A client who has been diagnosed with panic disorder visits the clinic and experiences a panic attack. The client tells the nurse, I'm so nervous. My hands are shaking, and I'm sweating. I feel as if I'm having a stroke right now. Which of the following would the nurse do first?

Correct Answer: A

Rationale: The correct answer is A: Stay with the client while remaining calm. Rationale: 1. Presence and calmness provide reassurance and support during a panic attack. 2. Staying with the client helps prevent further distress or harm. 3. The nurse can assess the client's condition and provide immediate assistance if needed. 4. It establishes trust and a therapeutic relationship. Summary: B: Moving the client to a safe environment is important, but staying with the client is the priority for immediate support. C: Telling the client the attack will soon pass may not be effective during the acute phase of panic. D: Teaching deep breathing techniques can be helpful, but it is not the first step in managing a client experiencing a panic attack.

Correct Answer: D

Rationale: The correct next comment for the nurse is D: "Are you comfortable conversing in English, or would you prefer to have a translator present?" This is the best choice because it directly addresses the patient's language preference and ensures effective communication. By asking this question, the nurse demonstrates cultural sensitivity and respect for the patient's linguistic needs. It also shows a willingness to accommodate the patient's communication preferences, promoting trust and understanding in the healthcare setting. Choice A is incorrect as it focuses on the patient's journey to the U.S., which is unrelated to the immediate healthcare assessment. Choice B assumes the patient needs help from a family member without first assessing the patient's language proficiency. Choice C, while offering an interpreter, does not directly inquire about the patient's language preference, potentially overlooking the patient's comfort level with English.

Correct Answer: C

Rationale: The adult's statements indicate feelings of inadequacy and lack of confidence, which align with Erikson's stage of Autonomy versus shame and doubt. In this stage, individuals develop a sense of independence and self-assurance. The adult's expressions of self-doubt and disempowerment suggest an unresolved conflict from this stage. A: Initiative versus guilt - This stage pertains to developing a sense of purpose and direction in actions, not relevant to the adult's statements. B: Trust versus mistrust - This stage focuses on building trust in relationships, not directly related to the adult's self-perception issues. D: Generativity versus self-absorption - This stage involves contributing to society and future generations, not reflective of the adult's self-depreciating thoughts.

Correct Answer: D

Rationale: The correct answer is D, "We can pray together if you'd like." This is the most appropriate spiritual nursing intervention because it acknowledges and respects the patient's faith, offers emotional support, and fosters a connection between the nurse and the patient. It shows empathy and understanding of the patient's spiritual needs during a challenging time. Explanation for why the other choices are incorrect: A: Taking the patient to visit the nurse's church may not align with the patient's faith and may not be comfortable for the patient. B: Requiring the patient to belong to the same church as the nurse to go to heaven is imposing the nurse's beliefs on the patient, which is inappropriate. C: Offering guided imagery may be helpful for relaxation, but it does not directly address the patient's spiritual needs or provide the emotional support that praying together can offer.

Correct Answer: B

Rationale: The correct answer is B: Gatekeeper. The member is facilitating the group by ensuring equal participation and time management. Gatekeepers help maintain communication flow and ensure everyone has a chance to speak. They focus on group dynamics and encourage participation without dominating the conversation. Group observer (A) mainly watches and records group interactions. Encouragers (C) provide support and positive feedback. Energizers (D) motivate and stimulate group energy but may not necessarily focus on time management.

Correct Answer: C

Rationale: The correct answer is C because the statement reflects persistent and severe somatic symptoms that are distressing to the client and significantly impact their daily life. This aligns with the criteria for complex somatic symptom disorder, which includes excessive thoughts, feelings, or behaviors related to somatic symptoms. Choices A, B, and D do not express the same level of distress, preoccupation, or impact on daily functioning as choice C, making them less indicative of complex somatic symptom disorder.

Correct Answer: A

Rationale: The correct answer is A because it encourages the patient to express their feelings without assuming or directing their response. This open-ended question allows the patient to share their emotional state freely, providing valuable insight into their psychological well-being. Choice B focuses specifically on depressed moods, which may limit the patient's response. Choice C is more focused on the patient's caregiving duration rather than their current emotional state. Choice D assumes the patient is feeling overwhelmed and may not capture the full range of emotions the patient is experiencing. Overall, choice A promotes effective communication and comprehensive assessment of the patient's psychological domain.

Correct Answer: C

Rationale: The correct answer is C: a combination of behavior therapy training that includes the child, the family, and the school. This is the most appropriate response because multisystemic treatment is a comprehensive approach involving various aspects of the adolescent's life. It targets behavior through therapy and involves not only the child but also the family and school to address underlying issues and promote positive change. Incorrect options: A: Immediate assessment for oppositional defiant disorder - This option focuses solely on a diagnosis and does not address the holistic approach of multisystemic treatment. B: Very upsetting, but just typical for teenagers - This option dismisses the seriousness of the situation and does not provide a constructive solution. D: A course of prescription medication - This option suggests a medical intervention, which is not typically the first-line approach for managing behavioral issues in adolescents.

Correct Answer: A

Rationale: Rationale: The correct answer is A. Malika's weight issues may be linked to emotional factors, such as depression or anxiety. SSRIs can help address these underlying emotional issues, leading to better adherence to weight loss interventions. Exercise alone may not address the root cause. Removing snack foods may help with weight loss but doesn't address emotional factors. Medication for hypertension only treats a symptom, not the underlying cause of weight gain.