A nurse wants to teach alternative coping strategies to a patient experiencing severe anxiety. Which action should the nurse perform first?

Correct Answer: B

Rationale: A patient experiencing severe anxiety has a markedly narrowed perceptual field and difficulty attending to events in the environment. A patient experiencing severe anxiety will not learn readily. Determining preferred modes of learning, devising outcomes, and constructing teaching plans are relevant to the task but are not the priority measure. The nurse has already assessed the patients anxiety level. Use of defense mechanisms does not apply.

Correct Answer: B

Rationale: The most appropriate nursing intervention in this scenario is to present the information again in a calm manner using simple language (Option B). This approach is crucial because the patient is experiencing moderate anxiety, which can impair their ability to understand complex information. By using simple language and a calm demeanor, the nurse can help alleviate the patient's anxiety and facilitate better comprehension of the preoperative instructions. Option A is incorrect because reassuring the patient about postoperative care does not address the immediate issue of the patient's anxiety and lack of understanding of preoperative information. Option C is incorrect as it focuses on recovery, which is not the primary concern at this moment. Option D is also incorrect as encouraging the patient to express feelings to family does not directly address the patient's understanding of preoperative information. From an educational perspective, this question highlights the importance of effective communication in nursing care, especially when patients are experiencing anxiety or stress. Nurses must adapt their communication style to meet the patient's needs, ensuring that information is conveyed clearly and understood by the patient, particularly in high-stress situations like surgery preparation.

Correct Answer: C

Rationale: The person whose anxiety is severe is unable to solve problems and may have a poor grasp of what is happening in the environment. Somatic symptoms such as those described are usually present. The individual with mild anxiety is only mildly uncomfortable and may even find his or her performance enhanced. The individual with moderate anxiety grasps less information about a situation and has some difficulty with problem solving. The individual in panic will demonstrate markedly disturbed behavior and may lose touch with reality.

Correct Answer: A

Rationale: Altruism is the mechanism by which an individual deals with emotional conflict by meeting the needs of others and receiving gratification vicariously or from the responses of others. The nurses reaction is conscious rather than unconscious. There is no evidence of suppression. Intellectualization is a process in which events are analyzed based on remote, cold facts and without passion, rather than incorporating feeling and emotion into the processing. Reaction formation is when unacceptable feelings or behaviors are controlled and kept out of awareness by developing the opposite behavior or emotion.

Correct Answer: B

Rationale: The correct answer is B) Her death is a terrible loss for you. In this situation, the nurse's response should validate the man's feelings of grief and acknowledge the significance of his loss. By reflecting back his emotions and demonstrating empathy, the nurse creates a safe space for the man to express his feelings and begin the process of grieving. This response also helps to establish a therapeutic relationship based on trust and understanding. Option A) Each day will get a little better, may diminish the man's feelings of grief by invalidating his current pain and offering false reassurance. Grieving is a complex process with ups and downs, and it is essential to acknowledge the intensity of the man's emotions at this moment. Option C) It's important to recognize that she is no longer suffering, may come across as dismissive of the man's feelings of loss and could minimize the depth of his grief. While acknowledging the end of suffering is important, it is equally crucial to address the emotional impact of the loss. Option D) Your friends will help you cope with this change in your life, shifts the focus to external sources of support rather than validating the man's emotions. While social support is valuable, in this moment, the man needs validation of his feelings and space to process his grief. In an educational context, this question highlights the importance of therapeutic communication in nursing practice, especially when caring for individuals experiencing grief and loss. Nurses must demonstrate empathy, active listening, and sensitivity to effectively support individuals through the grieving process. Acknowledging and validating emotions are crucial steps in providing holistic and patient-centered care.