A nurse is contributing to the plan of care for a client who has major depressive disorder.

Which of the following recommendations should the nurse include in the plan of care?

Suggest the client exercise before going to bed.

Recommend the client spend time alone in his room.

Encourage the client to use positive self-talk.

Offer the client low-protein snacks throughout the day.

Answer and Explanation

The Correct Answer is C

Helping the client develop positive self-talk and challenging negative thoughts can be beneficial in managing depressive symptoms. Assisting the client in recognizing negative self-perceptions and replacing them with more positive and realistic thoughts can help improve mood and self-esteem.

Exercise has been shown to have mood-enhancing effects and can help alleviate symptoms of depression. However, exercise should be done earlier in the day rather than right before bedtime, as it can have stimulating effects that may interfere with sleep.

It is important to encourage the client to engage in activities and spend time with others. Isolation and spending excessive time alone can exacerbate depressive symptoms. However, it is also important to respect the client's need for privacy and personal space.

While diet does play a role in overall well-being, there is no specific evidence to support the use of low-protein snacks for the treatment of major depressive disorder. It is important to provide the client with a well-balanced diet that includes a variety of nutrients to support overall health.

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Correct Answer is B

Explanation

The response acknowledges the client's feelings and validates their experience without reinforcing or denying the delusion. It demonstrates empathy and invites further exploration of the client's concerns. Open-ended statements like this can encourage the client to express their thoughts and feelings, allowing for therapeutic communication and building trust between the client and nurse.

"The psychiatric staff is not FBI. They are here to help you." This response directly contradicts the client's belief and may lead to increased distrust or resistance. It is important to avoid directly challenging delusions or imposing one's own reality on the client, as it can escalate their distress.

"What makes you think the staff is following you?" While this response seeks more information, it may inadvertently reinforce or amplify the client's delusion. It could be interpreted as confirmation or validation of their belief, potentially increasing anxiety or paranoia.

"Why do you feel the staff is the FBI?" This response also seeks more information, but it may come across as challenging or dismissive. It could potentially trigger defensiveness or hostility in the client. It is important to approach the client's beliefs with empathy and respect rather than questioning or interrogating them.

A. Elevated amylase B. Decreased bilirubin C. Elevated lipase D. Elevated ammonia

Correct Answer is D

Explanation

D, Elevated ammonia

Cirrhosis is a chronic liver disease characterized by the progressive scarring of liver tissue. As liver function becomes impaired, there is a decrease in the liver's ability to metabolize and detoxify substances, including ammonia. Elevated ammonia levels in the blood, known as hyperammonemia, are commonly seen in clients with advanced cirrhosis.

Elevated amylase in (option A) is incorrect because it is typically seen in conditions affecting the pancreas, such as pancreatitis, and is not specific to cirrhosis.

Decreased bilirubin levels in (option B) is incorrect because they are not expected in cirrhosis. In fact, bilirubin levels are often elevated in cirrhosis due to impaired liver function and the accumulation of bilirubin in the blood.

Elevated lipase in (option C) is incorrect because it is typically seen in pancreatic disorders, such as pancreatitis, and is not specific to cirrhosis.

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A nurse is contributing to the plan of care for a client who has major depressive disorder. Which of the following recommendations should the nurse include in the plan of care?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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A nurse is contributing to the plan of care for a client who has major depressive disorder.

Which of the following recommendations should the nurse include in the plan of care?