A nurse on a mental health unit is caring for a client who has generalized anxiety disorder. The client received a telephone call that was upsetting and now the client is pacing up and down the corridors of the unit. Which of the following actions should the nurse take?

Choice A reason: Instructing the client to sit down and stop pacing may escalate anxiety, as pacing is a physical outlet for heightened amygdala activity and cortisol release in generalized anxiety disorder. Forcing cessation dismisses the client’s emotional state, potentially worsening distress and hindering therapeutic engagement. Choice B reason: Escorting the client to her room isolates her and may increase anxiety by removing a coping mechanism (pacing) without addressing the underlying neurochemical imbalance, such as excessive norepinephrine. This approach risks escalation rather than de-escalation, as it does not engage the client therapeutically. Choice C reason: Walking with the client at a gradually slower pace is therapeutic, as it validates the client’s anxiety-driven pacing while gently reducing arousal. This mirrors the client’s energy, calming the overactive amygdala and lowering cortisol levels, promoting de-escalation and trust in a non-confrontational, supportive manner. Choice D reason: Allowing the client to pace alone until tired risks physical exhaustion and does not address the underlying anxiety driven by neurochemical imbalances, such as excessive norepinephrine or GABA dysfunction. Unsupervised pacing may reinforce anxiety without therapeutic intervention, making it less effective than guided de-escalation.