一名 45 歲診斷為廣泛性焦慮症的個案表達有瀕死感，並報告心悸。護理師首要介入措施為何？
A 45-year-old client diagnosed with generalized anxiety disorder expresses feelings of impending doom and reports palpitations. What is the most appropriate initial nursing intervention?
- AEncourage the client to ventilate their fears鼓勵個案抒發其恐懼
- BStay with the client and maintain a calm, quiet environment✓ 正解陪伴個案並維持安靜、平靜的環境
- CAdminister the prescribed PRN anxiolytic medication給予處方之備用抗焦慮藥物
- DTeach deep breathing exercises教導深呼吸運動
當廣泛性焦慮症（GAD）病人出現「瀕死感（Impending doom）」與心悸時，這可能正處於焦慮發作或恐慌發作（Panic attack）的巔峰。此時病人的認知功能受限，無法吸收複雜的衛教或進行深度交談。護理師的首要行動是「確保安全與降低刺激」。待在病人身邊（B）能提供即時的安全感，而平靜的環境能減少感官過載。臨床思路上，先穩定情緒與生理環境，才能進行後續的深呼吸教學（D）或藥物治療（C）。
The client is experiencing a panic attack, characterized by impaired cognition and high physiological arousal. The priority intervention is to ensure safety and reduce environmental stimuli by staying with the client and maintaining a calm presence. This approach helps de-escalate anxiety immediately, whereas teaching or medication administration requires the client to be calmer first.
美國 NCLEX 非常看重「Presence（陪伴）」的治療價值。在台灣，護理師可能因忙碌而傾向先給藥或請家屬陪伴，但在考試中，護理師親自陪伴是體現「Psychosocial Integrity」的關鍵答案。