A nurse is caring for a client who states, "Things will never work out." Which of the following responses should the nurse make?

"You should try to focus on yourself for a change."

"Why do you feel like things will never work out?"

"Have you been thinking about harming yourself?"

"Maybe an antidepressant will make you feel better."

Answer and Explanation

The Correct Answer is C

Choice A reason:
Telling a client to focus on themselves for a change may come across as dismissive and does not address the underlying feelings of hopelessness. It is important for the nurse to acknowledge the client's feelings and provide support rather than suggesting a shift in focus without understanding the root cause of their distress.

Choice B reason:
Asking the client why they feel like things will never work out can be a useful way to explore their thoughts and feelings. However, it may not be the most immediate concern if the client is experiencing severe hopelessness or suicidal ideation. The nurse should prioritize assessing the client's safety and risk of self-harm.

Choice C reason:
Asking if the client has been thinking about harming themselves is crucial in assessing their safety. Suicidal ideation is a serious concern, and it is important for the nurse to directly address this issue to determine if the client is at risk of self-harm. This response shows that the nurse is taking the client's feelings seriously and is concerned about their well-being.

Choice D reason:
Suggesting an antidepressant might make the client feel better can be helpful in the long term, but it does not address the immediate emotional distress the client is experiencing. Medication can be part of a treatment plan, but the nurse should first ensure the client's immediate safety and provide emotional support.

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Correct Answer is C

Explanation

Choice A reason:
While it is important for a social worker to be aware of a client's difficulty with remembering prescribed food restrictions, this information is more relevant to the dietary staff or a nutritionist who can assist with meal planning and education. However, if the memory issues are severe and impact the client's ability to live independently, then it would also be pertinent for the social worker.

Choice B reason:
Frustration with finding an activity to relieve restless energy may be relevant to a social worker if it pertains to the client's overall mental health and well-being. The social worker can collaborate with the healthcare team to find suitable activities or therapies that can help the client manage their energy levels.

Choice C reason:
The inability of the client to return home after discharge is critical information for a social worker. This directly impacts the client's need for support services, such as long-term care planning, home health services, or alternative living arrangements. The social worker plays a key role in coordinating these services and ensuring a smooth transition from the hospital to the next phase of care.

Choice D reason:
A request to talk to someone about changes in spiritual beliefs is also relevant to the social worker, as they can provide or arrange for spiritual support services. However, this is not as urgent as the need for housing or care planning, which has immediate practical implications for the client's discharge planning.

A. The client's best friend moved away. B. The client walks their dog daily. C. The client has stopped drinking coffee. D. The client exercises in the morning.

Correct Answer is A

Explanation

Choice A reason:
The client's best friend moving away can significantly impact their emotional well-being and stress levels. Emotional support is crucial during recovery from major surgery like coronary artery bypass. The absence of a close friend can lead to feelings of loneliness and increased stress, which can negatively affect the healing process. Stress can elevate cortisol levels, which may impair immune function and slow down recovery. Therefore, the nurse should recognize this factor as a potential interference with the client's recovery.

Choice B reason:
Walking the dog daily is generally beneficial for recovery. Physical activity, such as walking, can improve cardiovascular health, enhance mood, and reduce stress. It helps in maintaining mobility and preventing complications like blood clots. Therefore, this activity is unlikely to interfere with the client's recovery and may actually support it.

Choice C reason:
Stopping coffee consumption can have mixed effects. While reducing caffeine intake might be beneficial for some individuals, abrupt cessation can lead to withdrawal symptoms such as headaches, irritability, and fatigue. These symptoms can add to the client's stress and discomfort during recovery. However, this is generally a temporary issue and not as significant as the emotional impact of losing a close friend.

Choice D reason:
Exercising in the morning is typically a positive habit for recovery. Regular exercise can improve circulation, reduce stress, and enhance overall physical health. It can also help in maintaining a routine and providing a sense of normalcy. Therefore, morning exercise is unlikely to interfere with recovery and is usually encouraged.

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