A nurse is contributing to the care plan for a newly admitted client suffering from severe depressive disorder.
Which of the following interventions should the nurse incorporate into the plan?
Encourage the client to make decisions.
Spend time with the client.
Provide the client with a selection of activities.
Play a game of chess with the client.
The Correct Answer is B
Choice A rationale:
While encouraging decision-making can be empowering for some individuals with depression, it may not be appropriate for those with severe depressive disorder.
Individuals with severe depression often experience significant anhedonia (loss of interest in activities), fatigue, and difficulty concentrating, which can make decision-making overwhelming and even worsen their symptoms.
It's important to assess the client's individual level of functioning and decision-making capacity before implementing this intervention.
Choice C rationale:
Providing a selection of activities can be helpful, but it's crucial to tailor the activities to the client's interests and energy level.
Offering too many choices or activities that are too demanding can be counterproductive.
It's essential to collaborate with the client to identify activities that are meaningful and achievable, and to gradually increase the level of activity as tolerated.
Choice D rationale:
Playing a game of chess can be a stimulating and enjoyable activity, but it may not be appropriate for all clients with severe depression.
Chess requires cognitive focus and strategic thinking, which can be challenging for individuals experiencing cognitive impairment or fatigue associated with depression.
It's important to assess the client's cognitive abilities and interests before suggesting this activity.
Rationale for the correct answer, B:
Spending time with the client offers several benefits:
Conveys caring and support: It demonstrates to the client that they are not alone and that someone cares about their wellbeing.
Provides opportunities for therapeutic communication: Spending time together allows for meaningful conversations, which can help the client express their feelings, concerns, and experiences.
Facilitates observation and assessment: The nurse can observe the client's mood, behavior, and interactions, which can inform treatment planning and evaluation.
Promotes engagement and participation: Spending time with the client can encourage them to engage in other therapeutic activities and interventions.
Builds rapport and trust: Developing a strong therapeutic relationship is essential for effective treatment of depression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Answer and explanation
Choice A rationale:
Impaired judgment is a cognitive symptom of schizophrenia, not a positive symptom. It involves difficulties with decisionmaking, problem-solving, and understanding consequences. While it's a significant feature of schizophrenia, it doesn't reflect an excess or distortion of normal functions, which is the hallmark of positive symptoms.
Choice B rationale:
Dysphoria refers to a depressed mood or a state of unhappiness and dissatisfaction. It's a negative symptom of schizophrenia, characterized by a decrease or absence of normal functions. It's not considered a positive symptom as it doesn't involve an excess or distortion of normal processes.
Choice C rationale:
Disorganized speech is a hallmark positive symptom of schizophrenia. It involves significant disruptions in the way a person speaks and communicates. It can manifest in several ways, including: Derailment: Abrupt shifts in topic without logical connection
Tangentiality: Responding to questions in irrelevant or oblique ways
Incoherence: Speech that is fragmented and difficult to understand
Loose associations: Combining words or phrases in a way that lacks logical sense
Neologisms: Creating new words or phrases that have meaning only to the speaker
Word salad: Severely disorganized speech that is essentially incomprehensible
Disorganized speech is considered a positive symptom because it reflects an excess or distortion of normal speech processes. It's a core feature of schizophrenia and often has a significant impact on communication and social functioning.
Choice D rationale:
Anhedonia is the inability to experience pleasure. It's a negative symptom of schizophrenia, characterized by a decrease or absence of normal emotional responses. It's not considered a positive symptom as it doesn't involve an excess or distortion of normal processes.
Correct Answer is ["A","D"]
Explanation
Choice A rationale:
Establishing rapport with the client is essential when caring for someone experiencing acute anxiety. It creates a foundation of trust and understanding, which can help the client feel more comfortable and willing to engage in therapeutic interventions. Here's a detailed explanation of why rapport is crucial in this context:
Reduces Anxiety: A strong rapport can help to reduce the client's anxiety by fostering a sense of safety and security. When a client feels understood and supported, it can help to calm their nervous system and decrease the intensity of their anxiety symptoms.
Increases Communication: Effective communication is essential for identifying the cause of anxiety and developing appropriate interventions. When a nurse has a good rapport with a client, the client is more likely to be open and honest about their thoughts, feelings, and experiences. This can lead to a more accurate assessment and a more effective treatment plan.
Improves Cooperation: Clients who have a good rapport with their nurse are more likely to cooperate with treatment recommendations. This is because they trust the nurse's expertise and feel confident that the nurse has their best interests in mind.
Enhances Coping: A strong therapeutic relationship can help to improve the client's coping skills. The nurse can provide support, encouragement, and guidance as the client learns to manage their anxiety.
Techniques for establishing rapport:
Active listening: Pay close attention to the client's verbal and nonverbal communication, demonstrating that you are genuinely interested in what they have to say.
Empathy: Show understanding and compassion for the client's experiences and feelings.
Respect: Treat the client with dignity and respect, acknowledging their autonomy and choices.
Genuineness: Be authentic and honest in your interactions with the client.
Trustworthiness: Demonstrate that you are reliable and dependable, and that you will maintain confidentiality.
Cultural sensitivity: Be aware of and respect the client's cultural background and beliefs.
Choice B rationale:
Avoiding eye contact can convey disinterest, disrespect, or dishonesty, which can further heighten anxiety. Maintaining appropriate eye contact demonstrates attentiveness, empathy, and understanding, which can help to build trust and rapport.
Choice C rationale:
Speaking in a high-pitched voice can be perceived as agitated or tense, which can exacerbate the client's anxiety. It's essential to speak in a calm, soothing, and reassuring tone to promote relaxation and a sense of safety.
Choice D rationale:
Validating the client's feelings and identifying the cause of anxiety are crucial steps in effective anxiety management.
Validation helps the client feel understood and accepted, while identifying the cause can guide the development of appropriate interventions to address the underlying triggers.
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