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

Choice A reason: Panic-level anxiety activates the sympathetic nervous system, increasing catecholamine release, which impairs cognitive function. This leads to poor concentration as the brain prioritizes fight-or-flight responses, diverting resources from prefrontal cortex activity. Clients struggle to focus, process information, or maintain attention due to heightened arousal and overwhelming fear, making this a key finding. Choice B reason: Sleepiness is not typical in panic-level anxiety, which causes hyperarousal, not sedation. The sympathetic nervous system activation increases heart rate, alertness, and vigilance, counteracting drowsiness. Sleep disturbances may occur post-panic due to exhaustion, but during a panic episode, clients are hyperalert, making this choice incorrect. Choice C reason: Voice tremors are common in panic-level anxiety due to autonomic nervous system activation, causing muscle tension and vocal cord vibrations. Elevated adrenaline levels lead to physical symptoms like trembling, including the voice, as the body prepares for a perceived threat, making this a correct expected finding. Choice D reason: Depersonalization, a sense of detachment from oneself, occurs in panic-level anxiety due to intense fear overwhelming the brain’s sensory integration. The amygdala’s hyperactivation disrupts normal self-perception, leading to feelings of unreality. This dissociative symptom is a hallmark of severe anxiety, making this a correct expected finding.