Which neurotransmitter is most commonly targeted to reduce symptoms in clients diagnosed with obsessive-compulsive disorder (OCD)?

Choice A reason: Trauma-focused cognitive-behavioral therapy is the gold standard for treating acute stress disorder. It helps patients identify and restructure maladaptive thought patterns related to the trauma and employs coping strategies to manage autonomic arousal, potentially preventing the progression to chronic post-traumatic stress disorder.

Choice B reason: While exposure therapy is a component of CBT often used for chronic PTSD, it must be applied very carefully in the acute phase of stress. Immediate, intensive exposure can sometimes re-traumatize a patient who has not yet developed the foundational stabilization skills taught in broader CBT models.

Choice C reason: Medication alone, such as benzodiazepines or SSRIs, may manage acute symptoms like insomnia or severe anxiety but does not address the underlying cognitive processing of the traumatic event. Evidence suggests that pharmacological intervention is most effective when used as an adjunct to psychotherapeutic modalities.

Choice D reason: Long-term psychoanalysis focuses on unconscious conflicts and early childhood experiences over several years. This approach is not appropriate for the acute, time-limited nature of acute stress disorder, which requires immediate, symptom-focused, and practical interventions to restore the patient's level of functioning.

Choice A reason: Hypersensitivity reactions and contact dermatitis are significant risks associated with the use of essential oils in clinical settings. Before initiating aromatherapy, the nurse must assess the patient for a history of allergies or atopy. Essential oils contain volatile organic compounds that can trigger bronchospasm or anaphylaxis in susceptible individuals.

Choice B reason: Mixing essential oils with water only is an ineffective method of dilution because oils are hydrophobic and do not dissolve in water. This lack of solubility can lead to uneven distribution, where concentrated droplets of oil come into direct contact with the patient's skin or mucous membranes, potentially causing irritation or chemical burns.

Choice C reason: Utilizing high concentrations of essential oils is contraindicated as it increases the risk of systemic toxicity and localized skin irritation. Therapeutic effectiveness in aromatherapy does not follow a linear dose-response curve where more is better; instead, high concentrations can overwhelm the patient's sensory system and cause adverse physiological responses.

Choice D reason: Applying undiluted essential oils directly to the skin, known as "neat" application, is hazardous and bypasses essential safety testing. Standard nursing practice requires a patch test on a small area of skin to monitor for adverse reactions before broad application, especially in patients with compromised skin integrity or heightened sensitivities.