The nurse is caring for an adolescent in the outpatient psychiatric setting. To help the adolescent feel more in control of the initial therapy sessions, which statement by the nurse would be most appropriate?

Correct Answer: D

Rationale: The correct answer is D. By stating "If something is uncomfortable for you, you don't have to talk about it," the nurse empowers the adolescent to have control over the therapy session, fostering a sense of autonomy and trust. This statement respects the adolescent's boundaries and emotions, promoting a therapeutic relationship based on mutual understanding. Choice A is incorrect because it may undermine the adolescent's trust in confidentiality. Choice B is incorrect as it assumes distrust without allowing the adolescent to express their feelings. Choice C is incorrect as it may make the adolescent feel guilty or pressured by their parents' concern, potentially hindering open communication.

Correct Answer: C

Rationale: Rationale: Neuman's theory focuses on prevention through interventions that alter or manage stimuli for adaptive responses. Roy's theory, on the other hand, emphasizes adapting to stimuli. This makes choice C the correct answer. Choices A, B, and D do not align with Roy's theory as they focus on different aspects of nursing care unrelated to her theory.

Correct Answer: B

Rationale: The correct answer is B: Anhedonia. Anhedonia refers to the inability to experience pleasure or joy in activities that were previously enjoyable. In the scenario provided, the client's statement about not enjoying crossword puzzles anymore indicates a loss of pleasure, which is a key symptom of anhedonia commonly seen in depression. A: Dysthymic disorder is a type of chronic mood disorder characterized by persistently depressed mood. The client's symptoms do not meet the criteria for a diagnosis of dysthymic disorder based on the information provided. C: Delusion refers to a fixed false belief that is not based in reality. The client's statement does not involve any delusional beliefs, so this choice is incorrect. D: Psychosis involves a loss of contact with reality, often manifesting as hallucinations or delusions. The client's statement does not indicate a break from reality, so psychosis is not the correct choice.

Correct Answer: C

Rationale: The correct answer is C: Identifying the underlying beliefs. In cognitive behavior therapy, identifying the underlying beliefs is crucial as they drive the patient's thoughts and behaviors. By focusing on these core beliefs first, the nurse can help the patient understand the root causes of their issues and work towards challenging and modifying them effectively. A: Identifying alternative explanations of an event - This step usually comes after identifying the underlying beliefs. B: Exploring evidence to support or refute the beliefs - This step comes after identifying the beliefs and is not the initial focus. D: Examining the real implications if the beliefs are true - This step is important but is typically addressed after identifying and working on the underlying beliefs.

Correct Answer: B

Rationale: The correct answer is B, "I find that hard to believe." This statement demonstrates the therapeutic communication technique of voicing doubt by expressing skepticism in a non-confrontational manner. It allows the client to further elaborate on their thoughts and feelings, fostering open communication and exploration of underlying issues. Choice A paraphrases the client's statement, choice C assumes the client's feelings, and choice D shifts the focus to finding a solution rather than exploring the client's perspective.