A nurse is working with a patient diagnosed with generalized anxiety disorder. The patient states, 'I worry about everything, even things that are out of my control.' Which of the following is the priority nursing diagnosis?

Correct Answer: A

Rationale: In this scenario, the priority nursing diagnosis is option A) Anxiety. Generalized anxiety disorder is characterized by excessive worrying and anxiety that is difficult to control. Addressing anxiety is crucial because it is the underlying issue affecting the patient's overall well-being and ability to function. By prioritizing the management of anxiety, the nurse can help the patient regain a sense of control and reduce the impact of anxiety on daily life. Option B) Imbalanced nutrition: Less than body requirements is not the priority in this case as it does not directly address the patient's primary concern of anxiety. While nutrition is important for overall health, addressing anxiety should come first to ensure the patient can engage in effective self-care practices. Option C) Ineffective coping is also relevant to the patient's situation, but it is secondary to addressing the anxiety itself. By managing the anxiety, the patient may be better able to develop and utilize effective coping mechanisms. Option D) Powerlessness is not the priority nursing diagnosis in this case as the patient's primary concern is related to managing anxiety. Powerlessness may be a factor contributing to the anxiety, but addressing the anxiety directly will likely have a greater impact on the patient's sense of empowerment. In an educational context, understanding the prioritization of nursing diagnoses is crucial for providing effective and efficient care. By recognizing the most pressing issue, nurses can tailor interventions to address the root cause of the patient's distress and promote better outcomes. In this case, the emphasis on managing anxiety aligns with evidence-based practice and holistic patient care.

Correct Answer: C

Rationale: Increased anxiety results in scattered thoughts and an inability to articulate clearly. Clarifying helps the patient identify thoughts and feelings. Asking the patient why he or she feels anxious is nontherapeutic; the patient likely does not have an answer. The patient may be unable to determine what he or she would like the nurse to do in order to help. Telling the patient to get his or her feelings under control is a directive the patient is probably unable to accomplish.

Correct Answer: C

Rationale: Projection is the hallmark of blaming, scapegoating, prejudicial thinking, and stigmatizing others. Conversion involves the unconscious transformation of anxiety into a physical symptom. Introjection involves intense, unconscious identification with another person. Splitting is the inability to integrate the positive and negative qualities of oneself or others into a cohesive image.

Correct Answer: D

Rationale: In this scenario, option D is the most appropriate nursing intervention because teaching the person to use positive self-talk techniques can help them challenge and reframe their negative thoughts related to anxiety. By learning to replace self-defeating thoughts with positive affirmations, the individual can build self-confidence and reduce anxiety, ultimately empowering them to gradually overcome their fear of leaving the apartment. Option A, using online video calls, may provide temporary social interaction but does not address the underlying issue of anxiety. Option B, advising the person to accept the situation and use a companion, does not promote independence and may enable avoidance behavior. Option C, asking the person to explain the fear, while important for understanding their perspective, may not provide immediate coping strategies to manage the anxiety. Educationally, this question highlights the importance of cognitive-behavioral techniques in addressing anxiety disorders. Teaching individuals to reframe negative thoughts is a fundamental skill in mental health nursing practice. It emphasizes the role of nursing interventions in promoting self-management strategies for individuals experiencing anxiety, thus fostering empowerment and resilience in the face of mental health challenges.

Correct Answer: B

Rationale: The correct answer is option B: "Her death is a terrible loss for you." This response demonstrates empathy and acknowledges the man's feelings of loss and grief, which is crucial in therapeutic communication. By validating his emotions, the nurse creates a safe space for the man to express his feelings and begin the healing process. Option A ("Each day will get a little better.") may minimize the man's current feelings of intense grief by implying a quick recovery, which can be invalidating and unhelpful. Grieving is a complex process that takes time, and the nurse should acknowledge the man's pain rather than rushing him through it. Option C ("It's important to recognize that she is no longer suffering.") may come across as dismissive of the man's emotional pain by focusing on the positive aspect of the wife no longer suffering. While this perspective can be comforting in some contexts, it may not address the man's immediate need for emotional support and validation of his grief. Option D ("Your friends will help you cope with this change in your life.") shifts the focus from the man's feelings to external sources of support. While social support is valuable, at this moment, the man needs validation and emotional support from the nurse to process his grief effectively. In an educational context, it is essential for nurses to understand the principles of therapeutic communication, which involve active listening, empathy, and validation of clients' feelings. By choosing the most appropriate responses in challenging situations like this, nurses can build trust, foster healing, and support clients effectively through their emotional struggles.