Which activity is an example of primary prevention?
Teaching school-aged children about drug and alcohol abuse.
Assisting a patient with a long history of mental illness learn to manage money.
Encouraging a new amputee to talk about feelings associated with body image changes.
Providing genetic counseling with a middle-aged couple expecting their first child.
Correct Answer : A,D
Choice A rationale
Primary prevention aims to prevent disease or injury before it ever occurs by modifying risk factors and promoting health. Teaching school-aged children about the dangers of drug and alcohol abuse falls under this category as it is an intervention directed at a susceptible population to prevent the initial onset of substance use disorders and their related complications later in life, thus maintaining their current health status.
Choice B rationale
This is an example of tertiary prevention, which focuses on rehabilitation and minimizing the long-term effects of a chronic illness or disability. Assisting a person with a long history of mental illness to acquire money management skills helps to improve their functioning and quality of life, prevents further deterioration, and facilitates their optimal level of social integration despite the established mental health condition.
Choice C rationale
This is an example of tertiary prevention. Encouraging an amputee to talk about their feelings addresses the psychosocial consequences of a disability or illness that has already occurred. The goal is to limit the resulting disability by providing emotional support and coping mechanisms to prevent severe psychological distress and facilitate psychological adjustment and rehabilitation to the changed body image and life circumstances.
Choice D rationale
Genetic counseling for a couple who is expecting their first child is a form of primary prevention when it involves assessing the risk of inherited disorders and providing education on preventative measures or reproductive choices to avert the occurrence of a genetic condition in the fetus. This intervention is designed to prevent the development of a disease before its initial appearance.
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Correct Answer is C
Explanation
Choice A rationale
This statement reflects a global, self-defeating cognitive distortion known as overgeneralization, applying a single failure to all future attempts ("always fail"). Cognitive Behavioral Therapy (CBT) aims to challenge and modify such rigid, irrational beliefs toward more balanced, realistic thinking, making this statement a lack of progress within the therapeutic framework.
Choice B rationale
This is another example of pervasive cognitive distortion, specifically all-or-nothing thinking or catastrophizing, suggesting a view that all life events are inherently negative ("always go wrong"). Progress in CBT involves moving away from these absolute terms to recognize situational variance and positive outcomes, thus this statement indicates limited therapeutic change.
Choice C rationale
This statement, "Sometimes I do stupid things," demonstrates cognitive restructuring and de-personalization of failure, which are key goals in CBT. By using the word "Sometimes," the client reframes the self-criticism from a global, fixed self-identity ("I'm stupid") to a specific, contextualized behavior ("do stupid things"), showing an awareness that negative actions do not define the whole self.
Choice D rationale
"I'm disappointed in my lack of ability" shifts the language from a global self-label to a feeling about a performance deficit. While less absolute than the original statement, it still focuses on an internal, perceived deficit ("lack of ability") rather than separating the behavior from the self and acknowledging the situational nature of error, which is the hallmark of progress in CBT.
Correct Answer is B
Explanation
Choice A rationale
Prescribing antidepressant medication is an advanced practice function, legally restricted to Advanced Practice Registered Nurses (APRNs), specifically Psychiatric-Mental Health Nurse Practitioners (PMH-NPs), or physicians. This activity involves complex diagnostic reasoning and prescriptive authority that lies outside the scope of practice for a basic level registered nurse (RN), who focuses instead on medication administration and monitoring.
Choice B rationale
Teaching coping skills for specific life stressors or family dynamics is a core, appropriate function for a basic level registered nurse. It involves utilizing health teaching and health promotion principles to enhance the patient's adaptive abilities and stress management, a fundamental intervention within the general scope of psychiatric-mental health nursing practice.
Choice C rationale
Conducting psychotherapy, which involves the systematic application of a theoretical framework to treat mental disorders, is generally an independent function of a specialist, such as an APRN (PMH-NP) or other licensed mental health professionals. The basic level nurse's role is typically focused on therapeutic communication and counseling, not formalized, specialized psychotherapy.
Choice D rationale
The treatment of major depressive disorder encompasses a wide range of specialized interventions, including prescribing, advanced psychotherapeutic modalities, and complex case management. This comprehensive treatment function is ultimately the responsibility of the multidisciplinary team, with the APRN or psychiatrist primarily leading the medical and advanced therapy aspects, exceeding the basic RN's independent scope.
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