一位 28 歲患有廣泛性焦慮症的個案來到診所，主訴心悸、胸悶與瀕死感。在急性恐慌發作期間，護理師採取下列哪項介入措施最為適當？
A 28-year-old client with a history of generalized anxiety disorder presents to the clinic complaining of palpitations, chest tightness, and a fear of dying. Which nursing intervention is the most appropriate during the acute panic attack?
- AEncourage the client to take deep, slow breaths with the nurse✓ 正解鼓勵病人与護理師一起進行深而緩慢的呼吸
- BAdminister an as-needed PRN dose of lorazepam immediately立即給予處方備用劑量的勞拉西泮（lorazepam）
- CInstruct the client to lie down in a dark, quiet room alone指示病人獨自在黑暗安靜的房間躺下
- DChallenge the client's irrational thoughts about dying挑戰病人關於死亡的非理性想法
恐慌發作時，個案常因換氣過度（hyperventilation）導致呼吸性鹼中毒，進而加重心悸與麻木感。護理師此時的首要任務是協助個案控制呼吸節奏。引導個案進行腹式呼吸或模擬緩慢呼吸，能透過生理回饋機制降低交感神經活性，這是最安全且立即的非藥物處置。挑戰個案的認知（D）在恐慌發作當下是無效的，因為個案此時的理性思考已喪失。將個案獨自留置（C）可能導致其焦慮感因孤立而惡化，必須給予穩定陪伴。雖然藥物（B）可緩解症狀，但護理處置應先嘗試非藥物措施。這題強調了在危機時刻，護理師需展現『穩定感』，透過護理行為直接介入病人的生理需求，而非僅僅是口頭勸導。
During a panic attack, clients often hyperventilate, leading to respiratory alkalosis that further worsens palpitations and paresthesia. The nurse's first priority is to help the client regain control of their breathing rhythm. Guiding the client through diaphragmatic or slow breathing reduces sympathetic nervous activity through a physiologic feedback mechanism; this is the safest and most immediate non-pharmacologic intervention. Challenging the client's cognition (D) is ineffective during an acute panic attack, as rational thinking is impaired. Leaving the client alone (C) may worsen anxiety through isolation; stable presence and reassurance are needed. Although medication (B) can relieve symptoms, non-pharmacologic measures should be attempted first. This item emphasizes that in a crisis the nurse should convey a sense of stability and intervene directly with the client's physiologic needs rather than relying solely on verbal reassurance.
美國護理教育極度強調『護理師與病人同在』（Stay with the client）作為恐慌發作的核心指標，強調陪伴本身就是一種醫療處置；台灣臨床環境有時因護理人力緊繃，較傾向先給予 PRN 藥物以快速解決症狀，這在 NCLEX 考試中會被視為次佳選擇。