The nurse is implementing operant conditioning with a client who has a substance use disorder. Which intervention is an example of positive reinforcement?

Managing clients at acute risk of suicide involves creating a safe, controlled environment where self-harm is impossible. Constant observation is essential for high-risk individuals, especially during acute phases. Removing dangerous objects is necessary but secondary to direct monitoring. Early intervention reduces impulsivity and provides immediate emotional support.

Rationale for correct answers

B. Constant observation and safety assurance are crucial when a client is actively suicidal, providing immediate response to any self-harm attempt and fulfilling physiological safety needs.

Rationale for incorrect answers

A. Structured group activities may help later in treatment but are insufficient alone to protect actively suicidal clients.

C. Seclusion may increase distress and is not a first-line response unless the client is aggressive or cannot be managed through less restrictive means.

D. While removing harmful items is necessary, it does not provide continuous monitoring, which is essential for high-risk clients.

Take Home Points

• Active suicide risk requires constant observation.
• Safety measures must address both physical and emotional needs.
• Seclusion is not routine and should be used cautiously.
• Removal of dangerous items is helpful but not a substitute for supervision.

Systematic desensitization is a behavioral therapy used to treat phobias by gradually exposing clients to feared stimuli while teaching relaxation techniques. The process begins with relaxation training to manage anxiety, followed by creation of a fear hierarchy and gradual exposure. This stepwise desensitization helps recondition the anxiety response.

Rationale for correct answers

A. Relaxation training is the first step, enabling the client to manage anxiety during progressive exposure.

Rationale for incorrect answers

B. Exposure occurs after relaxation skills are established.

C. Hierarchy planning is second, following relaxation training.

D. Confrontation without preparation may trigger panic and is contraindicated initially.

Take Home Points

• Systematic desensitization starts with relaxation, not exposure.
• Clients need coping tools before facing phobic triggers.
• Gradual exposure is structured, not forced.
• Phobia treatment is goal-oriented and stepwise.