# A client in an outpatient clinic develops sudden intense fear, trembling, tingling, rapid breathing, and a racing heart. The client denies self-harm thoughts. For each nursing action, select the best phase of care. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=395603&lang=en > language: en > subject: Crisis Intervention > category: PSI ## Question A client in an outpatient clinic develops sudden intense fear, trembling, tingling, rapid breathing, and a racing heart. The client denies self-harm thoughts. For each nursing action, select the best phase of care. | | Use during peak symptoms | Use after symptoms ease | Requires revision | | --- | --- | --- | --- | | Remain with the client, lower environmental stimulation, and use short calm statements | | | | | Assess vital signs, breathing, chest symptoms, medication or substance cues, and other medical red flags | | | | | Coach slow breathing with a simple cue if the client is receptive | | | | | Explore triggers, coping supports, and follow-up when the client can process a longer discussion | | | | | Leave the client alone so attention from staff does not reinforce the episode | | | | | Insist on a detailed explanation of the underlying conflict while symptoms are at their peak | | | | ## Explanation Panic attacks can produce abrupt fear, palpitations, shortness of breath, dizziness, trembling, and tingling, but physical causes must still be considered. During peak distress, the nurse stays calm, uses short concrete statements, reduces stimulation, remains with the client when safe, assesses airway, breathing, circulation, vital signs, symptoms, and red flags, and may coach slow breathing if the client is receptive. Detailed exploration and treatment planning are more useful after arousal decreases. Leaving the client alone, demanding insight during peak panic, or dismissing symptoms as imaginary is unsafe and nontherapeutic. ## In-depth explanation Correct Answer During peak symptoms, remain calm, reduce stimulation, use brief statements, assess physical safety and medical red flags, and coach slow breathing if accepted. After symptoms ease, explore triggers, supports, and follow-up. Revise responses that isolate, challenge, or overload the client. Why It Fits Severe anxiety narrows attention and reduces the ability to process complex information. Simple support and a focused physical assessment address both immediate distress and the possibility of a nonpsychiatric cause. Clinical Picture Rapid breathing, tingling, palpitations, and fear fit a panic-like episode, but the nurse still checks vital signs, chest symptoms, breathing, substances or medications, and other red flags before attributing everything to panic. Memory Link Calm, concise, assess, breathe; explore later. NCLEX Rule Match communication to the client's processing capacity. Stabilize and assess first; use detailed teaching and problem solving after acute arousal decreases. Why the Alternatives Fail Leaving the client alone can increase fear and misses deterioration. Asking for a detailed cause during peak panic overloads the client. Calling physical symptoms imaginary dismisses real distress and can obscure a medical problem. Source 1NIMH Panic Disorder: What You Need to Know 2WHO Guidance for Immediate Mental Health Support 32026 NCLEX-RN Test Plan ## Clinical scenario The nurse treats panic-like symptoms as a clinical presentation rather than assuming a psychiatric cause. Immediate care includes safety, a brief physical assessment, calm communication, and reduced stimulation; longer exploration waits until the client can process information. ## Key concepts - **Panic Attack** — A sudden episode of intense fear or discomfort that can include palpitations, rapid breathing, trembling, dizziness, tingling, chest symptoms, and a sense of losing control. Similar symptoms can also have physical causes. - **Grounding and Breathing Support** — Brief, present-focused cues and slow breathing offered without coercion to reduce overload and help a receptive client regain a sense of control during acute anxiety. - **Crisis Intervention** — Immediate, practical, person-centered support that prioritizes safety, current needs, concise communication, and connection to appropriate assessment and follow-up. ## Related questions - [A nurse is admitting a 32-year-old client to an inpatient mental health unit with a diagno…](https://mymerci.kr/pages/nclex_q.php?qn_id=360525&lang=en) - [A 28-year-old client with schizophrenia is admitted to the inpatient psychiatric unit. 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Always follow current clinical guidelines and your institution’s protocols._