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The spouse of a client diagnosed recently with a mood disorder calls the nurse therapist to report a change in the client's mood. The spouse states, "My spouse is clearly in a better mood than usual. I would say my spouse seems mildly elated. They are functioning fine at work and home. My spouse is energetic, up and doing things at 500 a.m. and really confident again. It seems fantastic, but unusual. Is this something to worry about?"

Which potential response by the nurse accurately assesses the situation?

"It sounds as though the antidepressants are working well. Just ask the client if the client is experiencing any side effects and let me know."

"I'm concerned. Sometimes depressed people seem contented when they have decided to commit suicide. Let's schedule an appointment for tomorrow."

"Since the client is eating, sleeping, and not behaving inappropriately, there's nothing to worry about. Just let me know if the client starts getting irritable or has trouble sleeping."

"The client sounds hypomanic. Let's schedule an appointment for this week for an evaluation. The client may need additional or different medication."

Answer and Explanation

The Correct Answer is D

A. "It sounds as though the antidepressants are working well. Just ask the client if the client is experiencing any side effects and let me know." This response does not adequately address the change in mood and the potential for hypomania. It assumes the change is solely due to the antidepressants.

B. "I'm concerned. Sometimes depressed people seem contented when they have decided to commit suicide. Let's schedule an appointment for tomorrow." While it's important to assess for suicidality, the description provided does not indicate immediate suicidal intent. The client's behavior is more indicative of hypomania.

C. "Since the client is eating, sleeping, and not behaving inappropriately, there's nothing to worry about. Just let me know if the client starts getting irritable or has trouble sleeping." This response downplays the significance of the mood change and does not address the potential for hypomania.

D. "The client sounds hypomanic. Let's schedule an appointment for this week for an evaluation. The client may need additional or different medication." This response correctly identifies the potential for hypomania and takes appropriate action by scheduling an evaluation. Adjusting the client's medication may be necessary to address the change in mood.

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Correct Answer is C

Explanation

A. Encouraging descriptions of perceived failures may further exacerbate the client's poor self- esteem and is not a therapeutic intervention.
B. While setting limits is important in managing behavior, it may not directly address the underlying issue of poor self-esteem.
C. Providing activities that can be accomplished can help boost the client's confidence and self- esteem.
D. Teaching aggressive communication skills is not appropriate and may contribute to further negative self-perception.

A. "You are safe here. We will make sure nothing happens to you." B. "You're just lucky your roommate came home to help you when she did." C. "What exactly do you plan to do?" D. "I don't understand. You have so much to live for."

Correct Answer is C

Explanation

A. While providing reassurance is important, this response does not directly address the client's statement about future attempts.
B. This response may minimize the seriousness of the client's statement and is not the best way to address the situation.
C. This response directly addresses the client's statement, seeking clarification on her plans. It is important to assess the level of risk and ensure the client's safety.
D. While expressing empathy and highlighting the client's positive qualities can be helpful, it may not directly address the immediate concern of the client's statement about future attempts.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with poor self-esteem. What intervention would be important for the nurse to include in the plan of care?

Correct Answer is C

Explanation

A client is hospitalized following a suicide attempt after breaking up with her significant other. The client says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll get it right?" Which is the best response by the nurse?

Correct Answer is C

Explanation

A client diagnosed with bipolar disorder has recently started taking lamotrigine as part of their medication regimen. Which of the following would be an essential teaching point to include regarding the medication?

What client population is at risk of developing tardive dyskinesia?

A nurse is caring for a client who exhibits manifestations of major depressive disorder. The provider wants to rule out any other medical conditions that may be contributing or causing the symptoms. Which diagnostic test should the nurse expect to be ordered?

A female client staggers to day treatment smelling strongly of alcohol. She uses the defense mechanism "rationalization" when approached by the nurse and questioned about her recent alcohol consumption. How is this expressed?

Which nursing documentation entry accurately describes a client's use of confabulation?

A client is admitted to the hospital for alcohol intoxication. The family reports that he is a heavy drinker and has been admitted several times for alcohol detoxification. When can the nurse expect to observe the first symptoms of withdrawal?

The nurse is caring for a client who has become increasingly agitated. He is pacing in the hallway and shouting at other clients. What is the priority action of the nurse?