A nurse is conducting a mental health assessment for a patient reporting persistent feelings of hopelessness. Which intervention best aligns with evidence-based practice for addressing this symptom?

Choice A reason: A provider giving a telephone order is a standard practice in healthcare, not inherently requiring reporting unless the order is unsafe. It does not indicate negligence or ethical violations, unlike impaired practice or boundary issues, making it incorrect for mandatory intervention and reporting.

Choice B reason: A peer under the influence of alcohol compromises patient safety due to impaired judgment and coordination, a serious ethical and professional violation. Nurses are obligated to report such behavior to protect patients, aligning with nursing ethics and safety protocols, making this a correct choice.

Choice C reason: Violating relationship boundaries with a patient, such as inappropriate personal interactions, breaches ethical standards and risks patient harm. Nurses must report this to ensure patient safety and maintain professional integrity, aligning with mental health care ethics, making this a correct choice.

Choice D reason: A licensed provider prescribing medication is a routine clinical action, not requiring reporting unless the prescription is unsafe or inappropriate. This choice does not inherently indicate a need for intervention, unlike impaired practice or boundary violations, making it incorrect.

Choice A reason: Including the child in group activities promotes socialization but is not operant conditioning, which uses rewards to reinforce specific behaviors like speech. This approach lacks direct reinforcement, making it ineffective for the targeted behavior, thus incorrect.

Choice B reason: Observing others talking may model behavior but is not operant conditioning, which requires direct reinforcement of the desired action (speech). Passive observation does not provide the reward structure needed to encourage speech, making this choice incorrect.

Choice C reason: Operant conditioning uses positive reinforcement, like giving a treat for speaking, to increase the desired behavior. This directly rewards the child’s speech, aligning with behavioral psychology principles to encourage verbalization, making this the correct choice.

Choice D reason: Relaxation techniques address anxiety but are not operant conditioning, which focuses on reinforcing specific behaviors with rewards. They do not directly encourage speech, making this choice incorrect for the behavioral approach specified in the treatment plan.