The nurse notes that a client with depression has been more withdrawn and noncommunicative during the past two weeks.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.
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client's family to visit more often: Family involvement can be beneficial, but it may not be effective if the client is withdrawn.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Group activities promote social interaction but may feel intimidating or threatening for someone who has been withdrawn for weeks.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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This tablet clearly shows a bisecting score (a single line across the middle). This score is placed by the manufacturer to ensure that when cut, the tablet breaks evenly, and each half contains an approximately equal dose of the medication.
B. The ability to safely cut a tablet in half is indicated by the presence of a score (a line or indentation) on the tablet's surface. These tablets do not have a visible score. Cutting an unscored tablet is unsafe because it can result in uneven dosing.
C. The ability to safely cut a tablet in half is indicated by the presence of a score (a line or indentation) on the tablet's surface. These tablets do not have a visible score. Cutting an unscored tablet is unsafe because it can result in uneven dosing.
Correct Answer is A
Explanation
A. Hydrocortisone: The client is experiencing an Addisonian (adrenal) crisis, evidenced by weakness, confusion, dehydration, hyponatremia, hyperkalemia, and hypoglycemia. Intravenous hydrocortisone provides the deficient cortisol necessary to stabilize electrolytes, improve vascular tone, and support glucose regulation.
B. Potassium chloride: Although the client’s potassium is elevated, administering potassium would worsen hyperkalemia. The priority is treating the underlying adrenal insufficiency rather than directly correcting potassium at this stage.
C. Broad spectrum antibiotic: There is no evidence of a bacterial infection causing the crisis; the client’s acute illness is a viral infection, and antibiotics would not address adrenal insufficiency. Antibiotics may be considered only if a bacterial infection is confirmed.
D. Regular insulin: Insulin lowers blood glucose and potassium, but this client is hypoglycemic and hyperkalemic due to adrenal crisis. Administering insulin would exacerbate hypoglycemia and is contraindicated in this scenario.
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