A nurse is caring for a client who has major depressive disorder and states that he has given away his personal belongings. Which of the following responses should the nurse make?
"Why did you feel like giving away your belongings?"
"You should find a support group to attend."
"Everyone feels a little down sometimes."
"Can you tell me how you have been feeling lately?"
The Correct Answer is D
A. "Why did you feel like giving away your belongings?"
This response is empathetic and invites the client to explore their feelings and motivations. It shows understanding and can help the nurse comprehend the client's emotional state better.
B. "You should find a support group to attend."
This response suggests a proactive step to seek support, which can be helpful. However, it might be premature in this context as the nurse hasn't fully assessed the client's situation yet. It's important to understand the client's feelings and circumstances before recommending specific interventions.
C. "Everyone feels a little down sometimes."
This response minimizes the client's feelings and can be invalidating. It doesn't acknowledge the seriousness of the client's statement, which might discourage them from opening up further.
D. "Can you tell me how you have been feeling lately?"
As previously explained, this response is empathetic and open-ended, encouraging the client to share their emotions and thoughts. It's a good starting point for a therapeutic conversation, allowing the nurse to assess the client's current mental state.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hallways are long distances:
Long hallways can be challenging for individuals with dementia due to their potential mobility issues, disorientation, and decreased ability to navigate. Dementia often affects spatial awareness and can lead to confusion, making it difficult for patients to find their way back to their rooms or common areas. Long distances increase the risk of falls and disorientation.
B. The room has an area rug:
Area rugs can present tripping hazards for anyone, especially for individuals with mobility issues, balance problems, or cognitive impairments like dementia. Patients might trip on the edges of the rug, leading to falls and injuries.
C. The bed is in the low position:
Having the bed in a low position is generally considered a safety measure, especially for patients at risk of falls. However, for a patient with dementia, it might be important to strike a balance. Beds that are too low can be difficult for individuals with dementia to get in and out of, potentially leading to falls. It's important to assess the patient's ability to safely get in and out of bed.
D. Outside doors have locks:
Locks on outside doors are essential for the safety of individuals with dementia. Dementia patients are prone to wandering, which can lead them to dangerous situations if they leave the facility unsupervised. Locks on outside doors help prevent wandering, ensuring the patients stay within the secure confines of the facility.
Correct Answer is B
Explanation
A. "You should leave your partner if you feel your life is in danger."
While leaving an abusive relationship is often necessary for safety, this statement might oversimplify a complex situation. Safety planning should be individualized and may involve various steps, not just immediate departure.
B. "You do not deserve to live in fear of your partner."
This statement validates the client's feelings and emphasizes their right to live without fear. It empowers the client and encourages self-worth.
C. "You need to tell your partner that you intend to leave the relationship."
Telling an abusive partner about the intention to leave can escalate the situation and put the client at risk. Safety planning usually involves not disclosing plans until the client is in a safe environment.
D. "It is important to learn to diffuse your partner's anger."
This statement places the responsibility for the abusive behavior on the victim, which is not appropriate. Victims of abuse are not responsible for the actions of their abusers. The focus should be on their safety and well-being.
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