# A client who is breathing rapidly before a diagnostic test says, "I cannot do this. I feel completely out of control." Vital signs and oxygen saturation are within normal limits. Which response by the nurse is therapeutic?

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393567&lang=en  
> language: en  
> subject: NCLEX-RN  
> category: PSI

## Question

A client who is breathing rapidly before a diagnostic test says,
"I cannot do this. I feel completely out of control."
Vital signs and oxygen saturation are within normal limits.
Which response by the nurse is therapeutic?

## Option

1. You need to calm down so the test can start on time.
2. I will ask the provider to cancel the test.
3. Tell me what feels most frightening right now, and we will take one step at a time. **✔ Correct answer**
4. Most clients feel this way, so try not to think about it.

**Correct answer: 3**

## Explanation

The therapeutic response acknowledges the client's distress, invites the client to identify what feels most overwhelming, and offers to work through the situation one step at a time. This validates the client's emotions while helping them regain a sense of control. Telling the client to calm down dismisses the feelings behind the behavior. Offering to cancel the test bypasses the client's own coping process by making the decision for them. Minimizing the experience by suggesting it is common and should be ignored discourages the client from expressing genuine concerns and blocks further communication.

## In-depth explanation

Clinical Judgment
For anxiety, use presence, open-ended exploration, and concrete step-by-step support.

Memory Tip
Name the feeling, invite details, give one next step.

KR vs US
NCLEX communication items reward validation and client autonomy rather than reassurance that dismisses emotion.

## Clinical scenario

Clinical Practice Guide
Therapeutic communication uses open-ended prompts, reflection, validation, and simple next steps to reduce anxiety and maintain client autonomy.

Caution
Avoid false reassurance, minimization, advice-giving, or commands.

## Key concepts

- **Therapeutic Communication** — A purposeful communication approach that validates feelings and supports client-centered problem solving.
- **Anxiety** — A state of apprehension that may include rapid breathing, trembling, fear, or difficulty concentrating.
- **Grounding** — A technique that redirects attention to present, concrete details to reduce escalating anxiety.

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