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Which of the following symptoms should a healthcare professional expect to assess in a client diagnosed with major depressive disorder? Select one that does not apply.
- A. Loss of interest or pleasure
- B. Decreased ability to concentrate
- C. Significant weight loss or gain
- D. Increased energy
Correct Answer: D
Rationale: Symptoms of major depressive disorder include a loss of interest or pleasure, decreased ability to concentrate, significant weight loss or gain, and feelings of worthlessness or excessive guilt. Increased energy is not typically associated with major depressive disorder; instead, fatigue is more common. Clients with major depressive disorder often experience a lack of energy, motivation, or enthusiasm, leading to feelings of lethargy and fatigue. Therefore, increased energy is an atypical symptom in major depressive disorder, making it the correct answer.
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A nurse is providing education to the family of a client who has been diagnosed with major depressive disorder. Which of the following instructions should the nurse include?
- A. Encourage the client to avoid caffeine.
- B. Encourage the client to participate in physical activity.
- C. Encourage the client to express their feelings.
- D. Encourage the client to avoid isolation.
Correct Answer: D
Rationale: The nurse should instruct the family to encourage the client to avoid isolation. Social support and interaction are crucial for individuals with major depressive disorder as it can help in improving mood, reducing feelings of loneliness, and providing a sense of belonging and support. Choices A, B, and C are not the most appropriate instructions for a client with major depressive disorder. While avoiding caffeine can be beneficial for some individuals with anxiety or sleep issues, it is not a primary intervention for major depressive disorder. Encouraging physical activity and expressing feelings are important aspects of managing depression, but avoiding isolation is more critical to address first.
A client with bipolar disorder is experiencing a depressive episode. Which of the following interventions should the nurse implement? Select one that does not apply.
- A. Encourage participation in activities
- B. Promote adequate nutrition and hydration
- C. Monitor for suicidal ideation
- D. Discourage verbalization of feelings
Correct Answer: D
Rationale: Interventions for a client with bipolar disorder experiencing a depressive episode include encouraging participation in activities, promoting adequate nutrition and hydration, monitoring for suicidal ideation, and providing a structured daily schedule. Discussing feelings is an essential part of therapy for clients with bipolar disorder, thus discouraging verbalization of feelings is not therapeutic and should not be implemented. Choice D is incorrect because it goes against the principles of therapeutic communication and emotional expression, which are crucial in managing bipolar disorder.
A distraught, single, first-time mother cries and asks a nurse, 'How can I go to work if I can't afford childcare?' What is the nurse's initial action in assisting the client with the problem-solving process?
- A. Determine the risks and benefits of each alternative.
- B. Formulate goals for resolving the problem.
- C. Evaluate the outcome of the implemented solution.
- D. Assess the facts of the situation.
Correct Answer: D
Rationale: In this scenario, the nurse's first step should be to assess the facts of the situation. By gathering accurate information about the client's circumstances related to childcare and work, the nurse can better understand the client's needs and concerns, which is essential before proceeding with any problem-solving process. Choice A is incorrect because assessing risks and benefits comes later in the problem-solving process. Choice B is incorrect as formulating goals should follow a thorough assessment. Choice C is incorrect since evaluating outcomes happens after implementing a solution, which is premature at this stage.
A teenage boy is attracted to a female teacher. Without objective evidence, a school nurse overhears the boy state, 'I know she wants me.' This statement reflects which defense mechanism?
- A. Displacement
- B. Projection
- C. Rationalization
- D. Sublimation
Correct Answer: B
Rationale: The correct answer is B: Projection. The nurse should determine that the client's statement reflects the defense mechanism of projection. Projection involves attributing one's unacceptable feelings or impulses to another person. By projecting these feelings onto someone else, the individual reduces their own anxiety. Displacement involves transferring feelings from one target to another, not attributing them to another person. Rationalization involves making excuses to justify behavior, not attributing feelings to others. Sublimation involves channeling unacceptable drives or impulses into more constructive and acceptable activities, not attributing feelings to another person.
A client is diagnosed with obsessive-compulsive disorder (OCD). Which of the following interventions should the nurse include in the care plan? Select one that does not apply.
- A. Allow the client to perform rituals initially
- B. Set limits on the time allowed for rituals
- C. Encourage the client to verbalize feelings
- D. Provide a structured schedule of activities
Correct Answer: A
Rationale: Interventions for a client with OCD should include allowing the client to perform rituals initially, setting limits on the time allowed for rituals, encouraging the client to verbalize feelings, and providing a structured schedule of activities. Allowing the client to perform rituals is an essential part of managing OCD and should not be restricted in the initial stages of care. Setting limits on the time for rituals helps prevent excessive engagement in them. Encouraging the client to verbalize feelings promotes emotional expression and processing. Providing a structured schedule of activities helps establish routine and predictability, which can be beneficial for individuals with OCD.