A nurse in a community health clinic is assessing a client who has two preschoolers, was recently divorced, and is seeking help for managing depression. Which of the following questions should the nurse ask first?
"Are you having any thoughts about hurting yourself?"
"Who is available to help you?"
"Could you describe how you are feeling today?"
"Is there anything that makes you feel less depressed?"
The Correct Answer is A
The correct answer is choice A, "Are you having any thoughts about hurting yourself?" This is the most important question to ask because it assesses the client's risk for suicide, which is a potential complication of depression. The nurse should ask this question before exploring other issues related to the client's depression. If the client expresses suicidal thoughts or intent, the nurse should initiate appropriate interventions to ensure the client's safety.
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Related Questions
Correct Answer is B
Explanation
Cultural variances in the expression of pain can impact the assessment and management of pain. It is important to recognize and respect these cultural differences to provide culturally sensitive care. Puerto Rican cultural practices consider the expression of pain as a private matter, and individuals may not express their pain openly, as it may be viewed as a weakness or shameful. In contrast, Native American cultural practices often consider pain as a sign of strength, and individuals may express pain openly to receive validation and support from their community. Chinese cultural practices emphasize the importance of stoicism, and individuals may endure pain to prevent family dishonor. Middle Eastern cultural practices may consider pain as a test of faith, and individuals may hide their pain from close family members to avoid burdening them. By understanding these cultural variances, nurses can assess pain more effectively and develop culturally sensitive pain management plans.
Correct Answer is A
Explanation
The first step the nurse should take is to perform a needs assessment. This involves determining the specific needs of the older adults who will be served by the mobile meal program. The nurse should identify the target population and assess their nutritional needs, dietary restrictions, and food preferences. The nurse should also determine the availability of transportation for the delivery of meals and the potential need for volunteers. Once the needs assessment is complete, the nurse can begin to develop a plan for the program.
Inquiring about the availability of volunteers (choice B) and determining potential funding sources for the program (choice D) are important steps, but they should come after performing a needs assessment. Identifying alternative solutions (choice C) may be necessary at some point, but it is not the first step.
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