A nurse is planning care for a newly admitted client diagnosed with major depressive disorder following the loss of a child. Which of the following goals should the nurse identify as the priority?

The client assumes an active role in her care planning process.

The client identifies positive qualities about herself.

The client exhibits expected grieving behaviors.

The client makes a contract to avoid self-harm.

Answer and Explanation

The Correct Answer is D

Choice A reason:
While it is beneficial for clients to be involved in their care planning, this is not the immediate priority. Active participation in care planning is a goal that can be pursued once the client's safety and stability are ensured.

Choice B reason:
Identifying positive qualities about oneself is an important step in improving self-esteem and promoting recovery in clients with major depressive disorder. However, this is not the most immediate priority when compared to ensuring the client's safety¹.

Choice C reason:
Exhibiting expected grieving behaviors is a natural and necessary process for healing after the loss of a loved one. However, the priority in the acute phase of care, especially when a client is at risk for self-harm, is to ensure safety.

Choice D reason:
The priority nursing goal for a client with major depressive disorder, especially following a significant loss, is to ensure safety. Making a contract to avoid self-harm is a critical intervention that addresses the risk of suicide, which is heightened in individuals with major depressive disorder and recent significant loss. This contract is a verbal or written agreement between the client and the healthcare provider that the client will not harm themselves and will seek help if they have thoughts of self-harm.

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Correct Answer is ["B","D","E"]

Explanation

Choice A reason:
Regular exercise is generally not considered a predisposing factor for the development of anxiety disorders. In fact, regular physical activity is often recommended as a part of the treatment plan for anxiety because it can help reduce symptoms. Exercise can improve mental health by reducing levels of the body's stress hormones, such as adrenaline and cortisol. It also stimulates the production of endorphins, chemicals in the brain that are the body's natural painkillers and mood elevators.

Choice B reason:
A family history of anxiety disorders can be a predisposing factor. Anxiety disorders can run in families, suggesting that a combination of genes and environmental stresses can produce the disorders. If a close family member has an anxiety disorder, it may increase the likelihood that an individual will develop one as well.

Choice C reason:
Regular meditation practice is typically not a predisposing factor for anxiety disorders; rather, it is often used as a coping mechanism to manage anxiety. Meditation can help reduce stress levels and improve emotional health, which may decrease the risk of developing an anxiety disorder.

Choice D reason:
Being a perfectionist can sometimes be a predisposing factor for anxiety disorders. Perfectionism is often associated with fear of failure, fear of making mistakes, and a tendency to experience high levels of stress and pressure, which can contribute to the development of anxiety disorders.

Choice E reason:
Excessive caffeine consumption can be a predisposing factor for anxiety disorders. Caffeine is a stimulant that can mimic the symptoms of anxiety, such as increased heart rate and nervousness. People who consume large amounts of caffeine may have an increased risk of developing anxiety disorders.

Choice F reason:
Chronic physical illness can be a predisposing factor for anxiety disorders. Living with a chronic illness can cause significant stress and may lead to the development of anxiety disorders. The constant worry about health, treatments, and the future can be overwhelming and may trigger or worsen anxiety symptoms.

A. A: Administer activated charcoal to the client. B. B: Obtain a urine sample from the client for drug testing. C. C: Initiate seizure precautions for the client. D. D: Monitor vital signs frequently.

Correct Answer is D

Explanation

Choice A Reason:
Administering activated charcoal can be a treatment option in some overdose cases, particularly when the substance ingested is known to be adsorbed by charcoal. However, its effectiveness varies depending on the substance and the timing of administration post-ingestion. In the case of a stimulant overdose, activated charcoal is not the first-line treatment, especially when the specific stimulant and time of ingestion are unknown.

Choice B Reason:
Obtaining a urine sample for drug testing is important for confirming the type of stimulant ingested and can guide further treatment. However, this is not the immediate priority in an acute overdose situation where the patient's life may be at risk.

Choice C Reason:
Initiating seizure precautions is important in the management of stimulant overdose due to the risk of seizures¹. However, this is a precautionary measure and not the first action to take. The initial focus should be on assessing and stabilizing the patient's vital functions.

Choice D Reason:
Monitoring vital signs is the most critical initial step in managing a suspected stimulant overdose. Stimulants can cause severe hypertension, tachycardia, hyperthermia, and arrhythmias. Frequent monitoring allows for the early detection of life-threatening conditions and the initiation of appropriate interventions to stabilize the patient's condition.

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A nurse is planning care for a newly admitted client diagnosed with major depressive disorder following the loss of a child. Which of the following goals should the nurse identify as the priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

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