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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","B","D"]

Explanation

Choice A reason:

Improvement in activities of daily living (ADLs) and displaying hopefulness in interactions with others are positive nonverbal cues indicating that therapy and medication are effective. These improvements suggest that Edward is regaining interest in daily activities and looking forward to the future.

Choice B reason:

Being less tearful and able to discuss openly the loss of his grandfather with friends and in group settings are signs that Edward is processing his grief and benefiting from therapy. Open communication about his loss indicates emotional progress and acceptance.

Choice C reason:

Continuing to isolate is not a positive nonverbal cue. Isolation suggests that Edward is still struggling with his depressive symptoms and not fully engaging with his support system. This behavior indicates that further intervention may be needed.

Choice D reason:

Smiling appropriately and interacting with peers are positive nonverbal cues that therapy and medication are working. These behaviors show that Edward is beginning to re-engage socially and experience moments of joy and connection.

Correct Answer is C

Explanation

Choice A reason:

Tea-colored urine and constipation are not characteristic symptoms of serotonin syndrome. These symptoms may indicate other medical conditions but are not related to the excessive accumulation of serotonin in the body.

Choice B reason:

A productive cough and vomiting are not typical symptoms of serotonin syndrome. While vomiting can occur in severe cases, a productive cough is unrelated to serotonin syndrome and more indicative of respiratory conditions.

Choice C reason:

Muscle rigidity and high fever are hallmark symptoms of serotonin syndrome. This condition results from an excess of serotonin in the central nervous system and can lead to severe autonomic instability, hyperthermia, and neuromuscular abnormalities. Immediate medical intervention is required to manage these symptoms and prevent complications.

Choice D reason:

Hypotension and urinary retention are not primary symptoms of serotonin syndrome. While autonomic dysfunction can occur, the key features of serotonin syndrome include neuromuscular hyperactivity, autonomic instability, and altered mental status.

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