A nurse is caring for a client who has major depressive disorder.
The client tells the nurse, "I should be dead.
I have been a failure.”. Which of the following responses should the nurse make?

"You are feeling like a failure.”.

"I see many positive things about you.”.

"You're not the only client who feels this way.”.

"How can you feel that way when you have so much to live for?"

Answer and Explanation

The Correct Answer is A

Choice A rationale

Reflecting the client's feeling back to them, such as "You are feeling like a failure," acknowledges their emotional state without judgment or dismissal. This therapeutic communication technique validates the client's feelings and encourages further exploration of their thoughts and emotions.

Choice B rationale

While intended to be positive, stating "I see many positive things about you" can minimize the client's current feelings and may not address the underlying reasons for their negative self-perception. It can also sound dismissive of their distress.

Choice C rationale

Saying "You're not the only client who feels this way" can minimize the client's individual experience and may make them feel that their feelings are not unique or important. It does not directly address their specific statement of wanting to be dead.

Choice D rationale

Asking "How can you feel that way when you have so much to live for?" invalidates the client's current feelings and can make them feel misunderstood or defensive. It does not address the depth of their despair and suicidal ideation.

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Correct Answer is {"dropdown-group-1":"A"}

Explanation

Choice A rationale: WBC count

Clozapine carries a risk of agranulocytosis, a severe reduction in white blood cell (WBC) count that can leave the body vulnerable to infections. The client’s WBC count of 4,800/mm³ is below the normal range (5,000–10,000/mm³), raising concern for compromised immune function. Since routine monitoring of WBC is necessary for clients on clozapine, the provider should be notified to reassess whether the medication should be continued or adjusted.

Choice B rationale: Blood glucose level

While the client’s blood glucose level of 200 mg/dL is elevated, atypical antipsychotics like clozapine can contribute to metabolic syndrome and insulin resistance. However, this is not an immediate reason to clarify the prescription unless hyperglycemia is significantly worsening or causing complications.

Choice C rationale: Blood pressure

A blood pressure of 110/68 mm Hg is within normal limits and does not necessitate clarification of the prescription. Clozapine may cause hypotension in some clients, but this reading does not indicate a concerning drop in blood pressure.

Choice D rationale: Temperature

A temperature of 37.8°C (100.0°F) is slightly elevated but does not independently warrant medication clarification. However, because fever plus a low WBC count raises the suspicion of infection, the provider should be informed of both findings to assess potential complications.

A. Liver function tests. B. Chest x-ray. C. Prostate-specific antigen test. D. Urine culture.

Correct Answer is A

Explanation

Choice A rationale

Liver function tests, such as alanine aminotransferase (ALT) with a normal range of 7 to 56 U/L for females and 10 to 70 U/L for males, and aspartate aminotransferase (AST) with a normal range of 5 to 40 U/L for both sexes, should be reviewed before administering valproic acid. Valproic acid can cause hepatotoxicity, and pre-existing liver dysfunction is a contraindication or requires careful monitoring.

Choice B rationale

A chest x-ray is primarily used to assess the lungs and heart. It is not directly relevant to the potential side effects or contraindications of valproic acid therapy.

Choice C rationale

A prostate-specific antigen (PSA) test is used to screen for prostate cancer in men. It is not related to the potential adverse effects of valproic acid. The normal range for PSA is generally less than 4 ng/mL, but this can vary with age.

Choice D rationale

A urine culture is used to detect urinary tract infections. While important for overall health assessment, it does not directly assess for contraindications or potential organ-specific side effects associated with valproic acid administration. .

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A nurse is caring for a client who has major depressive disorder.The client tells the nurse, "I should be dead.I have been a failure.”. Which of the following responses should the nurse make?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a 50-year-old male client who has schizophrenia in an inpatient mental health facility Exhibits Complete the following sentence by using the list of options: The nurse should clarify the prescription for clozapine due to the client’s dropdown.

Correct Answer is {"dropdown-group-1":"A"}

Explanation

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A nurse is caring for a client who has major depressive disorder.
The client tells the nurse, "I should be dead.
I have been a failure.”. Which of the following responses should the nurse make?