Tiffany is a 16-year-old teenager who has obsessive-compulsive disorder and continually washes her hands until they are cracked and bleeding. She was placed on the inpatient unit on a 5150 after a recent suicide attempt in which she overdosed on her mother’s sleeping pills in the medicine cabinet. She is medically stable. You are her assigned nurse, and when you approach her room, you hear her in the bathroom washing her hands.Tiffany describes the ending of her relationship with her boyfriend as “ghosting.” He just “stopped calling me after a year of going out.” Important cognitive behavioral approaches for her lack of self-esteem and anxiety may be (select all that apply):
Reframe “all or nothing” thinking and that it is all “her fault.”
Have her identify self-soothing activities for decreasing anxiety.
Reframe self-criticism and give positive feedback for insightful comments during group therapy.
Tell her she “has her entire life ahead of her and shouldn’t be worried about her former boyfriend.”
Correct Answer : A,B,C
Choice A reason:
Reframing “all or nothing” thinking and that it is all “her fault” is an important cognitive behavioral approach. This technique helps Tiffany recognize and challenge irrational thoughts that contribute to her low self-esteem and anxiety. By learning to see situations in a more balanced way, she can reduce feelings of guilt and self-blame.
Choice B reason:
Having Tiffany identify self-soothing activities for decreasing anxiety is another effective cognitive behavioral approach. Self-soothing activities, such as deep breathing, listening to music, or engaging in hobbies, can help her manage anxiety and reduce the urge to engage in compulsive behaviors like handwashing.
Choice C reason:
Reframing self-criticism and giving positive feedback for insightful comments during group therapy can help Tiffany build self-esteem and develop a more positive self-image. Positive reinforcement encourages her to recognize her strengths and achievements, which can counteract negative self-perceptions.
Choice D reason:
Telling Tiffany she “has her entire life ahead of her and shouldn’t be worried about her former boyfriend” is not a cognitive behavioral approach. While it may be intended to provide reassurance, it does not address the underlying cognitive distortions or provide strategies for managing anxiety and low self-esteem.
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Correct Answer is B
Explanation
Choice A reason:
Thought content refers to the actual ideas and themes that a person expresses. It includes what the person is thinking about, such as delusions, obsessions, or preoccupations. Assessing thought content involves understanding the specific topics and beliefs the patient discusses.
Choice B reason:
Thought process refers to the way in which thoughts are organized and connected. Describing a patient’s speech as hesitant, slow, and with thought blocking indicates issues with the thought process. Thought blocking, where a person’s speech is interrupted by sudden silences, suggests difficulty in maintaining a coherent flow of ideas.
Choice C reason:
Affect refers to the observable expression of emotion. It includes the patient’s facial expressions, tone of voice, and body language. While affect can provide clues about a person’s emotional state, it does not directly relate to the organization of their thoughts.
Choice D reason:
Mood refers to the patient’s sustained emotional state, such as feeling depressed, anxious, or euphoric. While mood can influence speech patterns, the description of hesitant, slow speech with thought blocking specifically pertains to thought process rather than mood.
Correct Answer is A
Explanation
Choice A reason:
Yogurt is one of the foods that can interact with MAOI inhibitors like Nardil. MAOIs can cause dangerous increases in blood pressure when taken with foods containing high levels of tyramine, such as aged cheeses, yogurt, fermented foods, and certain meats. Patients on MAOIs must follow strict dietary restrictions to avoid these interactions.
Choice B reason:
Vegetable salad is generally safe for individuals taking MAOI inhibitors. Fresh vegetables do not contain high levels of tyramine and do not pose a risk of interaction with MAOIs.
Choice C reason:
Oatmeal is also safe for individuals taking MAOI inhibitors. It does not contain high levels of tyramine and is not associated with adverse interactions with these medications.
Choice D reason:
Crackers are typically safe for individuals taking MAOI inhibitors, provided they do not contain aged cheeses or other high-tyramine ingredients. Plain crackers do not pose a risk of interaction with MAOIs.