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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Free Nursing Study Resources

Correct Answer is B

No explanation

A. "You have a great deal to live for.". B. "Why do you feel you are worthless?". C. "It's not unusual for depressed people to feel that way.". D. "You've been feeling that your life has no meaning.".

Correct Answer is B

No explanation

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has depression. The client refuses to get out of bed, go to activities, or participate in any of the unit's programs. Which of the following responses should the nurse make?

Correct Answer is B

A nurse is caring for a client who has major depressive disorder and attempted suicide. The client tells the nurse, "I should have died because I am totally worthless." Which of the following responses should the nurse make?

Correct Answer is B

A nurse is preparing to administer fluoxetine 40 mg PO daily. The amount available is fluoxetine 20 mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.).

A nurse is creating a plan of care for a client who is experiencing mania. Which of the following interventions should the nurse include in the plan? (Select all that apply.).

A nurse is caring for a client who has depression. The client refuses to get out of bed, go to activities, or participate in any of the unit's programs. Which of the following responses should the nurse make?

When prescribing a tricyclic antidepressant, which patient would we be most concerned about dispensing the medication to?

Guadalupe is terminally ill with brain cancer and her family is considering home hospice. Which of the following statements by the nurse is accurate regarding hospice care?

A nurse in the emergency department is caring for a client who reports chest pain, headache, and shortness of breath. He continues to state, "I don't know why my wife left me." The client receives a diagnosis of anxiety. The nurse realizes the client's findings support which level of anxiety?

A nurse on an acute mental health unit is caring for a client who has major depressive disorder. Which of the following interventions is the nurse's priority?

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