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When evaluating a client's progress in psychotherapy, which outcome is appropriate for the client?
- A. The client will identify triggers for anxiety.
- B. The client will develop coping strategies.
- C. The client will decrease avoidance behaviors.
- D. The client will express feelings of anger.
Correct Answer: A
Rationale: In psychotherapy, identifying triggers for anxiety is a crucial step towards understanding and managing one's anxiety symptoms. By recognizing these triggers, clients can work on developing coping strategies and addressing the root cause of their anxiety, leading to improved mental health outcomes. Decreasing avoidance behaviors and expressing feelings of anger are also important aspects of therapy. However, identifying triggers for anxiety is a more specific and foundational goal in addressing anxiety disorders, making it the most appropriate outcome to evaluate a client's progress in psychotherapy.
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A client is being treated for obsessive-compulsive disorder (OCD). Which intervention should be included in the care plan?
- A. Discourage the client from performing rituals.
- B. Allow the client to perform rituals in the early stages of treatment.
- C. Encourage the client to focus on their compulsions.
- D. Isolate the client to prevent performance of rituals.
Correct Answer: B
Rationale: Allowing the client to perform rituals in the early stages of treatment is a common therapeutic approach for obsessive-compulsive disorder (OCD). Allowing the client to engage in rituals can help reduce anxiety by providing temporary relief. It is a part of exposure therapy, where the individual is gradually exposed to anxiety-provoking situations. As treatment progresses, the focus shifts to gradually reducing the frequency and intensity of rituals through interventions like exposure and response prevention therapy. Discouraging the client from performing rituals (Choice A) is not recommended as it may increase anxiety and resistance to treatment. Encouraging the client to focus on their compulsions (Choice C) may reinforce the behavior rather than helping to decrease it. Isolating the client (Choice D) is not therapeutic and can lead to feelings of abandonment and worsen symptoms.
A healthcare provider is evaluating a client who is taking selective serotonin reuptake inhibitors (SSRIs) for depression. Which symptom should the healthcare provider identify as an adverse effect that requires immediate attention?
- A. Increased appetite
- B. Weight gain
- C. Blurred vision
- D. Suicidal thoughts
Correct Answer: D
Rationale: Suicidal thoughts are a serious adverse effect associated with SSRIs and require immediate attention. This symptom is critical as it can increase the risk of self-harm or suicide in individuals taking these medications. Increased appetite and weight gain are common side effects of SSRIs but do not require immediate attention. Blurred vision is not a typical adverse effect of SSRIs, making it an incorrect choice. Healthcare providers must promptly recognize and address suicidal thoughts to ensure the safety and well-being of the client.
A client has been prescribed sertraline for depression, and the nurse is providing discharge instructions. Which dietary instruction should the nurse include?
- A. Avoid foods high in sodium.
- B. Avoid foods high in calcium.
- C. Avoid foods high in tyramine.
- D. Avoid foods high in potassium.
Correct Answer: C
Rationale: Clients prescribed sertraline should avoid foods high in tyramine to prevent a hypertensive crisis. Sertraline, an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class, can interact with tyramine-rich foods, potentially causing a dangerous increase in blood pressure known as a hypertensive crisis. Choices A, B, and D are incorrect because there is no specific dietary restriction related to sodium, calcium, or potassium intake when taking sertraline.
After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, 'You are incompetent!' Which is the nurse's best response?
- A. Do you believe that I was the cause of your blood test being canceled?
- B. I see that you are upset, but I feel uncomfortable when you swear at me.
- C. Have you ever thought about ways to express anger appropriately?
- D. I'll give you some space. Let me know if you need anything.
Correct Answer: B
Rationale: In this scenario, the most appropriate response for the nurse is option B. By acknowledging the client's feelings and setting a boundary regarding inappropriate behavior, the nurse addresses the situation with empathy. This response demonstrates understanding of the client's emotions while also maintaining a professional standard by expressing discomfort with swearing. Option A could come off as defensive and may escalate the situation. Option C may be perceived as condescending and not immediately address the client's behavior. Option D, although offering space, does not directly address the inappropriate behavior and misses an opportunity to set a professional boundary.
A client is experiencing panic attacks. Which intervention should the nurse implement to help the client manage anxiety?
- A. Encourage the client to avoid situations that trigger anxiety.
- B. Encourage the client to practice deep breathing exercises.
- C. Encourage the client to take anti-anxiety medication as prescribed.
- D. Encourage the client to engage in regular physical activity.
Correct Answer: B
Rationale: During panic attacks, deep breathing exercises can help the client manage anxiety effectively by promoting relaxation and reducing the intensity of symptoms. Encouraging the client to practice deep breathing can provide a quick and accessible strategy to cope with the immediate distress of a panic attack. Choices A, C, and D are incorrect because avoiding triggering situations may reinforce avoidance behavior, anti-anxiety medication is not the first-line intervention during a panic attack, and engaging in physical activity may not be feasible or effective during an acute episode of panic.