in case of an emergency, such as compromised circulation or the need for immediate medical intervention.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.