Which client would be most appropriate to refer for assertive community treatment (ACT)?
One diagnosed with a phobic fear of crowded places.
One diagnosed with schizophrenia who had four hospitalizations in the past year.
One who experienced an episode of severe anxiety to a tornado in the community.
One who experienced a single episode of major depressive disorder.
The Correct Answer is B
Choice A rationale
Assertive community treatment (ACT) is an intensive, non-traditional community-based mental health service for individuals with severe mental illness who have not responded to traditional outpatient care. A phobic fear of crowded places, while distressing, is typically manageable with exposure therapy or other psychotherapeutic interventions and does not meet the criteria for ACT.
Choice B rationale
A client diagnosed with schizophrenia with multiple hospitalizations in the past year is an ideal candidate for ACT. This service is designed for individuals with severe and persistent mental illness, such as schizophrenia, who have a history of repeated hospitalizations or are at high risk for them. ACT helps them achieve stability and live successfully in the community.
Choice C rationale
An episode of severe anxiety due to a tornado is an acute stress reaction. This is not a chronic mental illness and can often be addressed with crisis intervention and short-term therapy. The client does not meet the criteria for a severe and persistent mental illness that would necessitate the long-term, intensive support provided by an ACT team.
Choice D rationale
A single episode of major depressive disorder is treatable with standard outpatient interventions, including psychotherapy and medication. While depression is a serious illness, a single episode does not typically indicate the need for the intensive, long-term support of an ACT team, which is reserved for the most challenging and persistent cases.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The sympathetic nervous system is a branch of the autonomic nervous system responsible for the "fight-or-flight" response. When the client experiences severe anxiety, the sympathetic nervous system is stimulated. This activation leads to a cascade of physiological changes including an increased heart rate, elevated blood pressure, and pupil dilation, preparing the body to respond to a perceived threat or stressor.
Choice B rationale
The parasympathetic nervous system is responsible for the "rest-and-digest" response. It works antagonistically to the sympathetic nervous system, promoting relaxation and conserving energy. Its activation would lead to a decrease in heart rate and blood pressure, and would not be stimulated in a state of severe anxiety.
Choice C rationale
The vagus nerve is the tenth cranial nerve and is a major component of the parasympathetic nervous system. While it plays a crucial role in regulating heart rate and digestion, its primary function is to promote rest and relaxation. Therefore, it would not be stimulated during a state of severe anxiety.
Choice D rationale
The limbic system is a complex set of structures in the brain that plays a major role in emotion, motivation, and memory. While it is involved in the experience of anxiety, it is not part of the autonomic nervous system. The limbic system is the central processing unit for emotional responses, which then trigger the autonomic nervous system.
Correct Answer is C
Explanation
Choice A rationale
Eastern cultural traditions, such as traditional Chinese medicine and Ayurveda, often view health and disease as a dynamic balance of forces within the body, such as yin and yang or the three doshas. Disease is not always seen as having a single, stable cause but rather as a manifestation of imbalance. This perspective differs significantly from the Western biomedical model, which relies on a linear cause-and-effect relationship to explain illness.
Choice B rationale
Indigenous cultural traditions typically attribute disease to a complex interplay of spiritual, social, and environmental factors. Healing practices often involve ceremonies, rituals, and the restoration of harmony between the individual and their community or nature. The concept of reality and disease causation in this framework is highly interconnected and holistic, rather than being based on a single, stable, and scientifically verifiable cause in the biomedical sense.
Choice C rationale
The Western cultural tradition, heavily influenced by the biomedical model, is characterized by a belief in a stable reality where diseases have identifiable, single, or multiple causes. This tradition is founded on the scientific method, which seeks to establish clear cause-and-effect relationships. This perspective views illness as a biological malfunction caused by pathogens, genetic factors, or other physical agents, allowing for targeted medical interventions and diagnoses.
Choice D rationale
The term "Southern" is not a standard cultural or philosophical tradition used in this context. While it could refer to various regional cultures, it does not represent a unified framework for understanding reality and disease causation in the same way that Eastern, Indigenous, or Western traditions do. Therefore, it is an inappropriate choice in this comparison of established cultural paradigms.
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