A psychiatric nurse visits a client at home. The client tells the nurse that he or she experiences chest pain, shortness of breath, and sweating whenever leaving home. The client has been unable to go to work for six weeks. The nurse recognizes this problem as which behavior?

The symptoms described, chest pain, shortness of breath, and sweating, are characteristic of a panic attack, which frequently co-occurs with agoraphobia. In this condition, the individual fears being in places or situations from which escape might be difficult or where help might not be available, leading to significant functional impairment, such as being unable to leave the home for work. Rationale: A. Mysophobia is the pathological fear of contamination and germs. Although it can cause a person to avoid public spaces, the primary motivation is the fear of getting sick or being dirty rather than a fear of the environment itself or having a panic attack in a place where they cannot escape. B. Acrophobia is the specific fear of heights. This would only be triggered if the client’s home or workplace involved significant elevation. It does not explain a generalized inability to leave the house or the presence of panic symptoms upon simply leaving home. C. Agoraphobia is the correct diagnosis. It involves intense fear or anxiety triggered by real or anticipated exposure to a wide range of situations, including using public transportation, being in open spaces, or being outside of the home alone. The homebound status of the client for six weeks is a classic, severe presentation of agoraphobia where the home has become the only safe zone. D. Claustrophobia is the fear of enclosed or small spaces. While a person with agoraphobia might fear an enclosed space like an elevator, the core of their fear is the inability to escape to a safe place. A person with simple claustrophobia would generally be fine in a wide-open park, whereas a person with agoraphobia would likely find such a space terrifying.