A client with borderline personality disorder tells the nurse, "You are the best nurse on the unit! The other nurses don't care about me the way you do." Which response should the nurse provide to this client?

I do care about you as a person but nothing more.

I am not the best nurse. All the nurses are good.

The other nurses and I are here to help you get better.

You don't think the other nurses care about you?

Answer and Explanation

The Correct Answer is C

A.   This response may invalidate the client's feelings and might not provide reassurance about the nurse's support.
B.   This response deflects the client's statement and might not address the client's feelings of being cared for.
C.   This response acknowledges the client's feelings, reinforces the presence of the nursing team, and emphasizes the collective goal of helping the client get better.
D.   This response might indirectly question the client's perception and doesn't directly address the client's need for reassurance and support.

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Correct Answer is B

Explanation

A. Familial history of mental illness is important but might not directly impact the initiation of sertraline treatment.
B. Medication history is the most important information to obtain before starting sertraline. This includes any current medications the client is taking, especially other antidepressants, anticoagulants, or medications that may interact with sertraline. Sertraline is a selective serotonin reuptake inhibitor (SSRI), and it can interact with other medications, such as monoamine oxidase inhibitors (MAOIs) or other serotonergic drugs, leading to serious side effects like serotonin syndrome.

C. While current weight may be important for monitoring side effects such as weight gain, it is not as immediately critical as understanding the client’s medication history, particularly regarding potential drug interactions.

D. A history of heart disease is relevant to the overall health assessment, but sertraline is generally considered safe for most individuals with heart disease. However, the medication history is more crucial because of potential drug interactions.

A. Suggest that the client develop a list of pleasurable activities. B. Encourage the client to exercise. C. Provide education on methods to enhance sleep. D. Teach the client to develop a plan for daily structured activities. E. Teach the client to develop a plan for daily structured activities.

Correct Answer is D

Explanation

A. Developing a list of pleasurable activities might be beneficial but might not directly address the lack of motivation and psychomotor retardation.
B. Encouraging exercise is generally helpful but might be challenging for someone experiencing hypersomnia and lack of motivation.
C. Providing education on methods to enhance sleep is important, but it might not directly address psychomotor retardation or motivation.
D. Teaching the client to develop a plan for daily structured activities can provide a sense of purpose, routine, and help combat psychomotor retardation and lack of motivation commonly seen in depression.

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A client with borderline personality disorder tells the nurse, "You are the best nurse on the unit! The other nurses don't care about me the way you do." Which response should the nurse provide to this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Prior to initiating a treatment regimen with the antidepressant sertraline, it is most important for the nurse to obtain which information?

Correct Answer is B

Explanation

A middle-aged adult with major depressive disorder suffers from psychomotor retardation, hypersomnia, and lack of motivation. Which intervention is likely to be most effective in returning this client to a normal level of functioning?

Correct Answer is D

Explanation

The nurse is preparing the physical environment to interview a new client for admission to the mental health unit. Which environmental setting facilitates the best outcome of the interview?

The nurse is admitting a male client who takes lithium carbonate twice a day. Which information should the nurse report to the healthcare provider immediately?

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