A client becomes very dejected and states, "No one really cares what happens to me. Life isn't worth living anymore." Which of the following responses should the nurse make?
Tell me who you think doesn't care about you."
"Of course people care. Your family comes to visit every day."
"Why do you feel that way?
"I care about you, and I am concerned that you feel so sad."
The Correct Answer is D
A. "Tell me who you think doesn't care about you."
Explanation: This response might come across as confrontational or defensive, which could discourage the client from opening up further. It's important to offer support and understanding rather than putting the client on the spot.
B. "Of course people care. Your family comes to visit every day."
Explanation: While it's true that the client's family visits, depression often distorts perception and emotions. Telling the client that people care might not be fully effective in addressing their feelings of worthlessness.
C. "Why do you feel that way?"
Explanation: This response opens the door for the client to express their emotions and thoughts. It encourages further conversation and helps the nurse understand the underlying causes of the client's feelings.
D. "I care about you, and I am concerned that you feel so sad."
Explanation: Correct Answer. This response shows empathy and genuine concern for the client's well-being. It acknowledges the client's emotions, offers support, and validates their feelings.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
A. Low self-esteem is a risk factor for depression because negative self-perception and feelings of worthlessness can contribute to the development of depressive symptoms.
B. Irritability is associated with depression, especially in adolescents. It can manifest as a mood symptom and is often seen alongside other depressive features.
C. Chronic pain can be both a symptom and a risk factor for depression. Persistent pain can lead to changes in mood, behavior, and physical function, contributing to the development of depressive symptoms.
D. Insomnia, or difficulty sleeping, is a common symptom of depression and can also be a risk factor. Sleep disturbances are often seen in individuals with depression, and they can contribute to the severity of the condition.
E. Euphoria is not a risk factor for depression. In fact, it is more commonly associated with conditions like bipolar disorder, where individuals experience periods of elevated mood (mania or hypomania) alternating with periods of depression.
Correct Answer is A
Explanation
A. "Are you thinking of harming yourself?": Correct
This is the priority response because it directly addresses the client's statement about being better off gone, which raises concerns about potential suicidal thoughts. Asking this question allows the nurse to assess the client's risk of self-harm or suicide and take appropriate actions to ensure their safety.
B. "Do you really think your family would be better off without you?": Incorrect
While this response attempts to engage the client in a conversation, it doesn't directly address the immediate concern of suicidal thoughts. It's important to prioritize assessing the client's safety before exploring their feelings about their family's perspective.
C. "When did you first start feeling this way?": Incorrect
While understanding the client's history and the onset of their feelings is important, it's not the priority response in this situation. Assessing the client's risk of harm takes precedence over gathering historical information.
D. "Tell me what is happening right now.": Incorrect
This response doesn't directly address the client's statement about being better off gone and doesn't assess the immediate risk of self-harm or suicide. While understanding the client's current situation is valuable, safety concerns should be addressed first.
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