Which of the following are nursing interventions for phobias? Select all that apply.
Establishing a therapeutic relationship with the client based on trust, empathy, respect, and acceptance.
Providing a safe and supportive environment for the client.
Encouraging the client to avoid situations that trigger phobic responses.
Assisting the client to identify and challenge irrational thoughts and beliefs.
Implementing exposure therapy with the client.
Correct Answer : B,A
Choice A rationale:
Establishing a therapeutic relationship with the client based on trust, empathy, respect, and acceptance (Choice A) is a crucial nursing intervention for phobias. This helps create a foundation of trust and safety, allowing the client to feel understood and supported in addressing their phobic responses.
Choice B rationale:
Providing a safe and supportive environment for the client (Choice B) is another essential intervention. This environment enables the client to feel secure and encourages them to explore their fears gradually, knowing they are in a protected setting.
Choice C rationale:
Encouraging the client to avoid situations that trigger phobic responses (Choice C) is not a recommended intervention. Avoidance can reinforce the phobia and hinder progress in overcoming it. Encouraging gradual exposure to feared situations is a more effective strategy.
Choice D rationale:
Assisting the client to identify and challenge irrational thoughts and beliefs (Choice D) is an evidence-based intervention. This approach, known as cognitive-behavioral therapy, helps clients recognize and modify distorted thought patterns that contribute to their phobias.
Choice E rationale:
Implementing exposure therapy with the client (Choice E) is a valid intervention for phobias. Exposure therapy involves gradually exposing the client to the feared object or situation in a controlled manner, helping them desensitize and reduce their fear response.
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Correct Answer is C
Explanation
Choice A rationale:
The client reporting decreased fear and anxiety related to phobias (Choice A) is a subjective outcome that might not accurately reflect the effectiveness of the nursing interventions. It relies solely on the client's self-report and might not provide an objective measure of improvement.
Choice B rationale:
The client demonstrating increased avoidance behavior (Choice B) is not an outcome aimed at reducing fear and anxiety. Increased avoidance behavior would actually indicate a worsening of the phobia-related symptoms, as the client is avoiding the feared stimulus more.
Choice C rationale:
The client engaging in exposure therapy without excessive distress (Choice C) is a desired outcome for interventions targeting phobias. Exposure therapy involves gradually exposing the client to the feared stimulus in a controlled manner. If the client can tolerate exposure without excessive distress, it indicates a positive response to the intervention and a reduction in fear and anxiety over time.
Choice D rationale:
The client applying cognitive-behavioral techniques ineffectively (Choice D) is not a desirable outcome. The goal of cognitive-behavioral techniques is to equip the client with effective coping strategies to manage their phobias. If the client is applying these techniques ineffectively, it indicates a need for further intervention or adjustment of the therapeutic approach.
Correct Answer is A
Explanation
Choice A rationale:
The client's fear of flying in airplanes and the intense panic response when even thinking about it are indicative of a specific phobia. Specific phobias involve an intense and irrational fear of a specific object, situation, or activity. In this case, the fear of flying is specific and triggers a significant anxiety reaction.
Choice B rationale:
Social phobia (also known as social anxiety disorder) involves an excessive fear of social situations where the individual fears being scrutinized or judged by others. This fear extends beyond a specific object or situation, which is not the case in this scenario.
Choice C rationale:
Agoraphobia involves a fear of situations where escape might be difficult or help might not be available if a panic attack occurs. This fear often leads to avoidance of various places or situations, such as crowded spaces. The client's fear of flying is not characteristic of agoraphobia.
Choice D rationale:
Panic disorder is characterized by recurrent and unexpected panic attacks, often accompanied by a fear of having additional attacks. While the client does experience panic symptoms related to the fear of flying, the primary issue is the specific fear of flying itself, suggesting a specific phobia rather than panic disorder.
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