A nurse is creating a plan of care for a client who has panic disorder. Which of the following interventions should the nurse include?

Encourage the client to attend group therapy sessions

Allow the client to choose scheduled daily activities

Use simple words to describe procedures to the client

Avoid discussing topics that can trigger a panic attack

Answer and Explanation

The Correct Answer is C

A. Encourage the client to attend group therapy sessions: While group therapy can be beneficial for some individuals with panic disorder by providing support and opportunities for learning coping strategies, it may not be appropriate for all clients. Some clients may feel overwhelmed or anxious in group settings, especially during panic attacks. The nurse should assess the client's readiness and comfort level with group therapy and individualize the treatment plan accordingly.

B. Allow the client to choose scheduled daily activities: Providing the client with a sense of control and autonomy over their daily activities can be helpful in managing anxiety and panic symptoms. However, this intervention alone may not address the specific cognitive and behavioral aspects of panic disorder. It is important to incorporate other evidence-based interventions, such as cognitive-behavioral therapy (CBT) techniques, into the treatment plan to address the underlying causes of panic attacks.

C. Use simple words to describe procedures to the client: Individuals with panic disorder may experience difficulty processing information and focusing during panic attacks or periods of heightened anxiety. Using simple and clear language to describe procedures can help reduce confusion and alleviate anxiety in these situations. It is important to provide information in a calm and reassuring manner to facilitate understanding and cooperation.

D. Avoid discussing topics that can trigger a panic attack: While it is important to be mindful of potential triggers for panic attacks, avoiding all discussion of triggering topics may not be practical or helpful in the long term. Instead, the nurse should work collaboratively with the client to identify triggers and develop coping strategies to manage them effectively. Avoidance alone may reinforce avoidance behaviors and perpetuate anxiety.

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Correct Answer is D

Explanation

A. Autonomic dysreflexia: This condition typically occurs in individuals with spinal cord injuries above the T6 level and presents with sudden, severe hypertension, bradycardia, headache, and profuse sweating. It is not typically associated with alcohol withdrawal symptoms such as visual hallucinations and impaired consciousness.

B. Synergistic effect: This term refers to the combined effect of two or more substances or factors being greater than the sum of their individual effects. While alcohol withdrawal can interact with other substances or conditions to produce various effects, it is not a specific condition causing visual hallucinations and impaired consciousness.

C. Sleep deprivation: Prolonged sleep deprivation can lead to cognitive impairment, mood disturbances, and hallucinations, but it is not typically associated with impaired consciousness as described in the scenario. Additionally, the manifestations described are more indicative of alcohol withdrawal rather than sleep deprivation alone.

D. Delirium: Delirium is a state of acute confusion and altered consciousness characterized by disturbances in attention, awareness, cognition, and perception. Visual hallucinations and impaired consciousness are common features of delirium, especially in the context of alcohol withdrawal. Delirium often occurs due to underlying medical conditions, substance withdrawal, or medication side effects.

A. “Decreased startle response to loud noises.” B. “Reports uninterrupted sleep of 10 to 12 hr each night.” C. “Reluctance to discuss the event that precipitated the distress.” D. “Reports feelings of acute distress that began to 2 weeks ago.”

Correct Answer is C

Explanation

A. “Decreased startle response to loud noises.”: Individuals with PTSD often have an exaggerated startle response to loud noises or unexpected stimuli. This heightened startle response is a common symptom of hyperarousal associated with PTSD. Therefore, a decreased startle response would be unexpected in this context.

B. “Reports uninterrupted sleep of 10 to 12 hr each night.”: Sleep disturbances are common among individuals with PTSD. Symptoms can include difficulty falling asleep, staying asleep, or experiencing nightmares related to the traumatic event. Therefore, reports of uninterrupted sleep for 10 to 12 hours each night would be unexpected in someone with PTSD.

C. “Reluctance to discuss the event that precipitated the distress.”: Avoidance of trauma-related thoughts, feelings, or reminders is a hallmark symptom of PTSD. Individuals with PTSD often avoid discussing or thinking about the traumatic event to cope with distressing memories or emotions. Therefore, reluctance to discuss the precipitating event is a common manifestation of PTSD.

D. “Reports feelings of acute distress that began 2 weeks ago.”: PTSD symptoms typically develop shortly after experiencing a traumatic event, but the diagnosis of PTSD requires that symptoms persist for at least one month. Acute distress that began two weeks ago may indicate an acute stress reaction rather than PTSD. PTSD involves persistent symptoms beyond the acute phase of the trauma.

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A nurse is creating a plan of care for a client who has panic disorder. Which of the following interventions should the nurse include?

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