Nokea
The nurse is teaching a 70-year-old man about his depression. Which statement by the client would indicate that teaching has been effective?
- A. All old people get depressed at times.
- B. I'm glad I'll feel better in 2 or 3 days.
- C. I never knew depression could just happen for no specific reason.
- D. When I reduce the stress in my life, the depression will go away.
Correct Answer: C
Rationale: Recognizing that depression can be endogenous without an external cause indicates effective understanding of the illness.
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A client with mania is demonstrating hypersexual behavior by blowing kisses to other clients, making suggestive remarks, and removing some articles of clothing. Which nursing intervention would be most appropriate at this time?
- A. Redirect the client to appropriate behavior.
- B. Place the client in seclusion for his or her own protection.
- C. Ignore the behavior to avoid reinforcing it.
- D. Tell the client that the behaviors have to stop right now.
Correct Answer: A
Rationale: Redirecting to appropriate behavior is effective and non-confrontational, preventing escalation of manic behavior.
A client who is manic threatens others on the unit. Which would be the initial nursing action in response to this behavior?
- A. Administering a sedative that has been prescribed to be used PRN.
- B. Insisting the client take a time-out in his room.
- C. Clearing the area of all other clients.
- D. Setting limits on aggressive and intimidating behavior.
Correct Answer: D
Rationale: Setting limits on aggressive behavior is the initial action to ensure safety while allowing the client to exercise self-control.
At 1 AM, the client with mania rushes to the nurses' station and demands that the psychiatrist come to the unit now to write an order for a pass to go home. What would be the nurse's most therapeutic response?
- A. Go to the day room and wait while I call your psychiatrist.
- B. Don't be unreasonable. I can't call the psychiatrist at this time of night.
- C. I can't call the psychiatrist now, but you and I can talk about your request for a pass.
- D. You must really be upset to want a pass immediately; I'll give you some medication.
Correct Answer: C
Rationale: This response sets limits on an unreasonable demand while opening a dialogue to address the client's needs.
The nurse is planning care for a client with major depression. Which is an appropriate expected outcome?
- A. The client will avoid causing harm to others.
- B. The client will be free from stress.
- C. The client will independently carry out activities of daily living.
- D. The client will not experience agitation.
Correct Answer: C
Rationale: Independently performing activities of daily living is a realistic and appropriate outcome for a client with depression.
Which is a possible explanation for the increased risk of suicide in persons who have had a relative who committed suicide?
- A. The relative's suicide offers a sense of permission or acceptance of suicide as a method of escaping a difficult situation.
- B. Many people with depression who have suicidal ideation lack the energy to implement suicide plans, but antidepressant treatment can actually give clients with depression the energy to act on suicidal ideation.
- C. Suicide is more likely to occur in April when natural energy from increased sunlight may give the client the energy to act on suicidal ideation.
- D. The relative's suicide caused the family members to realize that suicide is emotionally harmful to the ones left behind and vow not to consider suicide.
Correct Answer: A
Rationale: A relative's suicide may normalize the act, increasing risk by providing a sense of acceptability.