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A client with depression is experiencing anhedonia. Which statement by the client reflects this symptom?
- A. I feel so anxious all the time.
- B. I don't enjoy the things I used to love.
- C. I can't concentrate on anything.
- D. I have trouble sleeping through the night.
Correct Answer: B
Rationale: Anhedonia is the inability to experience pleasure from activities usually found enjoyable. The statement 'I don't enjoy the things I used to love' directly reflects this symptom as the client is expressing a lack of pleasure from previously enjoyable activities. Choices A, C, and D do not specifically relate to anhedonia but rather indicate symptoms of anxiety, concentration difficulties, and sleep disturbances, respectively.
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A client states, 'I am the only one who can hear voices.' Which is the nurse's best response?
- A. Tell me more about these voices.
- B. Let's explore these voices together.
- C. How long have you been hearing these voices?
- D. Have you told anyone else about these voices?
Correct Answer: A
Rationale: The best response for the nurse is to encourage the client to talk about their experiences with hearing voices. By asking the client to share more details about the voices, the nurse can gain insight into the nature of the auditory hallucinations and better understand the client's condition. This open-ended question allows the client to express themselves freely and helps build rapport and trust between the client and the nurse. Choices B, C, and D do not directly address the client's statement or encourage further elaboration, making them less effective responses in this context.
A client with borderline personality disorder is admitted to the psychiatric unit. Which intervention should the nurse implement to promote the client's safety?
- A. Implement a no-harm contract with the client.
- B. Monitor the client closely for signs of self-harm.
- C. Encourage the client to participate in recreational activities.
- D. Encourage the client to maintain a structured daily routine.
Correct Answer: A
Rationale: When a client with borderline personality disorder is admitted to a psychiatric unit, implementing a no-harm contract is a crucial intervention to promote the client's safety. A no-harm contract is a formal agreement between the client and the healthcare provider stating that the client commits to not harm themselves or others. This intervention helps in establishing boundaries and promoting safety by enhancing communication and accountability between the client and the healthcare team. Monitoring the client closely for signs of self-harm (Choice B) is important but does not directly address promoting safety through a formal agreement. Encouraging participation in recreational activities (Choice C) and maintaining a structured daily routine (Choice D) are beneficial interventions but may not directly address the immediate safety concerns of a client with borderline personality disorder.
A healthcare provider is evaluating the effectiveness of medication therapy for a client diagnosed with bipolar disorder. Which outcome should indicate that the medication has been effective?
- A. The client reports a decrease in manic episodes.
- B. The client experiences fewer mood swings.
- C. The client sleeps for 8 hours each night.
- D. The client maintains a stable weight.
Correct Answer: A
Rationale: A decrease in manic episodes is a key indicator of the effectiveness of medication therapy for bipolar disorder. Manic episodes are a hallmark of bipolar disorder, and a decrease in their frequency or intensity suggests that the medication is helping to stabilize the client's mood and manage their symptoms. While choices B, C, and D are important aspects of overall health and well-being, they are not specific indicators of the effectiveness of medication therapy for bipolar disorder. Choice B focuses on mood swings in general, which may include depressive episodes as well, while choice C addresses sleep patterns and choice D relates to weight stability, which can be influenced by various factors unrelated to bipolar disorder treatment.
A client with major depressive disorder expresses feelings of hopelessness. Which nursing intervention should the nurse implement to address these feelings?
- A. Encourage the client to engage in physical activity.
- B. Provide opportunities for the client to make decisions.
- C. Help the client identify positive aspects of their life.
- D. Encourage the client to verbalize feelings of hopelessness.
Correct Answer: C
Rationale: When a client with major depressive disorder expresses feelings of hopelessness, helping them identify positive aspects of their life can be an effective nursing intervention. This approach can assist in shifting their focus from negativity to positivity, promoting a sense of hope and potentially improving their overall outlook and well-being. By highlighting the positive aspects, the nurse can support the client in recognizing reasons for hope and encourage a more optimistic perspective, which can aid in addressing and alleviating feelings of hopelessness. Encouraging physical activity (Choice A) may be beneficial for overall well-being but may not directly address feelings of hopelessness. Providing opportunities for decision-making (Choice B) can empower the client but may not specifically target feelings of hopelessness. Encouraging verbalization of feelings (Choice D) is important but may not be as effective as helping the client shift their focus to positive aspects of life.
A client is being treated for obsessive-compulsive disorder (OCD). Which intervention should be included in the care plan?
- A. Discourage the client from performing rituals.
- B. Allow the client to perform rituals in the early stages of treatment.
- C. Encourage the client to focus on their compulsions.
- D. Isolate the client to prevent performance of rituals.
Correct Answer: B
Rationale: Allowing the client to perform rituals in the early stages of treatment is a common therapeutic approach for obsessive-compulsive disorder (OCD). Allowing the client to engage in rituals can help reduce anxiety by providing temporary relief. It is a part of exposure therapy, where the individual is gradually exposed to anxiety-provoking situations. As treatment progresses, the focus shifts to gradually reducing the frequency and intensity of rituals through interventions like exposure and response prevention therapy. Discouraging the client from performing rituals (Choice A) is not recommended as it may increase anxiety and resistance to treatment. Encouraging the client to focus on their compulsions (Choice C) may reinforce the behavior rather than helping to decrease it. Isolating the client (Choice D) is not therapeutic and can lead to feelings of abandonment and worsen symptoms.