The correct answer is choice B: Is an aversion therapy that produces unpleasant consequences for undesirable behavior.

Choice A rationale:

Decreases or eliminates a behavior by introducing a more adaptive behavior that is incompatible with the unacceptable behavior. Choice A refers to the technique of "differential reinforcement," where an undesirable behavior is replaced by a more appropriate behavior. This technique involves reinforcing positive behaviors while ignoring or providing minimal attention to negative behaviors. It is not the same as covert sensitization.

Choice B rationale:

Is an aversion therapy that produces unpleasant consequences for undesirable behavior. Covert sensitization is a form of aversion therapy used to eliminate unwanted behaviors by associating them with unpleasant imagery or thoughts. It's based on the principle that if a person can associate a negative response with a certain behavior, they will be less likely to engage in that behavior. This technique is used for behaviors like addiction or certain compulsive behaviors.

Choice C rationale:

An aversive stimulus or punishment during which the client is removed from the environment where the unacceptable behavior is being exhibited. Choice C refers to "time-out," a technique used to decrease undesirable behaviors by removing the individual from the environment where the behavior is occurring. This is often used with children and involves giving them a brief break from a situation to help them calm down. It's not the same as covert sensitization.

Choice D rationale:

Relies on an individual's imagination rather than medication for unpleasant symptoms. Choice D is not directly related to covert sensitization. Covert sensitization involves creating a negative association with a behavior using mental imagery. It's not about relying on imagination instead of medication.

The correct answer is choice B: Maintain a nonjudgmental attitude.

Choice A rationale:

Verbalize disapproval of the client's substance abuse. Expressing disapproval can create a negative environment and hinder the therapeutic relationship. Judgmental attitudes can make clients feel defensive and less likely to open up about their struggles.

Choice B rationale:

Maintain a nonjudgmental attitude. Maintaining a nonjudgmental attitude is crucial in building trust and rapport with clients. It creates an environment where clients feel safe discussing their issues without fear of criticism. A nonjudgmental attitude encourages open communication and helps the nurse gather relevant information to provide appropriate care.

Choice C rationale:

Offer sympathetic support. While offering support is important, sympathy might inadvertently convey pity or enable the client's behavior. Empathy, where the nurse understands and shares the client's feelings without judgment, is more effective in building a therapeutic relationship.

Choice D rationale:

Avoid displaying an emotional response. While it's important for the nurse to maintain professionalism, avoiding any emotional response might come across as cold or detached. Expressing appropriate empathy and emotions can actually enhance the therapeutic relationship.

Answer: c. Document the client's verbatim statements.

Here's why the other options are wrong:

• a. Ask the client for permission to take photographs:While photographs may be collected as evidence later, it should not be the first priority. The priority is to focus on patient care and emotional well-being.
• b. Provide community sexual assault support contacts:Offering support resources is important, but documenting the details of the assault is crucial for forensic and legal purposes, and should come first.
• d. Determine any physical signs of injury:Looking for physical injuries is important, but documenting the client's account should come first. This ensures the client's narrative is captured accurately and can be referred to later.

Documenting the client's verbatim statements is the most important initial action because:

• It preserves the client's account of the assault in their own words.
• It allows for accurate reporting and investigation.
• It can be used as evidence in legal proceedings.

Here are some supporting points:

• The Rape, Abuse & Incest National Network (RAINN):"Law enforcement will need to take a detailed statement about the assault, and a medical professional will likely perform a physical exam. Be prepared to answer questions about what happened." [1]
• The National Sexual Assault Hotline:"Law enforcement will want to get a statement from you as soon as possible after the assault. Try to remember the details of the assault as clearly as you can." [2]

In conclusion, while all the other options are important aspects of caring for a sexual assault survivor, documenting the client's verbatim statements is the most critical initial action for a nurse to take in the emergency department setting.

The correct answer is choice B. A room containing personal belongings.

Choice A rationale:

A room without a window would likely be isolating and could contribute to feelings of confusion and disorientation in a cognitively impaired individual. Natural light from windows helps regulate the circadian rhythm and provides a sense of time, which is crucial for maintaining a therapeutic environment.

Choice B rationale:

A room containing personal belongings is the correct choice. Familiar items from home can provide comfort and a sense of familiarity, reducing anxiety and agitation in cognitively impaired individuals. These belongings can act as cues for memory recall and assist in maintaining a connection to their personal identity.

Choice C rationale:

A room adjacent to the nursing station might lead to increased noise and disruption for the client. Cognitively impaired individuals often benefit from a quiet and calm environment, which would not be ensured in a room close to a potentially busy nursing station.

Choice D rationale:

A room with dim lighting can exacerbate confusion and disorientation in cognitively impaired individuals. Adequate lighting is essential for maintaining a safe and structured environment, as poor lighting can lead to falls and increased disorientation.

The correct answer is choice B. A room containing personal belongings.

Choice A rationale:

Similar to the rationale provided for , a room without a window would not provide the necessary sensory input and connection to the outside world. Natural light and visual stimuli are important for maintaining a sense of time and orientation.

Choice B rationale:

A room containing personal belongings is the correct answer for the same reasons as mentioned in the previous question. Familiar items can provide comfort and reduce feelings of agitation in cognitively impaired individuals.

Choice C rationale:

Once again, a room adjacent to the nursing station could expose the client to unnecessary noise and activity, potentially causing distress and hindering the therapeutic environment required for cognitively impaired individuals.

Choice D rationale:

Dim lighting can contribute to disorientation and confusion. Adequate lighting helps individuals perceive their surroundings and reduces the risk of accidents.

Answer and explanation

The correct answers are choices A. Depression, B. Obsessive-compulsive disorder, E. Anxiety.

Choice A rationale:

Depression commonly coexists with eating disorders. The individual's distorted body image, feelings of low self-worth, and dietary restrictions can contribute to the development of depressive symptoms.

Choice B rationale:

Obsessive-compulsive disorder (OCD) often occurs alongside eating disorders. The obsessions and compulsions seen in OCD can overlap with behaviors related to food, eating rituals, and body image, reinforcing the eating disorder pathology.

Choice C rationale:

Schizophrenia is not typically considered a comorbidity of eating disorders. Schizophrenia involves disruptions in thought processes, emotions, and perceptions, which are distinct from the cognitive distortions and behaviors associated with eating disorders.

Choice D rationale:

Breathing-related sleep disorder is not a commonly recognized comorbidity of eating disorders. While sleep disturbances might occur in individuals with eating disorders due to physical discomfort or anxiety, a specific link to breathing-related sleep disorder is less established.

Choice E rationale:

Anxiety is a well-recognized comorbidity of eating disorders. Anxiety often accompanies the intense fears, worries, and preoccupations related to body weight, shape, and eating behaviors that are characteristic of eating disorders.

The correct answer is choice A: "Come with me to an area where we can talk without interruption."

Choice A rationale:

The nurse's response of inviting the client to a quieter area for conversation demonstrates therapeutic communication. By offering a private space, the nurse acknowledges the client's distress and creates an environment conducive to open discussion. This response allows the client to express their feelings without the pressure of being observed or interrupted, fostering a sense of safety and trust.

Choice B rationale:

This response suggests recommending relaxation exercises, which might not be appropriate for a client in a heightened state of anxiety. While relaxation techniques can be helpful for managing anxiety, the client's current level of distress requires immediate attention and active engagement rather than advice on future interventions.

Choice C rationale:

Mentioning an antianxiety pill oversimplifies the situation and ignores the importance of therapeutic communication. Medication is not the primary intervention at this moment, and assuming that a pill would be the immediate solution could diminish the client's need to express their feelings and concerns.

Choice D rationale:

Suggesting that most clients with anxiety issues benefit from lying down is an inaccurate generalization. Different individuals have varying coping mechanisms, and the client's pacing and rambling indicate a need for active support and conversation, rather than a one-size-fits-all approach of lying down.

The correct answer is Choice B.

Choice A rationale: Worrying about a pimple, while significant for self-esteem, does not indicate an immediate risk. Addressing more serious concerns first is crucial, although self-esteem issues should be considered subsequently.

Choice B rationale: Expressing feelings of social isolation and dislike towards peers can indicate underlying mental health concerns, such as depression or anxiety. Addressing these feelings is a priority to provide support and prevent potential escalation.

Choice C rationale: Feeling that parents treat them like a baby can be part of normal adolescent development and is not typically a priority concern unless it significantly impacts the child's well-being.

Choice D rationale: Concerns about not having started menstruation are common and usually not immediately alarming unless accompanied by other signs of developmental delay. Reassurance and providing information can address this issue effectively.

The correct answer is choice B: "I am powerless against my addiction to alcohol."

Choice B rationale:

This statement reflects an understanding of one of the fundamental principles of Alcoholics Anonymous (AA), which is the acknowledgment of powerlessness over alcohol. The concept of powerlessness is a cornerstone of the 12-step program and encourages individuals to recognize that attempting to control their addiction often leads to negative consequences. This admission is crucial for clients in recovery, as it opens the door to seeking support and relying on the fellowship and guidance of AA.

Choice A rationale:

While identifying triggers for alcoholism is important, this statement does not directly capture the essence of AA's principle. The focus on identifying causes does not fully encompass the concept of powerlessness over the addiction.

Choice C rationale:

Responsibility for one's alcoholism is not a core principle of AA. Instead, the program encourages individuals to take responsibility for their actions and their commitment to recovery, but not for causing their addiction in the first place.

Choice D rationale:

AA is a peer support program that emphasizes personal responsibility and self-accountability. While counseling might be beneficial, the statement implies external responsibility for recovery, which contradicts the self-help nature of AA.

The correct answer is choice B. Erotomanic.

Choice A rationale:

Persecution. Persecutory delusions involve the belief that one is being targeted, harmed, or conspired against by others. This choice is not applicable in this scenario because the client is not expressing fear or belief that they are being persecuted.

Choice B rationale:

Erotomanic. Erotomanic delusions involve the false belief that someone, often of higher social status, is in love with the individual. In this case, the client's statement about being engaged to the Prince of England suggests an erotomanic delusion. The client is holding a grandiose belief that they are romantically involved with someone of prominence.

Choice C rationale:

Somatic. Somatic delusions involve the belief that there is something physically wrong with the individual's body. These delusions often manifest as the belief in having an illness or defect that is not actually present. The client's statement does not revolve around physical health or bodily concerns, making somatic delusion an unlikely option.

Choice D rationale:

Control. Control delusions involve the belief that one's thoughts, feelings, or actions are being controlled by external forces. This choice is not applicable in this scenario, as the client's statement does not indicate any perceived loss of control over their thoughts or actions.