A patient diagnosed with generalized anxiety disorder is receiving cognitive-behavioral therapy (CBT). Which of the following should the nurse reinforce as an important goal of CBT?

Correct Answer: C

Rationale: The correct answer is C: To identify and change negative thought patterns that contribute to anxiety. In CBT for anxiety disorders, the main goal is to challenge and modify distorted thinking patterns that contribute to anxiety. By identifying and changing negative thought patterns, individuals can learn to respond to situations in a more adaptive and less anxiety-provoking way. This approach helps to break the cycle of anxiety and improve coping skills. Choices A and D are incorrect because avoiding stress or accepting anxiety as inevitable do not address the underlying cognitive processes that contribute to anxiety. Choice B is also incorrect as gaining insight into unconscious causes is more aligned with psychodynamic therapy rather than CBT, which focuses on changing current thoughts and behaviors.

Correct Answer: A

Rationale: The correct answer is A: Hopelessness. The patient's statement reflects a sense of despair and lack of interest, which aligns with the defining characteristics of hopelessness in major depressive disorder. The patient expressing not feeling anything and lacking care indicates a deep sense of hopelessness. Impaired social interaction (B) does not capture the core issue of hopelessness presented by the patient. Risk for self-directed violence (C) is not supported by the patient's statement, as there is no indication of self-harm. Powerlessness (D) does not fully encompass the patient's emotional state of hopelessness.

Correct Answer: D

Rationale: The correct answer is D because it indicates a potential serious mental health issue that requires immediate attention. Hearing evil voices commanding harmful actions may suggest psychosis or schizophrenia, posing a risk to the patient and others. This statement highlights the need for a thorough psychiatric evaluation and appropriate intervention. Choices A, B, and C are less concerning and do not pose an immediate threat, focusing on trust issues or perceptions of luck and relationships. Therefore, addressing the patient's hallucinations should be the priority focus for the plan of care.

Correct Answer: D

Rationale: The correct answer is D: Anxiety. This nursing diagnosis is the most appropriate because the patient is experiencing excessive worry and fear, which aligns with the defining characteristics of generalized anxiety disorder. Impaired social interaction (A) is not the best choice as the patient's primary concern is anxiety, not social interaction. Ineffective coping (B) may be a result of anxiety but does not address the primary issue. Disturbed thought processes (C) typically involves alterations in cognitive processes, which are not described in the scenario.

Correct Answer: A

Rationale: The correct answer is A because assessing the patient's suicidal thoughts and plan is the priority in this situation to ensure patient safety. By asking about suicidal ideation, the nurse can determine the level of risk and take appropriate actions to prevent self-harm. Choice B is incorrect as encouraging the patient to talk about their feelings is important but not the priority when immediate safety is at stake. Choice C is incorrect as simply reassuring the patient without assessing their suicidal ideation can be dangerous if the patient is at high risk of self-harm. Choice D is also incorrect as providing positive affirmations and support may not address the underlying risk of suicidal ideation.