一位 45 歲患有廣泛性焦慮症的個案，主訴心悸與強烈的瀕死感。護理師觀察到個案在病房內踱步。下列哪項護理措施為首要？
A 45-year-old client with a history of generalized anxiety disorder presents with reports of palpitations and a sense of impending doom. The nurse observes the client pacing the room. Which intervention is the priority?
- AEncourage the client to discuss the source of their anxiety鼓勵個案討論其焦慮的來源。
- BAdminister the prescribed PRN anxiolytic medication給予處方之備用（PRN）抗焦慮藥物。
- CMaintain a calm, quiet, and low-stimulus environment✓ 正解維持平靜、安靜且低刺激的環境。
- DInstruct the client to practice deep breathing exercises指導個案練習深呼吸運動。
核心概念：處理廣泛性焦慮症（Generalized Anxiety Disorder, GAD）急性發作（恐慌發作，Panic Attack）的優先護理措施。 為何正確答案對： C. 病人出現呼吸急促、心悸、瀕死感等症狀，顯示其處於高度焦慮狀態。護理師應立即在病人身邊提供穩定、支持性的陪伴，創造一個平靜、低刺激的環境。過多的感官刺激（如嘈雜的聲音、明亮的燈光、過多的訪客）會加劇病人的焦慮感。先降低環境刺激，建立安全感，是後續介入的基礎。 為何其他選項錯： A. 指導病人進行深呼吸練習（Instruct the client to practice deep breathing exercises）雖然是處理焦慮的技巧，但在病人處於極度恐慌狀態時，可能難以專注或執行。 B. 給予處方性的抗焦慮藥物（Administer the prescribed PRN anxiolytic medication）是可能的處置，但應在評估病人狀況並嘗試非藥物性介入後，或遵照醫囑進行，並非當下最優先的護理行動。 D. 鼓勵病人討論焦慮來源（Encourage the client to discuss the source of their anxiety）在病人處於急性恐慌狀態時，效果可能不佳，病人可能無法清晰表達或聽取建議。應先穩定其情緒，待其較平靜後再進行。
Core concept: Priority nursing intervention during an acute exacerbation (panic attack) of generalized anxiety disorder (GAD). Why the correct answer is right: C. The client presents with rapid breathing, palpitations, and a sense of impending doom, indicating a state of severe anxiety. The nurse should immediately provide a stable, supportive presence at the bedside and create a calm, low-stimulus environment. Excessive sensory stimulation (noise, bright lights, many visitors) intensifies the client's anxiety. Reducing environmental stimuli and establishing a sense of safety is the foundation for any subsequent intervention. Why the other options are wrong: A. Instructing the client to practice deep breathing exercises is a useful anxiety-management technique, but during extreme panic the client may be unable to focus on or perform it. B. Administering the prescribed PRN anxiolytic medication is a possible action, but it should occur after assessing the client and attempting non-pharmacologic interventions, or per provider order, and is not the most immediate nursing action. D. Encouraging the client to discuss the source of anxiety may be ineffective during an acute panic state, as the client may be unable to articulate or process information. The client must first be stabilized emotionally before discussion can begin.