A nurse is evaluating the outcomes for a client who has depression following the death of his wife 3 months ago. Which of the following client statements indicates a need for further intervention?

"I can't help it but I am mad at my wife for leaving me alone."

"I feel better now that I have reestablished a relationship with my son."

"It is hard for me to be around others, but I make a point of going to the community center each week."

"I just don't feel like eating because I never liked to eat alone."

Answer and Explanation

The Correct Answer is A

Choice A reason: Anger towards a deceased spouse can be a sign of unresolved grief and may indicate complicated grief or depression, requiring further intervention.

Choice B reason: Reestablishing relationships is a positive step in coping with loss and suggests progress in managing grief.

Choice C reason: Although it's difficult, the effort to engage with the community is a positive sign of coping and does not typically indicate a need for further intervention.

Choice D reason: A lack of desire to eat due to the absence of a loved one can be a normal part of grieving, but if persistent, it may require intervention to address potential depression.

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Correct Answer is D

Explanation

Choice A reason: This approach is non-intrusive and allows the patient to become accustomed to the presence of others without feeling pressured to interact, which can be beneficial for someone with major depressive disorder who is isolating themselves.

Choice B reason: While group therapy is important, insisting that the patient comes with you when they are isolating themselves might be too forceful and could lead to increased resistance or distress.

Choice C reason: Introducing the patient to others is a good step, but it should not be the first approach if the patient is actively isolating and may not be ready for social interaction.

Choice D reason: Asking "What are you thinking about?" can be a good way to start a conversation, but it might be too direct for a patient who is not yet ready to open up and could feel invasive.

A. Potassium 5.5 mEq/L B. Potassium 3.8 mEq/L C. Potassium 4.5 mEq/L D. Potassium 2.9 mEq/L

Correct Answer is D

Explanation

Choice A reason: A high potassium level can increase the risk of digoxin toxicity. The normal range for potassium is typically 3.5 to 5.0 mEq/L, so a level of 5.5 mEq/L should be reported.

Choice B reason: A potassium level of 3.8 mEq/L is within the normal range and would not typically increase the risk of digoxin toxicity.

Choice C reason: A potassium level of 4.5 mEq/L is within the normal range and would not typically increase the risk of digoxin toxicity.

Choice D reason: A low potassium level can also increase the risk of digoxin toxicity, but the question asks for the result that does not increase the risk, making 2.9 mEq/L incorrect in this context.

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A nurse is evaluating the outcomes for a client who has depression following the death of his wife 3 months ago. Which of the following client statements indicates a need for further intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

When the nurse is reviewing a patient's daily laboratory test results, which of the following potassium levels should the nurse report to the healthcare provider to reduce the risk of digoxin (Lanoxin) toxicity?

Correct Answer is D

Explanation

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