Share This Link

Depending solely on a partner to plan daily activities may indicate dependence rather than self-care.

Remaining in bed excessively can perpetuate depressive symptoms and hinder recovery.

Avoiding discussing upsetting events may prevent processing emotions and hinder progress in therapy.

Compensation involves overachieving in one area to make up for deficiencies in another area, which is not evident in the client's statement.

Sublimation involves channeling unacceptable impulses into socially acceptable activities, which is not demonstrated in the client's statement.

Regression involves reverting to an earlier stage of development in the face of stress, which is not evident in the client's statement.

Writing a detailed daily activity schedule may indicate organization and planning, which are not typically associated with acute mania.

Isolating oneself from others could be a sign of depression rather than acute mania.

Refusing to engage in conversation could be indicative of various factors, but it is not specific to acute mania.

Walking the dog daily can contribute positively to the client's recovery by promoting physical activity and potentially reducing stress.

Exercising in the morning can also contribute positively to recovery by promoting physical health and potentially reducing stress.

Stopping drinking coffee may have various effects on the client's health but is not directly related to recovery from coronary artery bypass surgery unless it exacerbates other issues such as anxiety or withdrawal symptoms.

Asking the client about the underlying reasons for their statement encourages exploration of their thoughts and feelings.

This response may come off as dismissive and lacks empathy towards the client's feelings.

Suggesting medication without further assessment is premature and may not address the root cause of the client's statement.

This statement reflects a realistic acknowledgment of the grieving process and does not necessarily indicate clinical depression.

Expressing dependence on family support is a common coping mechanism during grief and does not necessarily indicate clinical depression.

Feelings of anger are common during the grieving process and do not necessarily indicate clinical depression.

Orientation to person, place, and time is important for assessing mental status but may not necessarily indicate the need for restraint removal.

Self-harm threats should be taken seriously but may require further assessment and intervention rather than immediate restraint removal.

Refusal to take medication may necessitate further intervention but may not directly indicate the need for restraint removal unless it poses an immediate risk to the client's safety.

Speaking in rhyming sentences can be a manifestation of mania but may not necessarily require immediate reporting unless it escalates to disruptive or harmful behavior.

Making inappropriate sexual comments can indicate impulsivity and lack of social boundaries, which may pose risks to the client or others and should be reported for further evaluation and management.

Poor hygiene, such as not bathing, is common in mania due to increased energy and decreased need for sleep, but it may not require immediate reporting unless it poses a significant risk to the client's health.

This question addresses acceptance but may not fully assess the client's coping strategies or emotional response to the stroke.

This question addresses practical assistance with hygiene tasks but does not directly assess coping mechanisms.

This question focuses on the cause of the stroke rather than the client's coping abilities or emotional response.

Allowing the client to create their own meal schedule may exacerbate disordered eating patterns and is not recommended in the treatment of bulimia nervosa.

Allowing the client's family to bring food may enable or reinforce disordered eating behaviors and is not recommended in the treatment of bulimia nervosa.

Encouraging the client to exercise frequently may exacerbate unhealthy behaviors and is not recommended as a primary intervention for bulimia nervosa.

Encouraging the client to sleep during the day disrupts the natural sleep-wake cycle and may not address the underlying issue of noise disturbances at night.

Using a television to cover up noise may not address the root cause of the client's sleep disturbance and could interfere with sleep hygiene.

Dismissing the client's concern and suggesting they will eventually get used to the noise does not address the immediate issue or offer practical solutions.

This response challenges the client's belief and may cause distress or exacerbate paranoia.

While factually correct, this response may not address the client's underlying concerns or feelings.

This response may invalidate the client's experience and may not effectively address the delusional belief.

Encouraging the client to have the procedure disregards their autonomy and right to refuse treatment.

Obtaining consent from a family member is not appropriate if the client is capable of making their own decisions.

Requesting another nurse to review the procedure may be helpful for clarification but does not address the client's right to refuse treatment.

This response may inadvertently blame the client or imply that they provoked the inappropriate comment, which can be invalidating.

Encouraging the client to ignore the comment may minimize their feelings and the impact of the inappropriate behavior.

Agreeing that the comment was inappropriate is validating, but it does not address the client's emotional response or provide support.

Administering medications, such as atropine, requires nursing judgment and assessment of the client's condition, which should not be delegated to assistive personnel.

Witnessing the client's signature on the consent form ensures that the client provides informed consent for the procedure and requires nursing judgment.

Assessing the client's condition after the procedure involves monitoring vital signs, level of consciousness, and potential adverse reactions, which require nursing assessment and judgment.

Cocaine use typically causes hyperthermia (elevated body temperature) rather than hypothermia.

Cocaine use is more likely to result in increased alertness, agitation, and hyperactivity rather than lethargy.

Cocaine use is associated with tachycardia rather than bradycardia.

While anger is a common emotion in grief, the priority is addressing the client's inability to eat, which can have significant health implications.

Recalling negative experiences during the marriage may indicate unresolved issues but is not as immediately concerning as the client's inability to eat.

Feelings of guilt are common in grief, but the priority is addressing the client's physical health needs, particularly their inability to eat.

Frustration with finding an activity to relieve restless energy may be addressed by the nursing or therapy team and does not specifically require involvement from a social worker.

Talking about changes in spiritual beliefs may be addressed by a chaplain or spiritual counselor rather than a social worker.

Difficulty remembering prescribed food restrictions may be addressed through education and support from nursing or dietary staff and does not specifically require involvement from a social worker.

Exploring feelings of abandonment may be appropriate in therapy sessions but is not specifically aimed at improving social interactions.

Discussing maladaptive behaviors and working towards behavior change is important in the treatment of borderline personality disorder and should not be avoided.

Encouraging dependent behaviors can perpetuate maladaptive patterns and hinder progress in treatment for clients with borderline personality disorder.

Meeting one's own needs without manipulating others may be a desirable outcome but is not specific to the core deficits of autism spectrum disorder.

Acknowledging that delusions are not real is more relevant to psychotic disorders rather than autism spectrum disorder.

Individuals with autism spectrum disorder may have difficulty understanding and responding to peer pressure, so changing behavior as a result of peer pressure may not be a realistic or desirable outcome.

Encouraging countertransference can blur professional boundaries and may exacerbate distrust or suspicion in clients with paranoid personality disorder.

Monitoring for splitting behaviors is important in personality disorders but does not directly address the client's needs or promote therapeutic engagement.

Isolating the client from social or group interactions can exacerbate feelings of paranoia and may not be therapeutic or appropriate.

Changing the subject when the client becomes upset may invalidate their feelings and hinder emotional expression and processing.

Discouraging the client from forming new relationships may deprive the client of potentially meaningful connections during their remaining time.

Offering advice about treatment choices may be appropriate in some situations but should be done in collaboration with the client's healthcare team and in consideration of their wishes and values.