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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A rationale:

Concrete thinking is a cognitive distortion characterized by a rigid and literal interpretation of events and experiences. Individuals with concrete thinking often struggle to grasp abstract concepts, metaphors, or multiple perspectives. They tend to view situations in black-and-white terms, with little room for nuance or ambiguity.

Statement A, "I am aware that each problem has only one solution," exemplifies concrete thinking in several ways:

Absolute language: The use of the phrase "each problem has only one solution" suggests a fixed and inflexible mindset. It implies that there is only one correct way to approach any given problem, disregarding the possibility of alternative solutions or perspectives.

Oversimplification: The statement reduces the complexity of problem-solving to a single, definitive answer. It fails to acknowledge the multifaceted nature of most problems, which often require creative thinking, flexibility, and consideration of multiple factors.

Lack of abstract

Intolerance of ambiguity: Concrete thinkers often experience discomfort with uncertainty or open-ended situations. They prefer clear-cut answers and definitive conclusions, which can lead to frustration and anxiety when faced with complex or ambiguous problems.

A. Place the client in restraints. B. Administer haloperidol IM to the client. C. Ask the client to talk about his feelings. D. Move the client to a seclusion room with continuous observation

Correct Answer is D

Explanation

Choice A rationale:

Placing a client in restraints should be a last resort, as it can be traumatizing and can escalate agitation.

Restraints can also cause physical injury and psychological distress.

They should only be used when there is an immediate risk of harm to the client or others.

Choice B rationale:

Haloperidol is an antipsychotic medication that can be used to calm agitated clients.

However, it should not be the first-line intervention, as it can have significant side effects, including drowsiness, dizziness, and muscle stiffness.

It is important to assess the client's individual needs and risks before administering haloperidol.

Choice C rationale:

Asking a client to talk about their feelings can be helpful in some situations, but it is not appropriate when a client is agitated and yelling.

The client is likely to be too overwhelmed to engage in meaningful conversation.

It is important to first de-escalate the situation and ensure the safety of everyone involved.

Choice D rationale:

Moving the client to a seclusion room with continuous observation is the most appropriate intervention in this situation.

This will provide the client with a safe and quiet space to calm down.

It will also allow staff to monitor the client closely and intervene if necessary.

Continuous observation is essential to ensure the client's safety and to prevent self-harm.

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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?