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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):

A.

Reframe “all or nothing” thinking and that it is all “her fault.”

B.

Have her identify self-soothing activities for decreasing anxiety.

C.

Reframe self-criticism and give positive feedback for insightful comments during group therapy.

D.

Tell her she “has her entire life ahead of her and shouldn’t be worried about her former boyfriend.”

Question Solution

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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View Related questions

Correct Answer is A

Explanation

Choice A reason:

Duloxetine (Cymbalta) is an SNRI antidepressant commonly used for both chronic pain and depression. It works by increasing the levels of serotonin and norepinephrine in the brain, which helps improve mood and alleviate pain. Duloxetine is often prescribed for conditions such as fibromyalgia, diabetic neuropathy, and chronic musculoskeletal pain, in addition to its use in treating major depressive disorder.

Choice B reason:

Sertraline (Zoloft) is an SSRI antidepressant used primarily to treat depression, anxiety disorders, and other mood disorders. While it is effective for these conditions, it is not specifically indicated for chronic pain management.

Choice C reason:

Fluoxetine (Prozac) is another SSRI antidepressant used to treat depression, anxiety disorders, and certain eating disorders. Like sertraline, it is not typically used for chronic pain management.

Choice D reason:

Citalopram (Celexa) is also an SSRI antidepressant used to treat depression. It is not indicated for chronic pain management and is primarily used to improve mood and alleviate symptoms of depression.

Correct Answer is C

Explanation

Choice A reason:

Sleeping 4 hours each night is not an indication that the patient’s mood is improving. In fact, inadequate sleep can be a sign of ongoing depression or anxiety. Recovery from a suicide attempt typically involves improvements in sleep patterns, energy levels, and engagement in daily activities.

Choice B reason:

Showing a lack of energy with activities suggests that the patient is still experiencing depressive symptoms. Recovery from depression and suicidal ideation generally includes an increase in energy and participation in activities.

Choice C reason:

Discussing ways to find an outpatient therapist with a social worker indicates that the patient is taking proactive steps towards recovery. This behavior shows that the patient is engaging in their treatment plan, seeking support, and planning for ongoing care, all of which are positive signs of mood improvement.

Choice D reason:

Refusing to talk to staff or family is a sign that the patient may still be struggling with depressive symptoms and social withdrawal. Effective recovery involves open communication and support from healthcare providers and loved ones.

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