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 C

Explanation

Choice A rationale

Aripiprazole is an atypical antipsychotic medication primarily used to treat schizophrenia and bipolar disorder. It is not indicated for smoking cessation. While some individuals with mental health conditions also smoke, aripiprazole does not directly address nicotine dependence.

Choice B rationale

Quetiapine is another atypical antipsychotic medication used for the treatment of schizophrenia and bipolar disorder. Similar to aripiprazole, it does not have pharmacological properties that aid in smoking cessation.

Choice C rationale

Bupropion is an atypical antidepressant that has also been approved for smoking cessation. It is thought to work by affecting dopamine and norepinephrine levels in the brain, which are involved in nicotine addiction and withdrawal symptoms.

Choice D rationale

Risperidone is an atypical antipsychotic medication used to treat psychotic disorders. It does not have any known efficacy in aiding smoking cessation.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Explanation

The nurse should anticipate prescriptions for methadone as well as group therapy.

Rationale for correct answers

Methadone is a long-acting opioid agonist used in medication-assisted treatment (MAT) for heroin withdrawal and opioid dependence. Given the client’s history of heroin use and symptoms suggestive of withdrawal, methadone can alleviate withdrawal symptoms while preventing cravings and relapse.

Group therapy is a key component of substance use disorder treatment, providing peer support, relapse prevention strategies, and coping mechanisms. The client has already expressed willingness to participate in outpatient therapy and identified cravings as a challenge, making group therapy beneficial for sustained recovery.

Rationale for incorrect Response 1 options

Disulfiram: Used for alcohol dependence, but this client does not report alcohol use.
Naltrexone: Used to prevent opioid or alcohol relapse but does not treat withdrawal symptoms, making methadone a better choice during acute withdrawal.
Lorazepam: A benzodiazepine used for alcohol withdrawal and anxiety, but it is not first-line for opioid or methamphetamine withdrawal.

Rationale for incorrect Response 2 options

Electroconvulsive therapy: Primarily used for severe depression or treatment-resistant mood disorders, not substance use disorder management.
Antidepressant medication: The client has no history of depression or psychiatric disorders, making behavioral therapies a better fit for recovery.
Antipsychotic medication: No psychotic symptoms such as delusions or hallucinations are reported, so antipsychotics are not indicated.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing information to a client about smoking cessation.Which of the following medications should the nurse include?

Correct Answer is C

Explanation

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

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?