Which federal legislative act helps ensure equality in benefits for both medical/surgical and mental health needs to all insured Americans? Select all that apply.

Choice A rationale

A therapeutic nurse-patient relationship is fundamentally patient-centered and goal-oriented, with a focus exclusively on the patient's needs and growth. The nurse assists in identifying and discussing problems, exploring alternatives, and providing support, but the responsibility for implementing solutions and behavioral change ultimately lies with the patient, fostering autonomy and self-efficacy within the relationship's defined boundaries.

Choice B rationale

This describes characteristics of a personal or social relationship, which is mutually satisfying and involves the reciprocal sharing of feelings and meeting of both individuals' needs. A therapeutic relationship, by contrast, maintains strict professional boundaries, is not mutual in meeting needs, and is focused solely on the patient's therapeutic outcomes and mental health goals.

Choice C rationale

This explanation, while reflecting partnership in goals, is too broad and leans toward the mutuality and reciprocal satisfaction found in a personal relationship. The professional nature of the therapeutic relationship dictates that the nurse's concern is specifically for the patient's growth, not a mutual concern for the nurse's growth and satisfaction, maintaining a clear professional boundary.

Choice D rationale

In a therapeutic relationship, the focus always remains on the patient; it does not shift to the nurse. Furthermore, the nurse does not offer personal advice, but rather helps the patient explore their own solutions. Mutual implementation of solutions also breaches professional boundaries and diminishes the patient's responsibility for their own self-directed change and recovery.

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.