A nurse is planning care for a client newly admitted with major depressive disorder. Which of the following actions should the nurse plan to take?

Ask the client to create her own schedule of daily activities.

Teach the client to use passive communication when interacting with others.

Determine the client's need for assistance with grooming.

Limit the client's involvement in unit activities.

Answer and Explanation

The Correct Answer is C

A. Asking the client to create their own schedule of daily activities may overwhelm them and exacerbate feelings of hopelessness or indecisiveness commonly experienced with depression. The nurse should provide structure and guidance in establishing a manageable routine.

The other options do not align with best practices for caring for a client with major depressive disorder:

B. Teaching passive communication is not appropriate, as assertive communication is typically encouraged to help the client express her needs and feelings effectively.

C. Asking the client to create their own schedule of daily activities may overwhelm them and exacerbate feelings of hopelessness or indecisiveness commonly experienced with depression. The nurse should provide structure and guidance in establishing a manageable routine

D. Limiting involvement in unit activities could further isolate the client and exacerbate her symptoms. Encouraging participation and engagement is generally more beneficial.

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Correct Answer is A

Explanation

Remaining with the client provides support and ensures their safety. The client's behavior indicates distress, and having a nurse nearby can help the client feel more comfortable and secure.

B. Give the client a PRN sleeping medication:

Explanation: Administering a sleeping medication should not be the first response, especially if the client is agitated. It's important to address the underlying cause of the agitation and consider other interventions before resorting to medication.

C. Encourage the client to go back to bed:

Explanation: Encouraging the client to go back to bed might not be effective if they are experiencing significant distress or anxiety. It's better to address their emotional state first before suggesting any changes in activity.

D. Explore alternatives to pacing the floor with the client:

Explanation: This is a reasonable course of action. Exploring alternatives to the client's current behavior can help address their distress and find ways to manage their emotions more effectively.

A. Nystagmus B. Muscles C. Polyphagia D. Tremors E. Seizures

Correct Answer is ["A","D","E"]

Explanation

A. Nystagmus: Nystagmus is a rapid, involuntary movement of the eyes, which can occur during alcohol withdrawal due to disruption of the central nervous system. This can be a symptom of alcohol withdrawal.

D. Tremors: Tremors, also known as "the shakes," are a common physical manifestation of alcohol withdrawal. These tremors usually affect the hands and can be an early sign of withdrawal.

E. Seizures: Seizures can occur during alcohol withdrawal, particularly in severe cases. This is a serious complication that requires medical attention.

Incorrect answers:

B. Muscles: The term "muscles" is not specific enough to indicate a particular manifestation of alcohol withdrawal. Tremors or muscle spasms could be more specific symptoms to include.

C. Polyphagia: Polyphagia refers to excessive hunger and increased food intake. While alcohol withdrawal can lead to changes in appetite, it typically does not result in polyphagia. Instead, loss of appetite or nausea may be more common.

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A nurse is planning care for a client newly admitted with major depressive disorder. Which of the following actions should the nurse plan to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is having difficulty sleeping and is pacing the floor. The client's head down, and he is wringing his hands. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is teaching a newly-admitted client about the possible physical effects of alcohol withdrawal. Which of the following manifestation should the nurse include in the reaching? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

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