A man checks that his doors are locked two or more times each time he leaves home. The door is always found to be locked. Which of the following initial interventions would most likely be useful to this patient?
a. Explaining that his habit is irrational, leads to lateness, and should be discarded.
b. Discussing what the patient was thinking and feeling before checking the door.
c. Requiring the patient to force himself to leave without checking the doors at all.
d. Having him check the doors ten times until he sees the needlessness of checking.
B
Cognitive restructuring involves identifying and questioning automatic thoughts and reframing (rewording) them in ways that are more accurate or more based in reality. In this instance, it is likely that the man is thinking that he may have left the door unlocked and that he will be robbed if he does not catch and correct his error. Replacing this thought with a more accurate statement (e.g., while it is possible he has overlooked locking the door, this is almost never the case, and he has never found the door unlocked after checking it once) can allow him to decide to skip the second door check. Noting that the behavior is irrational and has consequences is unlikely to be beneficial. It is likely that on some level, the patient already appreciates the irrationality and problems associated with the behavior (otherwise he would not have complained about it or sought help for it). While one could require him to skip the door checks repeatedly until experience convinces him that no harm would come from doing so, this would heighten his anxiety in the near term and likely would not be as effective as changing the thought that underlies this behavior in the first place. Having him check the door multiple times might be a form of flooding, but this would be more appropriate for reducing phobias than for obsessive thoughts or compulsive behaviors.
You might also like to view...
The nurse assessing women for their risks of becoming victims of intimate partner violence (IPV) knows that which factors increase this risk? (Select all that apply.)
a. Exposure to abuse as a child b. Harmful use of alcohol c. Lower educational levels d. Single-parent family e. Witnessing IPV between parents
A nurse performed these actions while caring for patients in an inpatient psychiatric setting
1 . Removed cuticle scissors from a suicidal patient. 2 . Helped a patient make an appointment with an attorney. 3 . In patient's presence, opened a package mailed to patient. 4 . Remained within arm's length of patient with homicidal ideation. 5 . Permitted a patient with psychosis to refuse oral psychotropic medication. Which action violated patients' rights? (Select all that apply.) a. none b. 1 c. 2 d. 3 e. 4 f. 5
The nursing student attempting to validate an Internet source wonders whether the source's author is credible in the field. How can this student make this determination? (Select all that apply.)
1. Review the author's credentials. 2. Assume the author is credible because he or she is published on the Internet. 3. Conduct a literature search using the author's name. 4. Look for links to information about the author. 5. Identify sites sponsored by the author individually as valid.
Which intervention should the nurse include in a patient's plan of care to help preserve joint mobility in the acute phase of a CVA?
a. Pull the limbs on the affected side into a functional position. b. Perform aggressive full range-of-motion exercises for all extremities. c. Support affected points in good functional alignment. d. Exercise the limbs every 8 hours.