The nurse notes that a client with depression has been more withdrawn and noncommunicative during the past two weeks. Which intervention is most important to include in the updated plan of care for this client?

Engage the client in non-threatening conversations.

Encourage the client's family to visit more often.

Encourage the client to participate in group activities.

Schedule a daily conference with the social worker.

Answer and Explanation

The Correct Answer is A

A. Engage the client in non-threatening conversations: Establishing a therapeutic nurse–client relationship through simple, supportive communication helps reduce isolation, builds trust, and may encourage the client to begin expressing thoughts and feelings.

B. Encourage the client's family to visit more often: Family involvement can be beneficial, but it may not be effective if the client is withdrawn. Increasing visits without first fostering a supportive environment could overwhelm or further isolate the client.

C. Encourage the client to participate in group activities: Group activities promote social interaction but may feel intimidating or threatening for someone who has been withdrawn for weeks. Gradual re-engagement beginning with one-on-one communication is more appropriate.

D. Schedule a daily conference with the social worker: Involving the social worker can be helpful for comprehensive care planning, but this does not directly address the immediate nursing priority of engaging the client therapeutically and reducing withdrawal.

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Correct Answer is B

Explanation

A. Intubation tray: An intubation tray is necessary if the client experiences airway compromise or respiratory failure, but it does not directly address complications from an ineffective thoracentesis, such as persistent pneumothorax or pleural effusion.

B. Chest tube insertion tray: If the thoracentesis is ineffective and the pleural space continues to fill or air accumulates, a chest tube may be required to drain fluid or air and re-expand the lung. Having a chest tube tray ready ensures rapid intervention for these potential complications.

C. Crash cart: A crash cart is essential for emergencies involving cardiac or respiratory arrest, but it is not the first-line equipment for an ineffective thoracentesis unless the client acutely decompensates.

D. Ventilator: Mechanical ventilation may be required for severe respiratory failure, but it is not an immediate bedside intervention for an unsuccessful thoracentesis. The priority is to remove fluid or air from the pleural space.

A. Wear closed-toe shoes that are comfortable and fit well. B. Check blood sugar levels every four to six hours every day. C. Restrict alcoholic beverages to no more than 1 to 2 per week. D. Obtain an A1C blood test every year to monitor glucose control.

Correct Answer is A

Explanation

A. Wear closed-toe shoes that are comfortable and fit well: Proper footwear is essential to prevent foot injuries, ulcers, and infections in clients with diabetes, especially because neuropathy can reduce sensation. This response indicates understanding of a key self-care measure.

B. Check blood sugar levels every four to six hours every day: Blood glucose monitoring frequency should be individualized based on treatment regimen, activity, and glycemic control. A blanket schedule every four to six hours may not be appropriate for all clients.

C. Restrict alcoholic beverages to no more than 1 to 2 per week: Alcohol guidelines should be individualized, and alcohol can affect blood glucose unpredictably. Limiting intake is important, but this statement alone does not fully reflect diabetes management understanding.

D. Obtain an A1C blood test every year to monitor glucose control: The recommended frequency for A1C testing is usually every 3 months when starting treatment or if therapy changes, and every 6 months for stable control.

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The nurse notes that a client with depression has been more withdrawn and noncommunicative during the past two weeks. Which intervention is most important to include in the updated plan of care for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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