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Ego-related conflicts are more aligned with psychoanalytic theory, not cognitive theory, and are less directly tied to the cognitive distortions that precipitate panic attacks.

Elevated blood lactate may be associated with physiological responses in panic disorder, but it is not a primary cause in cognitive theory, which focuses on thought patterns.

Norepinephrine involvement relates to biological theories of panic disorder, not cognitive theory, which emphasizes cognitive misinterpretations over neurochemical changes.

Avoiding assessment delays care and fails to address the client's immediate needs. Anxiety may not resolve on its own, and avoidance increases the risk of missing safety threats or escalating symptoms. Prompt, calm, and structured interaction is key.

Open-ended questions are ideal for calm, reflective discussion but can overwhelm someone with high anxiety. Such questions require abstract thinking, which is impaired during moderate to severe anxiety states, leading to frustration or withdrawal.

Waiting for the client to volunteer information is not therapeutic during anxiety. Clients often become too overwhelmed to initiate communication. This passive approach misses opportunities for support and may compromise safety or rapport.

Mild anxiety involves minimal distress and normal functioning, not matching the intense symptoms described.

Moderate anxiety includes selective attention and restlessness, but not the extreme physical and cognitive symptoms observed.

Severe anxiety shows impaired concentration but lacks the acute, overwhelming symptoms of a panic attack.

This question begins with “why,” which can sound accusatory or confrontational. It may increase the client's defensiveness or shame, especially in someone already vulnerable from depression, thus blocking effective communication.

This is a form of false reassurance and dismisses the client's expressed fear. It minimizes the client’s concern, undermines their feelings, and can prevent them from opening up further. It is nontherapeutic and impairs trust.

Discouraging the client from talking about their feelings reinforces avoidance and suppresses emotional expression. It implies that discussing emotions is harmful, which contradicts therapeutic principles of helping the client process distress.

Confronting anxiety sources directly is not the primary goal of relaxation techniques, which focus on symptom control.

Eliminating all anxiety episodes is unrealistic, as relaxation techniques aim to manage, not eradicate, anxiety.

Suppressing feelings contradicts the therapeutic goal of processing emotions healthily.

Physical activity may increase heart rate and respiratory rate, worsening symptoms during a panic attack. It may also be unsafe if the client is disoriented, dizzy, or hyperventilating.

While distractions can be helpful after symptoms reduce, during a panic attack, cognitive overload limits the ability to focus. Distractions may be ineffective or confusing in the acute phase.

Teaching requires concentration and cognitive engagement, which are compromised during a panic episode. This intervention is better suited for a later stage once the client is calm.

Insight involves recognizing the impact of anxiety and understanding patterns. Avoidance behavior, like trying to forget, lacks self-awareness and does not reflect insight.

Improved coping is shown by active management such as cognitive restructuring or relaxation. Forgetting worries is a passive, ineffective defense that hinders emotional resolution.

Treatment success includes functional improvements and adaptive coping. Avoiding thoughts contradicts therapeutic goals of confronting and managing anxiety consciously.

Electroconvulsive therapy is used for severe, treatment-resistant mood disorders, not anxiety. It involves inducing seizures under anesthesia and is inappropriate for this client’s symptoms.

Family systems therapy addresses relational dynamics but does not directly treat the cognitive distortions or avoidance behaviors central to this client’s anxiety.

Psychoanalytical therapy explores unconscious conflicts from childhood rather than providing practical strategies for managing acute anxiety symptoms.

While diazepam may be used for acute anxiety, it is not the first-line intervention before non-pharmacological strategies (e.g., grounding techniques) are attempted.

Isolation can worsen panic, as the client may interpret abandonment as confirmation of danger, increasing helplessness and hyperventilation.

Discussing triggers is premature during acute panic, as the client’s impaired cognition prevents rational processing until physiological symptoms stabilize.

Alprazolam (Xanax) can be effective for GAD but has rapid onset and dependency risk. Buspirone’s recommendation is based on mechanism and onset, not because benzodiazepines are ineffective for GAD.

Changing to PRN dosing would not allow buspirone to reach effective concentrations and would undermine therapeutic goals. That suggestion could lead to treatment failure and misunderstanding of its pharmacokinetics.

Advising that her friend should take Xanax daily is inappropriate. Benzodiazepines pose risks of tolerance, dependence, and withdrawal and are typically not recommended for continuous, long-term GAD management.

Telling the client there’s no need to panic invalidates their feelings and may increase anxiety. It can be perceived as dismissive rather than supportive.

Explaining that there’s no need to worry is also minimizing the client's experience, which can worsen panic and reduce trust.

Providing a detailed explanation during the panic attack is ineffective because the client is unlikely to comprehend or retain complex information when overwhelmed.

Recognizing signs of elevated mood relates more to mood disorders like bipolar disorder, not GAD, which primarily involves anxiety symptoms.

Developing guidelines to manage manipulative peer behavior is unrelated to anxiety management and focuses on external social control rather than internal coping.

Facilitating participation in self-care is important but less specific to anxiety management compared to recognizing increasing anxiety and seeking help.

Recognizing unnecessary risk-taking is important but more relevant to impulse control disorders or bipolar disorder, not the primary intervention for panic disorder-related powerlessness.

Exploring identity issues pertains more to personality disorders or developmental concerns rather than immediate panic disorder management.

Discussing relationship desires may be supportive but is not directly related to alleviating powerlessness experienced during panic episodes.