A nurse caring for a client who has depression observes the client comes to breakfast freshly bathed wearing clean clothes, and styled hair. Which of the following responses by the nurse is therapeutic?

"Why are you all dressed up today?”

“I see you have done some grooming today"

“Everyone feels better after showering”

"You must be getting better. You look great”

Answer and Explanation

The Correct Answer is B

This response acknowledges the client's effort and self-care without making assumptions or imposing judgment. It is an open and non-intrusive statement that shows the nurse is paying attention to the client's appearance and recognizing their positive action of self-grooming. It allows the client to share their feelings or thoughts if they choose to without feeling pressured or judged. This response demonstrates empathy and understanding, creating a supportive and non-threatening environment for the client to express themselves if they wish to do so.

Incorrect:

A- "Why are you all dressed up today?" This question may put the client on the spot and make them feel self-conscious or defensive. It assumes that there must be a specific reason for the client's appearance, which may not be the case. It can also imply that the client's usual appearance is different or not as desirable.

C- "Everyone feels better after showering." While it is true that personal hygiene can have a positive impact on one's mood, this statement may come across as dismissive or oversimplifying the client's experience. It may invalidate any underlying emotions or struggles the client is facing with their depression. It is important to acknowledge and address the client's feelings rather than making broad generalizations.

D- "You must be getting better. You look great." This statement assumes that physical appearance is directly correlated with the client's mental health and suggests that improvement in appearance equates to improvement in mental well-being. However, a person's outward appearance may not accurately reflect their internal struggles or progress in managing depression. Additionally, it can create pressure for the client to maintain a certain appearance to be perceived as "better."

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Correct Answer is A

Explanation

A- Urinary frequency: Anxiety, particularly moderate to severe anxiety, can stimulate the sympathetic nervous system, which may lead to physical symptoms such as increased urination or urinary frequency. This is due to the body’s "fight-or-flight" response, which can affect the bladder.

B.Clients experiencing moderate anxiety may speak rapidly as their thoughts race, and they may feel an urgent need to express their concerns.

C- Chills: Chills are not typically associated with moderate anxiety disorder. Chills are more commonly seen in conditions such as infections or fever.

D- Distorted perceptual field: Distorted perceptual field, also known as perceptual disturbances, is not typically associated with moderate anxiety disorder. Perceptual disturbances refer to sensory experiences such as hallucinations or illusions, which are more commonly seen in severe mental health conditions like psychosis or substance-induced disorders.

A. "Do not worry about that. Your wife will be fine." B. "I think you should calm down a little before you see your partner." C. "Why do you think the crash is your fault?" D. "Tell me more about your feelings about what happened to your partner."

Correct Answer is D

Explanation

This response acknowledges the client's distress and invites them to share their thoughts and feelings about the situation. It shows empathy and demonstrates active listening, allowing the nurse to gather more information about the client's emotional state and concerns. By giving the client an opportunity to express themselves, the nurse can provide appropriate support and address any guilt or self-blame the client may be experiencing.

Dismissing the client's concerns and redirecting the conversation to their partner's condition (Option A) may invalidate the client's feelings and prevent them from processing their own emotions.

Telling the client to calm down (Option B) may come across as dismissive and insensitive.

Asking the client why they think the crash is their fault (Option C) may put the client on the defensive and hinder open communication. The best approach is to actively listen to the client's concerns and create a supportive environment for them to share their feelings.

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A nurse caring for a client who has depression observes the client comes to breakfast freshly bathed wearing clean clothes, and styled hair. Which of the following responses by the nurse is therapeutic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse on the psychiatric unit is assessing a client who has moderate anxiety disorder. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

A nurse is admitting a client who has multiple injuries following a motor vehicle crash. Shortly after admission, the client's partner distraught and blames himself for the accident. Which of the following responses should the nurse make?

Correct Answer is D

Explanation

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