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A nurse is caring for a client who is experiencing a situational crisis. Which of the following actions should the nurse take first?

Determine if the client is experiencing suicidal ideation.

Identify the client's social support.

Instruct the client about coping skills.

Explore the client's perception of the event.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Assessing for the client's immediate safety is the first priority in crisis intervention.

Choice B rationale:

Identifying social support is important but not the primary action in this situation.

Choice C rationale:

Instructing the client about coping skills is important, but immediate safety takes precedence.

Choice D rationale:

Exploring the client's perception of the event is valuable, but assessing for suicidality is more urgent.

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Correct Answer is D

Explanation

Choice A rationale:

Hot flashes are not typically associated with postpartum depression; they are more related to hormonal changes.

Choice B rationale:

Intermittent abdominal pain is common after childbirth due to uterine contractions and involution.

Choice C rationale:

Blurred vision is not a typical symptom of postpartum depression.

Choice D rationale:

Feelings of intense guilt are indicative of postpartum depression and require further investigation.

A. A client who developed influenza after receiving the vaccine last year B. A client who has hypertension C. A client who has a history of Guillain-Barré syndrome D. A client who has an allergy to dairy products.

Correct Answer is C

Explanation

Choice A rationale:

Developing influenza after receiving the vaccine the previous year is not a contraindication for receiving the vaccine this year. In fact, the vaccine is recommended annually.

Choice B rationale:

Hypertension is not a contraindication for receiving the influenza vaccine.

Choice C rationale:

Clients with a history of Guillain-Barré syndrome should generally avoid receiving the influenza vaccine due to a potential increased risk of recurrence of the syndrome.

Choice D rationale:

Allergies to dairy products are not a contraindication for receiving the influenza vaccine.

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A nurse is caring for a client who is experiencing a situational crisis. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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