A nurse is providing teaching about activities to promote mobility with a client who has osteoporosis. Which of the following statements should the nurse identify as an understanding of the teaching?

A) Diarrhea: Metabolic alkalosis is more likely to be associated with constipation rather than diarrhea. Diarrhea is typically a cause of metabolic acidosis due to the loss of bicarbonate in stool, rather than a result of metabolic alkalosis.

B) Bradycardia: Bradycardia is not a typical manifestation of metabolic alkalosis. Alkalosis can lead to arrhythmias, but it generally does not cause a slow heart rate. Instead, tachycardia might occur as the body compensates for the altered acid-base balance.

C) Tinnitus: Tinnitus is not a common symptom of metabolic alkalosis. It is more often associated with aspirin toxicity or other conditions affecting the auditory system, rather than changes in acid-base balance.

D) Tetany: Tetany is a common manifestation of metabolic alkalosis. The alkalosis causes a decrease in ionized calcium levels, which increases neuromuscular excitability and can lead to muscle cramps, spasms, and tetany. This is a key sign for nurses to monitor as it indicates significant electrolyte disturbances associated with the alkalotic state.

A) Administering risperidone 25 mg IM is not typically appropriate for treating a panic attack. Risperidone is an antipsychotic medication used for treating conditions like schizophrenia and bipolar disorder, not for the immediate management of panic attacks. Immediate pharmacological intervention is not generally the first line of treatment in acute panic attacks unless the client has a specific medication prescribed for such episodes.

B) Teaching the client how to perform guided imagery can be beneficial for long-term anxiety management but is not the most effective intervention during an acute panic attack. During a panic attack, the client's ability to focus and learn new techniques may be impaired, making it less effective in the immediate situation.

C) Staying with the client until the panic attack subsides is the most appropriate action. Presence and reassurance from the nurse can help the client feel safer and more grounded. This approach provides emotional support and can help reduce the severity and duration of the panic attack by addressing the client's immediate need for security and stability.

D) Encouraging the client to take quick, shallow breaths can exacerbate hyperventilation and increase anxiety during a panic attack. Instead, slow, deep breathing techniques are recommended to help calm the client's physiological response and reduce the intensity of the panic attack.