During a regular home health visit to an elderly client, the nurse observes that the client has feelings of hopelessness and despair. The client says, "I'm old, and my life has no purpose anymore. But promise me you won't tell anyone." How should the nurse respond?
"I'm sorry, but I can't keep that kind of secret."
"Don't worry, I won't tell anyone else."
"What can we do to help you feel better?"
"Let's talk about something to cheer you up."
The Correct Answer is A
A. The nurse must not promise to keep information about hopelessness or potential suicidal thoughts secret because safety concerns override confidentiality; the nurse should explain this and immediately assess for suicidal ideation and take appropriate protective actions.
B. Promising not to tell anyone maintains secrecy and prevents the nurse from ensuring the client's safety.
C. Asking “What can we do to help you feel better?” is therapeutic but skips the necessary clarification about confidentiality and an immediate suicide risk assessment.
D. Changing the subject to “cheer you up” minimizes the client's feelings and is nontherapeutic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Anxiety and low self-esteem can interfere with the ability to trust others, making it harder for patients to form therapeutic relationships.
B. Fatigue may affect energy and engagement but does not directly impair trust.
C. Mistrust of the health care system reflects broader societal issues, not specific patient symptoms.
D. Sadness is a common symptom in mental illness but does not inherently prevent trust-building.
Correct Answer is D
Explanation
A. The initial phase is when members get to know each other, establish trust, and set group rules.
B. The final stage involves termination, closure, and reflection on accomplishments.
C. "Competition phase" is not a recognized stage in group development.
D. The working phase is when members focus on the group’s purpose, actively engage in problem-solving, and work toward accomplishing goals.
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