A nurse is assessing a patient who graduated at the top of his class but now obsesses about being incompetent in his new job. The nurse recognizes that this patient may benefit from the following type of psychotherapy:

Correct Answer: D

Rationale: The correct answer is D: Cognitive-behavioral therapy (CBT). CBT is effective for addressing distorted thought patterns and behaviors, which are characteristic of the patient's feelings of incompetence. Firstly, CBT helps the patient identify and challenge negative beliefs about their abilities. Secondly, it teaches them to replace these thoughts with more balanced and realistic ones. Thirdly, CBT incorporates behavioral techniques to help the patient practice new, healthier behaviors. In contrast, A: Interpersonal therapy focuses on improving relationships, B: Operant conditioning involves modifying behavior through reinforcement, and C: Behavioral therapy focuses on changing specific behaviors without addressing underlying thought patterns. Therefore, D is the most appropriate choice for addressing the patient's cognitive distortions and behaviors.

Correct Answer: D

Rationale: The correct answer is D: Checking the patient's belongings for dangerous items. This is important to ensure the safety of the patient and others. By removing any potential harmful items, the risk of another suicide attempt or harm to others can be minimized. This intervention takes priority over the other options as safety is the immediate concern. A: Allowing the patient to return to her previous room may not address the safety issue and could potentially put the patient at risk. B: Orienting the patient to the unit is important but ensuring safety should come first. C: Building trust through therapeutic communication is crucial in the long term, but immediate safety should be the priority.

Correct Answer: C

Rationale: The correct answer is C because in the problem-oriented charting system (SOAPIE), documentation is not listed in chronological order. This is a disadvantage because it can make it difficult to track the progression of the patient's care over time. In SOAPIE, information is organized based on the patient's problems, which may not align with the timeline of events. A: Incorrect. The problem-oriented charting system does not necessarily affect the support for a universal organizational system. B: Incorrect. Including subjective information is not inherently a disadvantage of the SOAPIE system. D: Incorrect. The nursing process can still be followed using the problem-oriented charting system, although it may not be as structured as other formats.

Correct Answer: B

Rationale: The correct answer is B: Secondary. The sister is considered a secondary information source because she is not the patient themselves. Secondary sources provide information based on knowledge of the primary source (the patient). Primary sources are the patients themselves. Private (C) refers to confidentiality, not the source of information. Informed (D) does not specify the relationship to the patient.

Correct Answer: B

Rationale: The correct answer is B because it reflects active listening and empathy. By acknowledging the patient's conflicting verbal and nonverbal cues, the response shows understanding and encourages further exploration of the patient's feelings. Choice A minimizes the patient's emotions, choice C may come off as confrontational, and choice D makes assumptions without seeking clarification. Overall, choice B promotes a therapeutic relationship by addressing the discrepancy between the patient's words and body language.