# Place the nursing actions in order for a client who develops acute panic-level anxiety in the waiting area.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=396392&lang=en  
> language: en  
> subject: Crisis Intervention  
> category: PSI

## Question

Place the nursing actions in order for a client who develops acute panic-level anxiety in the waiting area.

After the anxiety decreases, reassess, document the response, and explore triggers and follow-up supports

Use a low calm voice and short statements such as, ‘You are safe here. I will stay with you.’

Coach slow breathing or a simple grounding exercise when the client can follow one-step directions

Remain with the client, summon appropriate assistance, reduce stimulation, and guide the client to a safer quiet area

Assess airway, breathing, vital signs, oxygenation, symptoms, substances or medications, and cues of an acute medical cause

## Explanation

Stay with the client, obtain assistance, and reduce environmental stimulation. Perform a focused physiologic and safety assessment because panic-like symptoms can accompany acute medical conditions. Communicate with brief calm statements, then coach breathing or grounding only when the client can process a simple direction. Reassess and explore triggers after the acute anxiety subsides.

## In-depth explanation

Correct sequence
Stay and reduce stimuli → screen safety and physical causes → use short calm statements → coach one simple technique → reassess after the crisis.

Why this is correct
A person at panic level may not process lengthy teaching or open-ended problem solving. Presence, safety, a quiet environment, and simple language come first. Focused assessment prevents a dangerous medical condition from being mislabeled as anxiety.

NCLEX decision rule
During severe anxiety, reduce demands and communicate one step at a time. Save detailed education and trigger exploration until attention and information processing improve.References
1NCBI Open RN: anxiety disorders and panic-level care
2NCSBN 2026 NCLEX-RN Test Plan

## Clinical scenario

Acute crisis support
The client is pacing, trembling, and saying, ‘I cannot breathe; I am going to die.’ No diagnosis should be assumed until urgent physical causes are screened. The nurse has immediate backup available.

## Key concepts

- **Panic-Level Anxiety** — Extreme anxiety with markedly reduced ability to process information, solve problems, or respond to complex directions.
- **Grounding** — A brief technique that directs attention to immediate sensory or environmental cues to reduce escalating distress.
- **Severe Anxiety** — An anxiety level that markedly narrows attention and reduces the ability to process information or solve problems.

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