A client prescribed diazepam for anxiety is receiving education from a healthcare professional. Which statement by the client indicates a need for further teaching?

Correct Answer: A

Rationale: The correct answer is A. Clients should avoid alcohol while taking diazepam (Valium) as it can potentiate the effects of the medication, leading to excessive sedation and other adverse effects. Mixing alcohol with diazepam can also increase the risk of overdose and other serious complications. Therefore, it is crucial for the client to refrain from consuming alcohol while on this medication to ensure their safety and optimize the therapeutic benefits of diazepam for managing anxiety.

Correct Answer: B

Rationale: For a client experiencing severe anxiety, the primary goal of intervention is to reduce immediate distress and promote safety by minimizing external stimuli that could exacerbate the symptoms. Providing a quiet and calm environment, as in option B, is the most appropriate initial intervention because severe anxiety often involves heightened physiological arousal, such as rapid heartbeat, hyperventilation, and sensory overload. A serene setting helps lower sensory input, allowing the client's nervous system to downregulate naturally. This aligns with evidence-based practices like those from the American Psychiatric Association, which recommend de-escalation through environmental control for acute anxiety episodes. By dimming lights, reducing noise, and ensuring privacy, the healthcare professional creates a space for the client to regain composure without added pressure, preventing escalation to panic or crisis. In contrast, option A—encouraging the client to talk about their feelings—may be beneficial in therapeutic settings for processing emotions during milder anxiety or post-acute phases, but it's unsuitable for severe anxiety. At this intensity, verbal expression can feel overwhelming or impossible due to cognitive fog or racing thoughts, potentially increasing agitation rather than alleviating it. Therapeutic talking is more appropriate after stabilization, as forcing it prematurely could heighten vulnerability and lead to emotional flooding. Option C—encouraging vigorous exercise—is counterproductive for severe anxiety because it can mimic or intensify the physical symptoms of anxiety, such as elevated heart rate, sweating, and adrenaline surges, confusing the client's body signals and worsening the panic response. While moderate exercise aids long-term anxiety management by releasing endorphins, vigorous activity during an acute severe episode risks physical exhaustion or injury, especially if the client is already breathless or disoriented. Guidelines from the National Institute for Health and Care Excellence (NICE) advise against high-intensity interventions in acute states, favoring rest instead. Option D—encouraging participation in group activities—introduces social pressures and interpersonal dynamics that could amplify anxiety for someone in severe distress, as it involves exposure to multiple people, noise, and expectations of interaction. This might trigger social anxiety components or feelings of inadequacy, leading to withdrawal or further isolation. Group interventions are valuable for building support networks in recovery phases but are contraindicated initially when the client needs individualized calming to rebuild a sense of control. Overall, selecting B prioritizes immediate safety and physiological relief, forming the foundation for subsequent interventions like those in A, C, or D once the severity subsides. This step-by-step approach ensures ethical, client-centered care rooted in crisis intervention principles.

Correct Answer: A

Rationale: During a panic attack, the immediate priority for the nurse is to provide support and reassurance to the client. Remaining with the client helps establish a sense of safety and trust, which can help calm the client during an episode of panic. Administering medication, encouraging physical activity, and deep breathing techniques are beneficial interventions, but offering reassurance and support should be the initial step to address the immediate emotional distress and anxiety experienced by the client.

Correct Answer: A

Rationale: The most appropriate short-term goal for a client with major depressive disorder is for them to report a decrease in depressive symptoms. This goal is specific, measurable, and achievable, focusing on the primary symptoms of the disorder. By monitoring and assessing the client's self-reported improvement in depressive symptoms, the healthcare team can track progress and adjust interventions accordingly.