A nurse in a hospital is caring for a client who has agoraphobia.
Which of the following statements by the client indicates understanding of the goals of treatment?

"I can try participating in group therapy every week."

"I should avoid entering elevators and other closed spaces."

"I plan to sit on a park bench for a few minutes each day."

"I will join a book club in my neighborhood.".

Answer and Explanation

The Correct Answer is C

Choice A rationale: Agoraphobia is a type of anxiety disorder where the person fears and avoids places or situations that might cause them to panic, feel trapped, or helpless. The goal of treatment for agoraphobia is to help the person feel less anxious and fearful about being in places or situations that they perceive as difficult to escape from. This is often achieved through a combination of cognitive-behavioral therapy (CBT) and medication. In CBT, the person learns to understand and change thought patterns that lead to troublesome feelings, behaviors, and symptoms.

Gradual exposure to the feared situation, under controlled conditions, can help the person gain better control over their anxiety. Therefore, the statement “I plan to sit on a park bench for a few minutes each day” indicates an understanding of the goals of treatment as it suggests a willingness to gradually expose oneself to feared situations.

Choice B rationale: The statement “I can try participating in group therapy every week” does not necessarily indicate an understanding of the goals of treatment for agoraphobia. While group therapy can be beneficial for many mental health conditions, it is not specific to the treatment of agoraphobia. In the context of agoraphobia, the focus of treatment is more on individual cognitive-behavioral therapy and gradual exposure to feared situations.

Choice C rationale: The statement “I will join a book club in my neighborhood” does not necessarily indicate an understanding of the goals of treatment for agoraphobia. Joining a book club could potentially provide social support and a sense of community, which can be beneficial for mental health in general. However, it does not specifically address the fears and avoidance behaviors associated with agoraphobia.

Choice D rationale: The statement “I should avoid entering elevators and other closed spaces” indicates a misunderstanding of the goals of treatment for agoraphobia. Avoidance of feared situations is a common symptom of agoraphobia, and treatment aims to reduce this avoidance behavior, not reinforce it. Therefore, this statement suggests a need for further education about the goals of treatment.

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Correct Answer is B

Explanation

Choice A rationale:

Suppression involves the conscious, intentional effort to push unwanted thoughts, feelings, or memories out of awareness. It is not evident in the client's statement, as they are not actively trying to forget or avoid their alcohol use. Instead, they are attempting to justify it.

Choice B Rationale:

Rationalization is the defense mechanism most clearly demonstrated in the client's statement. It involves creating false but seemingly logical reasons to justify unacceptable behavior or feelings. The client is attributing their alcohol use to external factors (their boss and job requirements) rather than taking responsibility for their own choices and actions. This allows them to avoid confronting the reality of their addiction and the need for change.

Key characteristics of rationalization that align with the client's statement:

Externalizing blame: The client places responsibility for their drinking on their boss and job, rather than acknowledging their own agency.

Minimizing the problem: The client suggests that their drinking was merely a necessary part of their job, downplaying the extent of their alcohol use and its negative consequences.

Avoiding negative emotions: By shifting blame, the client protects themselves from feelings of guilt, shame, and responsibility associated with their addiction.

Choice C Rationale:

Reaction formation involves behaving in a way that is opposite to one's true feelings or impulses. This is not evident in the client's statement, as they are not expressing overly negative or critical attitudes towards alcohol. Instead, they are attempting to justify their use of it.

Choice D Rationale:

Compensation involves overemphasizing a desirable trait or behavior to make up for a perceived weakness or deficiency. This is not evident in the client's statement, as they are not highlighting any positive qualities or accomplishments to offset their alcohol use.

A. Prepare for gastric lavage due to an extremely elevated lithium level. B. Administer the morning dose of lithium. C. Hold the medication and assess for early manifestations of toxicity. D. Check the client's medication record to assess whether the client has been refusing her lithium.

Correct Answer is B

Explanation

The correct answer is choice b. Administer the morning dose of lithium.

Choice A rationale:

Preparing for gastric lavage is unnecessary because a lithium level of 1.0 mEq/L is within the therapeutic range (0.6-1.2 mEq/L) and does not indicate toxicity.

Choice B rationale:

Administering the morning dose of lithium is appropriate as the current lithium level is within the therapeutic range, indicating that the medication is being managed correctly.

Choice C rationale:

Holding the medication and assessing for early manifestations of toxicity is not necessary since the lithium level is not indicative of toxicity. Toxicity typically occurs at levels above 1.5 mEq/L.

Choice D rationale:

Checking the client’s medication record to assess whether the client has been refusing her lithium is not relevant in this scenario because the lithium level is within the therapeutic range, suggesting compliance with the medication regimen.

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A nurse in a hospital is caring for a client who has agoraphobia. Which of the following statements by the client indicates understanding of the goals of treatment?

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A nurse in a hospital is caring for a client who has agoraphobia.
Which of the following statements by the client indicates understanding of the goals of treatment?