A nurse and client are engaged in a discussion. The client says, “I feel really close to you. You are my only true friend.” Which response by the nurse would be most therapeutic?

Since ours is a professional relationship, let’s explore other opportunities in your life for friendship

We are definitely not friends; this is strictly professional

I am sure there are other people in your life who are your friends; besides, we just met

It makes me feel good that you see me as a friend; it is important for the work we are doing together

Answer and Explanation

The Correct Answer is A

Choice A reason: This response reinforces professional boundaries while therapeutically redirecting the client to explore external social support, addressing potential dependency. It validates the client’s feelings without personalizing the relationship, promoting healthy coping and social integration, which are critical for mental health recovery and maintaining therapeutic integrity.

Choice B reason: Bluntly denying friendship dismisses the client’s feelings, potentially damaging trust and therapeutic rapport. This approach risks alienating the client, who may feel rejected, hindering open communication and progress in addressing underlying emotional needs, making it non-therapeutic in a mental health context.

Choice C reason: Suggesting other friends without exploration dismisses the client’s expressed feelings, potentially invalidating their emotional experience. The assumption about existing friends may not apply, and the response lacks therapeutic engagement, failing to address the client’s dependency or need for social connection, making it less effective.

Choice D reason: Affirming the client’s view of friendship blurs professional boundaries, fostering dependency and compromising therapeutic objectivity. While validating feelings is important, reinforcing a personal connection risks hindering the client’s ability to develop external support systems, making this response non-therapeutic for mental health progress.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: Schizophrenia alone does not typically warrant court-mandated outpatient treatment unless associated with criminal behavior. Living with family suggests stability, reducing the likelihood of court intervention. Mandates are linked to legal infractions, not diagnosis alone, making this client less likely for mandated treatment.

Choice B reason: Petty theft may lead to legal consequences, but courts typically mandate treatment for offenses directly tied to mental health or substance use, like DUI. A single theft may not justify mandated outpatient mental health treatment unless it explicitly stems from a diagnosable condition requiring intervention.

Choice C reason: Two DUI offenses indicate repeated substance use (alcohol) posing public safety risks. Courts often mandate outpatient treatment for substance abuse in DUI cases to address addiction and prevent recidivism, making this client the most likely to receive a court-ordered treatment mandate for outpatient care.

Choice D reason: Job loss due to depression does not typically result in court-mandated treatment, as it lacks a criminal component. Treatment may be recommended, but courts intervene when behavior poses legal or safety risks, like DUI, making this client less likely for mandated outpatient treatment.

A. Because your kidneys no longer produce urine, fluid can build up quickly and lead to complications like high blood pressure or difficulty breathing B. You should actually drink more fluids to stay hydrated since you’re not urinating C. As long as you’re attending all your dialysis sessions, your fluid intake doesn’t need to be restricted D. It’s not the fluids that are harmful, it’s the foods that are high in potassium and phosphorus

Correct Answer is A

Explanation

Choice A reason: In ESRD, anuria means no urine output, so excess fluid accumulates in the body, increasing intravascular volume. This can cause hypertension, pulmonary edema, and respiratory distress. Educating the client about these risks emphasizes the importance of fluid restrictions to prevent life-threatening complications between dialysis sessions, addressing their frustration accurately.

Choice B reason: Advising increased fluid intake is incorrect for anuric ESRD patients, as their kidneys cannot excrete fluid. This would exacerbate fluid overload, leading to hypertension, heart failure, or pulmonary edema. Hydration is managed through dialysis, not increased oral intake, which could overwhelm the body’s limited fluid-handling capacity.

Choice C reason: Stating that fluid intake is unrestricted with dialysis is incorrect. Even with regular dialysis, excessive fluid intake between sessions can lead to overload, causing hypertension or pulmonary edema. Dialysis removes a limited amount of fluid per session, requiring strict restrictions to maintain safe fluid balance and prevent complications.

Choice D reason: While potassium and phosphorus restrictions are critical in ESRD to prevent hyperkalemia and hyperphosphatemia, the client’s question focuses on fluid restrictions. This response does not address fluid overload risks like hypertension or pulmonary edema, which are direct consequences of excessive fluid intake in anuric patients, making it irrelevant to the query.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse and client are engaged in a discussion. The client says, “I feel really close to you. You are my only true friend.” Which response by the nurse would be most therapeutic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a group of clients in the mental health outpatient clinic. Which client is most likely to be mandated by a criminal court for outpatient treatment?

Correct Answer is C

Explanation

Correct Answer is A

Explanation

A nurse is reviewing an electronic medical record to determine if a client’s rights have been violated by another member of the healthcare team. Which finding will the nurse identify that would indicate a violation of the client’s rights?

A client with end-stage kidney disease is scheduled to begin hemodialysis. The nurse is working with the client to adapt the client’s diet to maximize the therapeutic effect and minimize the risks of complications. The client’s diet should include which of the following modifications?

Which statement about nonverbal communication is accurate?

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?

A nurse is caring for a client who is in the diuresis phase of acute kidney injury. The nurse should closely monitor the client for what complication during this phase?

The healthcare provider prescribes haloperidol 10 mg for a client with severe psychosis, but the client refuses the medication. Which initial nursing action is appropriate?

The client feels that the client’s rights have been violated. Placing a client in restraints before using other methods of intervention violates which of the client’s rights?

A nurse assesses a confused older adult. The nurse experiences sadness and reflects, “The patient is like one of my grandparents… so helpless.” What feelings does the nurse describe?