A nurse is leading a grief support group for bereaved clients. Which of the following client statements should the nurse report to the provider as an indication of clinical depression?
"I feel like I'm angry at the whole world right now."
"I don't feel anything but numbness anymore."
"I don't know how I could cope if I didn't have my family's support."
"It'll be a long time before I'm happy again."
The Correct Answer is B
Choice A reason:
Feeling angry at the world is a common reaction to grief and loss. Anger is one of the stages of grief and does not necessarily indicate clinical depression. While it is important to monitor the client's emotional state, anger alone is not a definitive sign of depression.
Choice B reason:
Expressing a sense of numbness and an inability to feel emotions is a significant indicator of clinical depression. This symptom, known as anhedonia, reflects a loss of interest or pleasure in most activities and is a core feature of major depressive disorder. It is crucial to report this to the provider for further evaluation and intervention.
Choice C reason:
Acknowledging the importance of family support is a positive coping mechanism. This statement indicates that the client recognizes their support system, which is beneficial for managing grief. It does not suggest clinical depression.
Choice D reason:
Feeling that it will take a long time to be happy again is a normal part of the grieving process. Grief can be prolonged, and it is natural for clients to feel that their happiness is distant. This statement alone does not indicate clinical depression
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Explanation
The nurse should identify that the client’s diagnostic results and abdominal examination are consistent with sexual assault.
Choice A: The diagnostic results show a positive test for GHB (gamma-hydroxybutyric acid). GHB is a central nervous system depressant that is commonly referred to as a “club drug” or “date rape” drug. It is often used in cases of drugging and sexual assault due to its euphoric and calming effects at low doses. Larger doses can cause loss of consciousness and a type of short-term memory loss known as anterograde amnesia4. These effects have led sexual predators to use GHB as a date-rape drug.
Choice B: The client’s blood pressure is 128/88 mm Hg, which falls within the normal range of 90/60 mmHg to 120/80 mmHg. Therefore, the blood pressure does not provide any specific indication of sexual assault.
Choice C: the abdominal examination reveals tenderness, which could be a result of the assault. This, along with the client’s statement and physical signs such as bruising and broken fingernails, supports the client’s claim of sexual assault.
Choice D: The client’s temperature is 37°C (98.6°F), which is within the normal body temperature range of 97.8°F to 99.1°F (36.5°C to 37.3°C). Therefore, the temperature does not provide any specific indication of sexual assault.
Choice E: While the presence of GHB in the client’s system is a significant finding, it is part of the diagnostic results rather than a separate drug assessment. Therefore, this choice is not as accurate as Choice A (Diagnostic results).
Correct Answer is A
Explanation
Choice A reason:
Chlordiazepoxide is a benzodiazepine commonly used in the management of alcohol withdrawal symptoms. It acts as a sedative and hypnotic, which helps in reducing the agitation and tremors associated with withdrawal. It is often the medication of choice due to its effectiveness in preventing seizures, which are a serious risk during the acute detoxification phase. The nurse can expect chlordiazepoxide to be prescribed as it helps in maintaining physiological stability and managing symptoms, ensuring the patient's safety and comfort during withdrawal.
Choice B reason:
Bupropion is an antidepressant and is not typically used for the treatment of acute alcohol withdrawal. It is primarily used for major depressive disorder and as an aid to quit smoking. Therefore, it would not be the expected medication for managing acute alcohol withdrawal symptoms.
Choice C reason:
Disulfiram is a medication used as a deterrent agent in chronic alcoholism. It causes unpleasant effects when even small amounts of alcohol are consumed, which helps to reinforce abstinence from alcohol use. However, it is not used for the acute management of alcohol withdrawal symptoms and is more appropriate for long-term treatment plans after the acute withdrawal phase has been managed.
Choice D reason:
Buprenorphine is an opioid used to treat opioid use disorder, chronic pain, and acute pain. It is not indicated for the treatment of alcohol withdrawal, which requires medications that can manage the hyperactivity of the central nervous system resulting from alcohol cessation.
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