A 56-year-old patient comes to the walk-in clinic reporting scant rectal bleeding and intermittent diarrhea and constipation for the past several months. There is a history of polyps and a family history of colorectal cancer. While you are trying to teach about colonoscopy, the patient becomes angry and threatens to leave. What is the priority diagnosis?

• A. Diarrhea/Constipation related to altered bowel patterns
• B. Deficient Knowledge related to the disease process and diagnostic procedure
• C. Risk for Deficient Fluid Volume related to rectal bleeding and diarrhea
• D. Anxiety related to unknown outcomes and perceived threats to body integrity

Answer: (D)

When a patient becomes angry and threatens to leave during teaching about a potentially frightening procedure, the immediate priority is addressing the emotional distress that is interfering with care. Anxiety about unknown outcomes and perceived threats to body integrity can block the patient’s ability to listen, understand, and consent to testing or treatment. By acknowledging the patient’s fear, validating their concerns, and using calm, empathic communication to provide information in manageable steps, you reduce that anxiety and create a safer, more cooperative environment for decision-making and upcoming procedures. Once the patient’s anxiety is being managed, you can address education and planning more effectively, and then consider other needs such as fluid status or knowledge deficits. The emotional response here takes precedence because it directly affects the patient’s ability to participate in care and consent.