A college student with generalized anxiety disorder attends counseling; the client describes persistent worry about exams and tension. Which response by the nurse is therapeutic?

A college student with generalized anxiety disorder attends counseling; the client describes persistent worry about exams and tension. Which response by the nurse is therapeutic?

• A. It's common to feel anxious before exams; tell me what thoughts run through your mind.
• B. You should try to stop worrying so much.
• C. Let's focus on grading strategies instead.
• D. You just need to calm down and relax.

Answer: (A)

This item hinges on therapeutic communication that validates the client's experience and invites exploration of their thoughts. Acknowledging that anxiety before exams is common helps normalize the feeling, reducing isolation and defensiveness. By asking what thoughts run through their mind, the nurse opens an open-ended conversation that reveals automatic thoughts and cognitive patterns driving the worry. This gives a foundation for later cognitive-behavioral strategies and coping skills, and it strengthens the therapeutic alliance. The other approaches miss this opportunity: telling the client to stop worrying minimizes their experience and offers no insight into their thinking; shifting to grading strategies avoids addressing the anxiety itself; telling them to calm down implies they should manage emotions instantly without guidance, which can feel dismissive and unhelpful.

This item hinges on therapeutic communication that validates the client's experience and invites exploration of their thoughts. Acknowledging that anxiety before exams is common helps normalize the feeling, reducing isolation and defensiveness. By asking what thoughts run through their mind, the nurse opens an open-ended conversation that reveals automatic thoughts and cognitive patterns driving the worry. This gives a foundation for later cognitive-behavioral strategies and coping skills, and it strengthens the therapeutic alliance.

The other approaches miss this opportunity: telling the client to stop worrying minimizes their experience and offers no insight into their thinking; shifting to grading strategies avoids addressing the anxiety itself; telling them to calm down implies they should manage emotions instantly without guidance, which can feel dismissive and unhelpful.