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A client with major depressive disorder is receiving cognitive-behavioral therapy (CBT). Which outcome indicates that the therapy is effective?
- A. The client identifies and challenges negative thoughts.
- B. The client reports an increase in suicidal thoughts.
- C. The client experiences an increase in anxiety.
- D. The client shows no change in behavior.
Correct Answer: A
Rationale: In cognitive-behavioral therapy, identifying and challenging negative thoughts is a fundamental aspect of the treatment process. This cognitive restructuring helps individuals with major depressive disorder to develop healthier thinking patterns and cope more effectively with their emotions, which ultimately leads to improvement in their mental health. Therefore, when a client is able to identify and challenge negative thoughts, it indicates that they are actively engaging in the therapeutic process and making progress towards better mental well-being.
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In assessing a client with major depressive disorder, which of the following findings shouldn't the nurse expect?
- A. Anhedonia
- B. Hypersomnia
- C. Fatigue
- D. Flight of ideas
Correct Answer: D
Rationale: In major depressive disorder, common findings include anhedonia (loss of interest or pleasure), hypersomnia (excessive sleepiness), fatigue, and feelings of worthlessness. Flight of ideas, characterized by racing thoughts and rapid speech, is typically associated with bipolar disorder during manic episodes, not major depressive disorder.
Which of the following interventions should not be included in the care plan for a client with major depressive disorder?
- A. Encourage participation in activities
- B. Promote adequate nutrition and hydration
- C. Discourage verbalization of feelings
- D. Monitor for suicidal ideation
Correct Answer: C
Rationale: Interventions for a client with major depressive disorder should focus on promoting activities, adequate nutrition, hydration, and monitoring for suicidal ideation. Verbalizing feelings is a crucial part of therapy for clients with depression as it helps in processing emotions and seeking support. Therefore, discouraging verbalization of feelings is not appropriate and goes against therapeutic principles.
A client with schizophrenia is experiencing auditory hallucinations. Which intervention should the nurse implement to address this symptom?
- A. Encourage the client to discuss the voices.
- B. Tell the client that the voices are not real.
- C. Provide reality-based feedback to the client.
- D. Distract the client from the voices.
Correct Answer: C
Rationale: When a client with schizophrenia is experiencing auditory hallucinations, providing reality-based feedback is a therapeutic intervention. This helps the client differentiate between what is real and what is not, aiding in reducing the impact of hallucinations. Encouraging the client to discuss the voices may validate the hallucinations, telling the client that the voices are not real dismisses their experience, and distracting the client may not address the underlying issue of the hallucinations.
During an assessment, a nurse observes a client showing signs of moderate anxiety. Which symptom is not typically associated with moderate anxiety?
- A. Fidgeting
- B. Laughing inappropriately
- C. Palpitations
- D. Nail biting
Correct Answer: C
Rationale: When assessing a client with moderate anxiety, the nurse should anticipate signs such as fidgeting, laughing inappropriately, and nail biting. These behaviors are common manifestations of increased stress levels. Palpitations, on the other hand, are more commonly associated with severe anxiety or panic attacks. Other symptoms of severe anxiety may include restlessness, difficulty concentrating, muscle tension, and sleep disturbances.
A healthcare professional is assessing a client with suspected substance use disorder. Which of the following findings should the healthcare professional not expect?
- A. Neglect of responsibilities
- B. Increased tolerance to the substance
- C. Withdrawal symptoms when not using the substance
- D. Unsuccessful attempts to cut down or control use
Correct Answer: B
Rationale: Findings in a client with substance use disorder typically include neglect of responsibilities, withdrawal symptoms when not using the substance, and unsuccessful attempts to cut down or control use. Increased tolerance to the substance is a common phenomenon in substance use disorder and is expected as the individual requires higher doses to achieve the same effect.