A client who has agoraphobia is beginning desensitization with the therapist, and the nurse is reinforcing the process. Which intervention has the highest priority for this client's plan of care?

Establish trust by providing a calm, safe environment.

Encourage deep breathing when anxiety escalates in a crowd.

Progressively expose the client to larger crowds.

Encourage substitution of positive thoughts for negative ones.

Answer and Explanation

The Correct Answer is A

A.   Establishing trust by providing a calm, safe environment is crucial for clients with agoraphobia, as it lays the foundation for effective therapeutic interventions and supports the client's sense of safety and security.
B.   Encouraging deep breathing is a helpful coping strategy, but it may not be the highest priority compared to establishing trust and safety.
C.   Progressively exposing the client to larger crowds is part of desensitization therapy, but it should be done gradually and only after trust and rapport have been established.
D.   Encouraging substitution of positive thoughts for negative ones is a valuable cognitivebehavioral technique, but it may be more effective once the client feels safe and supported in the therapeutic environment.

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Correct Answer is C

Explanation

A. While a history of heart disease is important to consider, it is not the most crucial information to obtain prior to administering sertraline.
B. Familial history of mental illness is relevant but may not directly impact the immediate administration of sertraline.
C. Obtaining a thorough medication history is essential to identify potential drug interactions, allergies, or contraindications that could affect the safety and efficacy of sertraline.
D. While current weight may influence the dosing of certain medications, it is not typically a primary consideration prior to administering sertraline.

A. Concentrate on and ventilate emotions when distressed. B. Relax and reduce the amount of effort to solve the problem. C. Shift attention from self to the needs and requests of others. D. Focus on small achievable tasks, not taxing problems.

Correct Answer is D

Explanation

A. Ventilating emotions when distressed may be helpful in some situations, but it may not directly address the client's avoidance behavior or assist in building coping skills to manage responsibilities.
B. Relaxing and reducing effort to solve problems may exacerbate feelings of helplessness and avoidance, rather than promoting active coping strategies.
C. Shifting attention from self to the needs and requests of others may be beneficial in certain contexts, but it may not directly address the client's depressive symptoms or avoidance behavior.
D. Focusing on small achievable tasks allows the client to experience a sense of accomplishment and mastery, which can help counteract feelings of helplessness and build confidence in managing responsibilities. This approach aligns with behavioral activation techniques commonly used in the treatment of depression.

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A client who has agoraphobia is beginning desensitization with the therapist, and the nurse is reinforcing the process. Which intervention has the highest priority for this client's plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse has received a new prescription for the client to begin taking sertraline. Prior to administering the initial dose of sertraline, it is most important for the nurse to obtain which information?

Correct Answer is C

Explanation

A client with depression does not want to communicate with friends, uses television watching as a means of escaping responsibilities, and describes the inability to handle personal circumstances. Which coping strategy should the nurse include in the plan of care?

Correct Answer is D

Explanation

The nurse observes a client with a history of psychosis repeatedly looking to the side and mumbling responses to no one present in that direction. Which comment is best for the nurse to make?

Which individual should the nurse consider at highest risk for suicide?

The nurse documents that a client with schizophrenia is delusional. Which statement by the client confirms this assessment?

Which intervention(s) should the nurse include in the plan of care for an adolescent client who is depressed? Select all that apply.

Which reason(s) should the nurse expect a female client to use when she is having difficulty leaving a relationship where she is a victim of intimate partner violence? Select all that apply.

The nurse is performing intake interviews at a psychiatric clinic. A client with a known history of drug abuse reports having had a heart attack four years ago. Use of which substance places the client at highest risk for myocardial infarction?

A client requests permission for the spouse to remain in the room during the admission assessment. While interviewing the client, the nurse notes a discrepancy between the client's verbal and nonverbal communication. Which action should the nurse take?

During a family group meeting, the client's daughter tells the group, "I hope I didn't cause Mom to be depressed." Which response is best for the nurse to provide?