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"You will feel better if you tell me what you did last night." While this response might seem supportive, it can come across as dismissive of the client's feelings. It implies that the nurse knows what will make the client feel better, which can undermine the client's autonomy and sense of control. Effective communication in nursing involves validating the client's feelings and allowing them to lead the conversation about their experiences.

"You shouldn't feel embarrassed to talk to me." This response is not ideal because it dismisses the client's feelings of embarrassment. Telling someone how they should or shouldn't feel can be invalidating and may prevent the client from opening up. Instead, the nurse should focus on creating a non-judgmental space where the client feels comfortable sharing their thoughts and emotions.

"Lots of people feel ashamed to tell their secrets." Although this response attempts to normalize the client's feelings, it does not directly address the client's specific situation or encourage them to share their feelings. It can also come across as minimizing the client's unique experience. The nurse should aim to provide individualized care by focusing on the client's specific concerns and emotions.

The Pain Assessment in Advanced Dementia (PAINAD) Scale is used to assess pain in individuals with advanced dementia who may not be able to communicate their pain verbally. While this tool is crucial for managing pain in dementia patients, it is not typically used for active older adults without dementia. The focus of the PAINAD Scale is on non-verbal cues and behaviors that indicate pain, which may not be relevant for the general active older adult population.

The CAGE Questionnaire is a screening tool for identifying potential alcohol abuse. It consists of four questions that help determine if an individual has issues with alcohol consumption. While alcohol abuse can be a concern in older adults, the CAGE Questionnaire is more specific to substance abuse rather than a general health screening for active older adults. It is important, but not as broadly applicable as the Geriatric Depression Scale for this context.

The Denver II Developmental Screening Test is designed to assess developmental progress in children from birth to six years old. It evaluates areas such as personal-social, fine motor-adaptive, language, and gross motor skills. This tool is not relevant for screening active older adults, as it is specifically tailored for identifying developmental delays in young children. Therefore, it would not be appropriate for use in a community clinic setting focused on older adults.

Asking "Why did you feel like giving away your belongings?" might come across as judgmental or confrontational. It could make the client feel defensive or misunderstood. In therapeutic communication, it's important to avoid "why" questions as they can imply criticism and may not encourage the client to open up. Instead, focusing on the client's feelings and experiences is more effective in understanding their condition.

Saying "Everyone feels a little down sometimes" minimizes the client's feelings and can be perceived as dismissive. Clients with major depressive disorder often feel isolated and misunderstood, and such a response could exacerbate these feelings. It's important for nurses to validate the client's emotions and provide support rather than downplaying their experiences.

While suggesting a support group can be helpful, it is not the most immediate or appropriate response in this context. The client has expressed a significant behavior (giving away personal belongings) that could indicate suicidal ideation or severe depression. The nurse's priority should be to assess the client's current emotional state and risk factors before suggesting long-term solutions like support groups.

Sodium levels within the range of 136 to 145 mEq/L are considered normal. A sodium level of 140 mEq/L falls within this range and does not indicate any immediate concern. Sodium is an essential electrolyte that helps maintain fluid balance, nerve function, and muscle function. Since the sodium level is normal, there is no need to notify the provider about this result.

A WBC (white blood cell) count of 6,000/mm³ is within the normal range of 5,000 to 10,000/mm³. White blood cells are crucial for the immune system to fight infections. Since the WBC count is normal, it does not warrant notifying the provider. Monitoring WBC counts is important in clients taking antipsychotic medications like risperidone, but this result is within the expected range.

Platelet counts within the range of 150,000 to 400,000/mm³ are considered normal. A platelet count of 250,000/mm³ falls within this range and does not indicate any immediate concern. Platelets are essential for blood clotting and wound healing. Since the platelet count is normal, there is no need to notify the provider about this result.

Naltrexone is primarily used to treat alcohol and opioid dependence. It works by blocking the euphoric and sedative effects of these substances, reducing the desire to use them. While naltrexone has been studied for smoking cessation, it is not commonly prescribed for this purpose. Its primary use remains in the management of alcohol and opioid addiction.

Donepezil is a medication used to treat symptoms of Alzheimer's disease. It works by increasing the levels of acetylcholine in the brain, which helps improve cognitive function. Donepezil is not indicated for smoking cessation and does not have any known effects on nicotine addiction or withdrawal symptoms.

Disulfiram is a medication used to support the treatment of chronic alcoholism by producing an acute sensitivity to ethanol (drinking alcohol). It works by inhibiting the enzyme acetaldehyde dehydrogenase, leading to unpleasant effects when alcohol is consumed. Disulfiram is not used for smoking cessation and does not affect nicotine addiction.

Documenting the client's behavior every 60 minutes is important for monitoring the client's condition and ensuring their safety. However, it is not the most immediate action required following the initiation of seclusion. Continuous documentation helps in assessing the effectiveness of the intervention and making necessary adjustments to the care plan.

Keeping the client in seclusion for no longer than 6 hours is a guideline to prevent prolonged isolation, which can have negative psychological effects. However, this is not the first action the nurse should take. The duration of seclusion should be based on the client's behavior and the clinical judgment of the healthcare team.

Monitoring the client's vital signs every 4 hours is essential for assessing the client's physical health and detecting any adverse effects of seclusion. However, like documenting behavior, it is not the most immediate action required. Regular monitoring helps in ensuring the client's safety and well-being during the period of seclusion.

Expressing feelings of inferiority is more commonly associated with depressive episodes rather than manic episodes. During a depressive episode, individuals may experience low self-esteem, feelings of worthlessness, and a pervasive sense of sadness. These symptoms are in contrast to the elevated mood and increased self-confidence typically seen in mania.

Memory loss is not a primary indicator of mania. While cognitive impairments can occur in bipolar disorder, they are not specific to manic episodes. Memory loss can be associated with various conditions, including depression, anxiety, and other neurological disorders. It is important to differentiate between symptoms specific to mania and those that may arise from other conditions.

Sleeping over 10 hours a day is indicative of hypersomnia, which is more commonly seen in depressive episodes. During a manic episode, individuals typically experience a decreased need for sleep and may function on very little rest without feeling tired. The reduced need for sleep is a hallmark symptom of mania and helps distinguish it from depressive episodes.

Verbalizing an improved mood is a positive outcome, but it is not specific to borderline personality disorder (BPD). Clients with BPD often struggle with interpersonal relationships and emotional regulation. While mood improvement is beneficial, it does not directly address the core issues of BPD, such as difficulty in expressing needs and managing relationships.

Attending to personal hygiene is important for overall health and well-being, but it is not a primary focus in the treatment of BPD. Clients with BPD may have issues with self-care during depressive episodes, but the primary treatment goals usually revolve around emotional regulation, interpersonal effectiveness, and distress tolerance.

Reporting a decrease in hallucinations is not typically associated with BPD. Hallucinations are more commonly linked to psychotic disorders such as schizophrenia. While some clients with BPD may experience transient psychotic symptoms under extreme stress, these are not the primary focus of treatment. The main treatment goals for BPD involve managing emotional dysregulation and improving interpersonal relationships.

Exploitative behavior is more commonly associated with narcissistic personality disorder rather than obsessive-compulsive personality disorder (OCPD). Individuals with narcissistic personality disorder often manipulate and exploit others to achieve their own goals and maintain their self-esteem. This behavior is not characteristic of OCPD, which is more focused on orderliness, perfectionism, and control.

Lack of empathy is a hallmark of antisocial personality disorder and narcissistic personality disorder. Individuals with OCPD may have difficulty understanding others' emotions due to their rigid thinking and focus on rules, but they do not typically exhibit a complete lack of empathy. Their interactions are more characterized by a need for control and perfectionism rather than a disregard for others' feelings.

Excessive clinging is a symptom more commonly associated with dependent personality disorder. Individuals with dependent personality disorder have an excessive need to be taken care of, leading to submissive and clinging behaviors. In contrast, those with OCPD are more focused on maintaining control and order in their environment and relationships, rather than exhibiting dependency.

Showing a 30-minute teaching video might be overwhelming for a client with moderate anxiety. While visual aids can be helpful, the length and complexity of the video could increase the client's anxiety rather than alleviate it. It is important to tailor the educational approach to the client's current emotional state, ensuring that the information is presented in a way that is easy to understand and not overwhelming.

Providing detailed explanations can be counterproductive for a client with moderate anxiety. Detailed information might overwhelm the client, leading to increased anxiety and difficulty in processing the information. Instead, the nurse should focus on delivering key points in a clear and concise manner, ensuring that the client understands the most important aspects of the procedure and what to expect afterward.

Avoiding questions is not an effective strategy for client education. Asking questions allows the nurse to assess the client's understanding and address any concerns or misconceptions. Engaging the client in a dialogue helps to build rapport and ensures that the client feels supported and informed. It is important to create an open and interactive environment where the client feels comfortable asking questions and expressing concerns.