一位近期病史有恐慌症的26歲女性正坐在診所的候診區。突然間，她開始劇烈發抖、緊抓自己的胸膛、大量冒汗，並陷入過度換氣。她尖叫著說：「救命！我不能呼吸了！我的心臟要爆炸了，我心臟病發作快要死掉了！這裡根本沒有空氣！」護理師確認其生命徵象功能上皆為正常（除了預期中的心搏與呼吸過速）。針對這場急性的恐慌發作，護理師的首要介入為何？
A 26-year-old female with a recent history of panic disorder is sitting in the clinic waiting area. Suddenly, she begins to tremble violently, clutches her chest, sweats profusely, and hyperventilates. She screams, "Help! I can't breathe! My heart is exploding, I'm having a massive heart attack and I am going to die! There is no air!" The nurse confirms functionally normal vitals (aside from expected tachycardia and tachypnea). What is the priority nursing intervention for this acute panic attack?
- ASpeak in a calm, authoritative but reassuring tone, use simple direct phrases, and stay with her while coaching her to breathe into a paper bag.✓ 正解以平靜、權威但令人安心的語調說話，使用簡單直接的短句，並在旁陪伴，指導她用紙袋呼吸。
- BSit down beside her, gently hold her hand to reassure her, and ask her to detailedly describe the underlying stressor that caused this attack.坐在她旁邊，輕握她的手以安撫她，並請她詳細描述引發此次發作的潛在壓力源。
- CFirmly instruct her to snap out of it, reminding her logically that her blood oxygen saturation is perfectly normal and it is all in her mind.堅定地指示她振作起來，並理性提醒她血氧飽和度完全正常，這一切都是心理作用。
- DQuickly leave the waiting area to run to the medication room and retrieve an intramuscular injection of a benzodiazepine.迅速離開候診區去藥房取一支苯二氮平類藥物的肌肉注射劑。
本題測驗焦慮症狀，尤其是最嚴重的「恐慌發作（Panic Attack）」的護理應對。當患者處於恐慌發作期（Panic level of anxiety）時，其認知與理解能力會縮小至隧道視野，伴隨壓倒性的生理性瀕死感與失控感。任何長篇的問話、邏輯說理或探究原因，此時都是毫無意義且會引起極度反彈的。唯一正確的物理介入是：降低周圍環境刺激、護理師「絕對不可留病患獨自一人（Do not leave the client alone）」，並使用『平靜明確、簡短且具體的指引（Calm, short, clear statements）』將大腦的注意力帶回現實的生理控制。帶著病患用紙袋呼吸不但能減輕因為過度換氣引起的呼吸性鹼中毒與手腳發麻，亦提供了一項單一的專注點（選項A正確）。選項B探究病源是「降低到輕度焦慮時」才能做的心理治療，現階段做錯了時機。選項D離開病患去拿藥是大忌，這會讓病患感覺被拋棄並更加確信自己要死了。選項C的責罵或試圖用血氧儀邏輯說服她，完全否認了她恐怖的情緒體驗。
The nurse should remain with the client, speak in a calm and reassuring tone, and guide her through controlled breathing, such as using a paper bag. This provides a sense of security and helps correct respiratory alkalosis caused by hyperventilation, whereas leaving the client alone or engaging in lengthy discussion is ineffective during a panic attack.
Stay with the client (待在病患身旁) 是精神科恐慌症發作護理的第一天條。不管是台美，留下發做中的恐慌症病患獨自去打電話或找藥都是護理上的嚴重失職。