A nurse is caring for a client hospitalized for major depressive disorder who states, "I've made so many mistakes in life. My family would be better off without me." Which of the following is the most therapeutic response by the nurse?
"Have you talked to your family about how you're feeling?"
"You should try to think more positively. Everyone makes mistakes."
"Your family would be devastated if something happened to you.
"It sounds like you're feeling overwhelmed and hopeless. I'm here to listen."
The Correct Answer is D
Rationale:
A. While this question opens communication, it shifts the focus to others instead of validating the client’s current emotional state.
B. This is a nontherapeutic response that minimizes the client’s feelings and offers false reassurance.
C. This can evoke guilt and is not therapeutic—it shifts the focus away from the client’s emotions and may increase their distress.
D. This response demonstrates empathy, acknowledges the client’s emotional pain, and shows willingness to listen—a cornerstone of therapeutic communication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Displacement involves transferring emotional responses from the original source of distress (the supervisor) to a safer or more acceptable substitute target (family members).
B. Denial is the refusal to accept reality or facts, often to avoid painful emotions, and is not demonstrated in this scenario.
C. Projection involves attributing one's own unacceptable thoughts or feelings to someone else (e.g., accusing others of being angry when you're angry).
D. Sublimation is a healthy defense mechanism where negative impulses are channeled into positive, socially acceptable activities (e.g., exercising or creating art instead of acting out anger).
Correct Answer is D
Explanation
Rationale:
A. Reassurance alone does not address the underlying cause of the restlessness, which may be distressing and impair functioning.
B. Although this can be an expected side effect (akathisia), documenting without intervention neglects the client's discomfort.
C. Notifying the provider is important, but immediate symptom relief is the priority before adjusting long-term therapy.
D. The client is exhibiting signs of akathisia, a common extrapyramidal side effect of haloperidol. Diphenhydramine (an anticholinergic/antihistamine) can relieve symptoms promptly and should be administered as the first nursing action.
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