A nurse in an acute mental health facility is caring for a client who has major depressive disorder. Since her admission 3 days ago, she has not put on clean clothes, washed her hair, or participated in any of the unit activities. On this day, the nurse observes that she is wearing clean clothes and has combed her hair. Which of the following responses should the nurse make?

"Your mood must be lifting because you have on clean clothes and have combed your hair.".

"Oh, I'm so pleased that you finally put on clean clothes.".

"I see that you have on clean clothes and have combed your hair.".

"Why did you wear clean clothes and comb your hair today?".

Answer and Explanation

The Correct Answer is C

A. "Your mood must be lifting because you have on clean clothes and have combed your hair.": This makes an assumption about the client’s mood, which may not be accurate and can be interpreted as minimizing the client’s ongoing struggle.

B. "Oh, I'm so pleased that you finally put on clean clothes.": This response might come across as condescending or patronizing, which can negatively impact the therapeutic relationship.

C. "I see that you have on clean clothes and have combed your hair."This response is an example of therapeutic communication that acknowledges the client’s actions without making assumptions or passing judgment. It is an observational statement that recognizes the client's effort, which can help to encourage further positive behavior without imposing interpretations on the client's motivations.

D. "Why did you wear clean clothes and comb your hair today?": This could be interpreted as questioning the client's actions in a way that might make them feel defensive or uncomfortable.

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Correct Answer is A

No explanation

A. Place metal utensils on the client's meal tray. B. Inspect the client's personal belongings. C. Assign the client to a private room. D. Tuck bedcovers over the client's hands and arms. PREVIOUSs . E. Assign the client to a private room. Rationale: This choice is incorrect. While providing privacy and a safe space is important, isolating the client in a private room could potentially increase feelings of loneliness and distress, especially during a vulnerable time. Keeping the client in a supportive and monitored environment is more appropriate.

Correct Answer is B

No explanation

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Naxlex Comprehensive Predictor Exams

The nurse has a patient who checks and rechecks her home in response to an obsessive thought that her house will burn down. The nurse and the patient explore the likelihood that the house will actually burn. The patient states there is little likelihood of this occurring. This is making use of:.

Correct Answer is A

A nurse is caring for a client following a recent suicide attempt. Which of the following actions should the nurse take?

Correct Answer is B

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