Question

an anxious client expressing a fear of people and open places is admitted to the psychiatric unit. which is the most effective way for the nurse to assist this client?

plan an outing with the peer group within the first week of admission.
distract the client whenever discomfort about being with others is expressed.
confront fears and discuss the possible causes of these fears with the client.
accompany the client outside for an increasing amount of time each day.

Explanation:

Identify the client's condition and core clinical need

The client exhibits symptoms of agoraphobia (fear of open spaces and crowds/people). The therapeutic goal is to help the client overcome these fears safely and progressively.

Evaluate the intervention strategies

• Planning a group outing early in admission is too overwhelming and counterproductive.
• Distraction avoids addressing the underlying anxiety and does not promote coping.
• Confronting fears directly can increase anxiety and damage the therapeutic relationship.
• Gradual exposure (systematic desensitization) by accompanying the client outside for increasing periods of time is the most effective, evidence-based nursing intervention.

Answer:

• Plan an outing with the peer group within the first week of admission.
• Distract the client whenever discomfort about being with others is expressed.
• Confront fears and discuss the possible causes of these fears with the client.
• Accompany the client outside for an increasing amount of time each day. (Correct answer)