A mental health nurse is scheduling a home health appointment with a client who has recently lost his partner in a motor-vehicle crash. Which of the following statements by the client indicates the need for immediate nursing intervention?
"There's no need for anyone to come see me, including you."
"I just feel so angry right now."
"Everything is going to be fine soon."
"I'm not going to talk to you about my problems."
The Correct Answer is A
This statement indicates the need for immediate nursing intervention because it suggests that the client is feeling hopeless and may be at risk for suicide. The nurse should assess the client's suicidal ideation and develop a plan of care to ensure the client's safety. Feeling angry, expressing hope, and declining to talk about problems are common reactions to grief and are not indications of immediate nursing intervention.
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Related Questions
Correct Answer is B
Explanation
The hepatitis A virus is primarily transmitted through the fecal-oral route, either through close contact with an infected person or through the consumption of contaminated food or water. The virus can survive on surfaces for several hours and can be transmitted through inadequate hand hygiene practices. Therefore, good hygiene practices, such as washing hands thoroughly with soap and water after using the toilet, changing diapers, or handling food, are essential in preventing the transmission of the hepatitis A virus. The virus does not spread through skin contact, the genitourinary tract, or blood.
Correct Answer is D
Explanation
." Eye health is an essential aspect of overall health, and many eye disorders and diseases can be asymptomatic. The American Optometric Association (AOA) recommends that adults aged 18-64 should have a comprehensive eye exam at least every two years. After age 65, the frequency of eye exams should be increased, depending on the individual's eye health status. During an eye exam, the optometrist or ophthalmologist evaluates the client's visual acuity, peripheral vision, and intraocular pressure, as well as examines the internal and external structures of the eyes to detect any abnormalities. The assessment of the retina is particularly important as it can reveal the presence of chronic diseases such as diabetes, high blood pressure, and macular degeneration.
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