A nurse is collecting data from a client who has depression to identify his ability to perform activities of daily living (ADLs) prior to discharge. Which of the following data should the nurse collect? (Select all that apply.)

Ability to dress himself

Ability to identify how often he should schedule his car for an oil change

Ability to bathe himself

Ability to perform oral hygiene

Ability to balance his bank account

Answer and Explanation

Correct Answer : A,C,D

Choice A reason: The ability to dress oneself is a basic ADL and is important for independence after discharge.

Choice B reason: Scheduling car maintenance is not considered a basic ADL; it is an instrumental activity of daily living (IADL), which is not typically assessed for depression-related ADLs.

Choice C reason: The ability to bathe oneself is another basic ADL that is crucial for self-care and should be assessed before discharge.

Choice D reason: Performing oral hygiene is a fundamental ADL and should be included in the assessment.

Choice E reason: Balancing a bank account is an IADL and, similar to choice B, is not typically part of the basic ADL assessment for a client with depression.

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Correct Answer is D

Explanation

Choice A reason: The statement "Your heart stops" is incorrect; heart failure does not mean the heart has stopped functioning.

Choice B reason: "Your heart is pumping too much blood" is not accurate; heart failure often means the heart cannot pump enough blood to meet the body's needs.

Choice C reason: While an area of heart muscle may die during a heart attack, this is not the defining characteristic of heart failure.

Choice D reason: The most accurate description of heart failure is that the heart is not pumping efficiently, which can lead to symptoms like fatigue and shortness of breath.

A. Be honest. B. Develop trust. C. Show acceptance. D. Be judgmental.

Correct Answer is D

Explanation

Choice A reason: Being honest is important in building a therapeutic relationship and can help the patient feel understood and respected.

Choice B reason: Developing trust is crucial for effective interventions and can encourage the patient to engage in treatment and share their feelings.

Choice C reason: Showing acceptance helps the patient feel safe and validated, which is essential in treating depression.

Choice D reason: Being judgmental is not an effective intervention as it can further alienate and discourage the patient, potentially worsening their condition.

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A nurse is collecting data from a client who has depression to identify his ability to perform activities of daily living (ADLs) prior to discharge. Which of the following data should the nurse collect? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient asks the nurse what a diagnosis of heart failure means. Which of the following is the nurse's best response?

Correct Answer is D

Explanation

Your patient appears withdrawn and depressed. Which of the following would not be an effective intervention?

Correct Answer is D

Explanation

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Your patient with major depressive disorder isolates herself in her room for the whole day. You find her sitting and staring out the window. What is your best therapeutic response when you walk into her room?

The nurse reinforces teaching to the patient on left heart failure (HF). The nurse would evaluate the patient as understanding if the patient stated which of these occurs to blood flow through the heart?

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