A nurse on an inpatient mental health unit is assisting with the care of a client who is experiencing panic level anxiety. Which of the following findings should the nurse expect?

Choice A reason: Poor concentration is common in moderate anxiety but not specific to panic level anxiety. Panic level anxiety overwhelms cognitive functioning to the point where depersonalization and derealization occur. Choice B reason: Shakiness is a physical manifestation of anxiety but is more typical of mild to moderate anxiety. In panic level anxiety, symptoms escalate beyond simple tremors to profound psychological disturbances. Choice C reason: Depersonalization is a hallmark of panic level anxiety. Clients may feel detached from themselves, as though they are observing their body or actions from outside. This dissociative symptom reflects the extreme disruption of reality perception caused by panic. Choice D reason: Voice tremors are associated with moderate anxiety. While they indicate nervousness, they do not capture the severity of panic level anxiety, which involves profound psychological and perceptual disturbances.