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
Leaving the picture of the Virgin Mary where the client placed it shows cultural respect and acknowledges the client's spiritual beliefs. This action promotes a trusting therapeutic relationship by validating the client's values and practices. Culturally competent care involves honoring an individual's unique background, and this simple act demonstrates that the nurse respects the client as a whole person, which is essential for holistic care and patient satisfaction.
Choice B rationale
Sending the picture home with the client’s family would be culturally insensitive and could be perceived as disrespecting the client's spiritual beliefs. This action may cause the client to feel their values are not important or are being disregarded, which can damage the nurse-client relationship. Furthermore, it could lead to increased anxiety and mistrust, negatively impacting the client's overall well-being and willingness to cooperate with the treatment plan.
Choice C rationale
Sending a personal, religious item to the business office safe is unnecessary and disrespectful. This action implies the item is of no importance to the client's care, which can be spiritually and emotionally distressing. It separates the client from a source of comfort and spiritual strength, which is a vital part of a holistic approach to healing. It also fails to recognize the significance of such items in many cultures.
Choice D rationale
Moving the picture to a different location, even to a window, can be seen as dismissive of the client's wishes and spiritual needs. The client placed the picture in a specific spot for a reason, likely for comfort and proximity. Relocating it without permission disregards their autonomy and could be perceived as a subtle form of disrespect, potentially causing a client to feel powerless and unimportant in their own care.
Correct Answer is A
Explanation
Choice A rationale
Primary prevention aims to stop a problem from ever happening by targeting populations at risk before any illness or disease manifests. Leading a psychoeducational group in a community care home is an example of primary prevention because it provides education and skills to prevent mental health issues before they arise in a vulnerable population. This proactive approach focuses on reducing risk factors and enhancing protective factors.
Choice B rationale
Helping a client practice mindfulness for anxiety is an example of tertiary prevention. Tertiary prevention is aimed at reducing the negative impact of an already established disease by restoring function and reducing disease-related complications. In this case, the client already has anxiety, and mindfulness is being used to manage the symptoms and prevent the condition from worsening.
Choice C rationale
Assisting a person with a serious mental illness to fill a pill-reminder is an example of tertiary prevention. Tertiary prevention focuses on rehabilitation and preventing further deterioration in individuals with an existing disease. By ensuring medication adherence, this intervention helps to manage the chronic illness, reduce symptoms, and prevent relapses, thereby improving the client's quality of life and functioning.
Choice D rationale
Medicating an acutely ill client who has assaulted a staff person is an example of tertiary prevention. This intervention is a reactive response to a dangerous behavior that has already occurred, aiming to manage acute symptoms and prevent further harm. Tertiary prevention is implemented after a disease or crisis has manifested to mitigate its consequences and restore stability.
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