A nurse is caring for a client in an inpatient mental health facility. The client tells the nurse that the government is reading her mail. Which of the following responses should the nurse make?

"It must be frightening to think that someone is reading your mail."

"You know that's not true, because it is against the law for others to read your mail."

"All of your letters come sealed, so that seems unlikely."

"Why do you think the government wants to read your mail?"

Answer and Explanation

The Correct Answer is A

A. This response acknowledges the client's feelings and validates their experience without confirming or denying the delusion.
B. This response challenges the client's belief and may cause distress or exacerbate paranoia.

C. While factually correct, this response may not address the client's underlying concerns or feelings.
D. This response may invalidate the client's experience and may not effectively address the delusional belief.

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Correct Answer is D

Explanation

A. This statement reflects a realistic acknowledgment of the grieving process and does not necessarily indicate clinical depression.
B. Expressing dependence on family support is a common coping mechanism during grief and does not necessarily indicate clinical depression.
C. Feelings of anger are common during the grieving process and do not necessarily indicate clinical depression.
D. Feeling numb or anhedonic, the inability to experience pleasure, is a symptom commonly associated with clinical depression and should be reported to the provider for further evaluation and intervention.

A. Place the client in a reclining chair. B. Put locks at top of doors. C. Encourage physical activity prior to bed time. D. Position the mattress on the floor. E. Install sensor devices on outside doors.

Correct Answer is ["B","C","D","E"]

Explanation

A. Placing the client in a reclining chair is not recommended as it does not prevent wandering or falls and may even restrict movement leading to discomfort or pressure sores.
B. Putting locks at the top of doors can prevent the client from wandering outside, which reduces the risk of falls and getting lost, especially during the night.
C. Encouraging physical activity prior to bedtime can help in expending energy which may lead to better sleep and reduce restlessness and wandering at night.
D. Positioning the mattress on the floor can minimize injury from falls that may occur when the client attempts to get out of bed during the night.
E. Installing sensor devices on outside doors can alert the caregiver if the client attempts to leave the house, which is crucial for preventing wandering and potential falls.

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A nurse is caring for a client in an inpatient mental health facility. The client tells the nurse that the government is reading her mail. Which of the following responses should the nurse make?

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Naxlex Comprehensive Predictor Exams

A nurse is leading a grief support group for bereaved clients. Which of the following client statements should the nurse report to the provider as an indication of clinical depression?

Correct Answer is D

Explanation

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Correct Answer is ["B","C","D","E"]

Explanation

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