A client diagnosed with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?

Correct Answer: A

Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).

Correct Answer: C

Rationale: Buspirone (Buspar) is a medication used to treat generalized anxiety disorder, and its pharmacological properties and clinical use explain why choice C is correct while the others are incorrect. **Correct Answer (C):** Buspirone has a delayed onset of action, typically requiring **2-4 weeks** for noticeable therapeutic effects. Unlike benzodiazepines, which provide rapid relief, buspirone works by modulating serotonin and dopamine receptors over time. This slow mechanism means patients must take it consistently—not as needed—to achieve anxiety reduction. The statement "It may take several weeks for this medication to take effect" demonstrates accurate understanding, as it aligns with the drug's pharmacokinetics and prescriber instructions. **Incorrect Answer (A):** "I should take this medication as needed for anxiety" is incorrect because buspirone is not a PRN (as-needed) medication. It does not provide immediate relief like benzodiazepines (e.g., lorazepam) due to its gradual effect on neurotransmitter systems. Taking it intermittently would undermine its efficacy, as steady blood levels are required for therapeutic benefits. **Incorrect Answer (B):** "I need to avoid aged cheeses" is incorrect because this precaution applies to **MAO inhibitors** (e.g., phenelzine), not buspirone. MAO inhibitors interact with tyramine-rich foods (like aged cheeses), causing hypertensive crises. Buspirone lacks this interaction, so dietary restrictions are unnecessary. This statement reflects confusion with another drug class. **Incorrect Answer (D):** "I can stop taking this medication abruptly if I feel better" is incorrect because sudden discontinuation, though not typically associated with severe withdrawal (unlike benzodiazepines), can lead to symptom recurrence. Buspirone should be tapered under medical supervision to prevent rebound anxiety. Abrupt cessation disregards the need for gradual adjustment and ongoing management of anxiety disorders. The key distinctions lie in buspirone's **mechanism (slow-acting, non-sedating), dosing regimen (scheduled, not PRN), and lack of dietary or abrupt-discontinuation risks** compared to other anxiolytics. Choice C correctly reflects these nuances, while the others misrepresent the drug’s use or confuse it with other medications.

Correct Answer: D

Rationale: Encouraging the client to express their feelings is essential during alcohol withdrawal as it can help them cope with the emotional and psychological stress associated with the process. This intervention promotes open communication, allows the client to verbalize their emotions, and may prevent escalating anxiety or agitation, ultimately reducing the risk of complications. Providing a well-lit environment (Choice A) is not directly related to preventing complications of alcohol withdrawal. Administering antipsychotic medication (Choice B) is not the standard treatment for alcohol withdrawal; medications such as benzodiazepines are more commonly used. While monitoring vital signs (Choice C) is important, encouraging the client to express their feelings (Choice D) directly addresses emotional well-being, which is crucial during this vulnerable time.

Correct Answer: C

Rationale: When caring for a client with schizophrenia experiencing delusions, the most appropriate intervention is to acknowledge the client's feelings without reinforcing the delusions. This approach helps maintain trust and communication, fostering a therapeutic relationship. Challenging the delusions directly can lead to increased distress and resistance from the client. Providing evidence to disprove the delusions may not be effective due to the deeply ingrained nature of the client's beliefs. Ignoring the delusions may make the client feel dismissed or unheard, which can hinder the therapeutic process.

Correct Answer: A

Rationale: The correct answer is A because clients should avoid alcohol while taking diazepam (Valium) due to potential interactions. Alcohol can increase the sedative effects of diazepam, leading to excessive drowsiness or respiratory depression. Choice B is correct as it reflects the need to avoid alcohol. Choice C is incorrect because diazepam is usually taken regularly, not just when feeling anxious. Choice D is incorrect as abruptly stopping diazepam can lead to withdrawal symptoms and should be done gradually under medical supervision.