Try Naxlex NCLEX-RN (Free-Trial)

During intake assessment, the nurse is most likely to hear a client with major depressive disorder say which of the following statements about depression? (SELECT ALL THAT APPLY)

I’d rather be dead than living like this. I do not want to be alive.

If I can just keep ignoring feelings.

I deserve to be this way. I’ve not accomplished anything important in my life.

This is a bad episode, but I will be well soon.

I am determined to fight this episode and get through it.

Answer and Explanation

Correct Answer : A,C,D

Choice A Reason:

“I’d rather be dead than living like this. I do not want to be alive.”

This statement reflects a common symptom of major depressive disorder, which is suicidal ideation. Individuals with major depressive disorder often experience feelings of hopelessness and worthlessness, leading them to believe that life is not worth living. This statement is a clear indication of the severity of the individual’s depressive symptoms and the need for immediate intervention to ensure their safety.

Choice B Reason:

“If I can just keep ignoring feelings.”

This statement is less likely to be heard from a client with major depressive disorder. Ignoring feelings is a coping mechanism that some individuals might use, but it does not directly reflect the core symptoms of major depressive disorder, which include persistent sadness, loss of interest in activities, and significant impairment in daily functioning. Therefore, this choice is not as indicative of major depressive disorder as the other statements.

Choice C Reason:

“I deserve to be this way. I’ve not accomplished anything important in my life.”

This statement reflects feelings of guilt and worthlessness, which are common symptoms of major depressive disorder. Individuals with this disorder often have a negative self-view and believe that they are failures or that they deserve to suffer. This statement highlights the individual’s low self-esteem and the pervasive negative thoughts that characterize major depressive disorder.

Choice D Reason:

“This is a bad episode, but I will be well soon.”

This statement reflects a more optimistic outlook, which is less common in individuals with major depressive disorder. However, it can still be heard from some clients who experience episodic depression and have hope for recovery. This statement indicates that the individual recognizes their current state as temporary and believes in the possibility of improvement, which can be a positive sign in the context of treatment.

Choice E Reason:

“I am determined to fight this episode and get through it.”

This statement reflects a proactive and positive attitude towards managing depression, which is less characteristic of major depressive disorder. While determination and resilience are important for recovery, individuals with major depressive disorder often struggle with motivation and energy, making it difficult for them to adopt such a mindset. Therefore, this choice is less likely to be heard from a client with major depressive disorder.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A Reason:

Stable and satisfactory relationships. This statement is incorrect. Individuals with borderline personality disorder (BPD) often struggle with maintaining stable and satisfactory relationships. They may experience intense and unstable relationships characterized by extreme fluctuations between idealization and devaluation of others. This instability is a hallmark of BPD and can lead to significant interpersonal difficulties.

Choice B Reason:

Little tolerance for being alone. This statement is correct. One of the defining characteristics of BPD is a profound fear of abandonment and an intense need for companionship. Individuals with BPD often have little tolerance for being alone and may go to great lengths to avoid real or imagined abandonment. This fear can lead to frantic efforts to maintain relationships, even if they are unhealthy or abusive.

Choice C Reason:

Predictability. This statement is incorrect. People with BPD typically exhibit unpredictable and impulsive behaviors. Their emotional responses can be intense and rapidly changing, making their behavior difficult to predict. This unpredictability can further complicate their relationships and daily functioning.

Choice D Reason:

Controlled anger. This statement is incorrect. Individuals with BPD often struggle with controlling their anger. They may experience intense and inappropriate anger, which can be difficult to manage and may result in aggressive or self-destructive behaviors. This difficulty in controlling anger is another key feature of BPD.

A. Distinct wound borders to plantar aspect of foot B. +3 edema to the mid-calf C. Patient reports 9 (0-10) pain scale to area D. Irregular wound borders E. Minimal serous drainage

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

Explanation

b. +3 edema to the mid-calf

d. Irregular wound borders

e. Minimal serous drainage

Explanation of Choices

Choice A Reason: Distinct Wound Borders to Plantar Aspect of Foot

Venous ulcers typically present with irregular wound borders rather than distinct ones. They are usually found on the lower legs, particularly around the medial malleolus (inner ankle), rather than the plantar aspect of the foot. The plantar aspect of the foot is more commonly associated with diabetic ulcers or pressure sores. Therefore, distinct wound borders to the plantar aspect of the foot are not indicative of a venous ulcer.

Choice B Reason: +3 Edema to the Mid-Calf

Edema, or swelling, is a common finding in patients with venous ulcers. Venous insufficiency leads to increased pressure in the veins, causing fluid to leak into the surrounding tissues, resulting in edema. The presence of +3 edema (a significant level of swelling) in the mid-calf is a strong indicator of venous insufficiency and, consequently, venous ulcers. This finding supports the diagnosis of a venous ulcer.

Choice C Reason: Patient Reports 9 (0-10) Pain Scale to Area

While pain can be associated with venous ulcers, it is not a definitive diagnostic criterion. Pain levels can vary widely among individuals with venous ulcers, and some may experience minimal discomfort. A pain scale rating of 9 out of 10 indicates severe pain, which could be due to various conditions, not specifically venous ulcers. Therefore, this finding alone is not sufficient to suspect a venous ulcer.

Choice D Reason: Irregular Wound Borders

Venous ulcers are characterized by their irregular wound borders. Unlike arterial ulcers, which have well-defined edges, venous ulcers tend to have uneven, irregular borders. This is due to the chronic nature of venous insufficiency and the ongoing damage to the skin and underlying tissues. The presence of irregular wound borders is a key indicator of a venous ulcer.

Choice E Reason: Minimal Serous Drainage

Venous ulcers often produce serous drainage, which is a clear to pale yellow fluid. The amount of drainage can vary, but minimal serous drainage is a common finding. This type of drainage is due to the chronic inflammation and fluid leakage associated with venous insufficiency. Therefore, minimal serous drainage is consistent with the presence of a venous ulcer.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

During intake assessment, the nurse is most likely to hear a client with major depressive disorder say which of the following statements about depression? (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In assessing a client diagnosed with borderline personality disorder, which characteristic would the nurse expect to observe?

Correct Answer is B

Explanation

Which of the following assessment findings would lead the nurse to suspect the client has a venous ulcer to the right lower extremity? (SELECT ALL THAT APPLY)

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

Explanation

The nurse in the Emergency Department (ED) assesses a 17-year-old patient with blue-tinged lips, slowed respirations, and pinpoint pupils. The patient has no response to painful stimuli. Which of the following should be the nurse’s priority action?

The nurse is aware that the major health complication associated with anorexia nervosa is:

A client diagnosed with borderline personality disorder is admitted to a psychiatric unit. Which behavior pattern would the nurse expect to observe?

A nurse is caring for a 22-year-old female client who has bulimia nervosa and frequently self-induces vomiting. Which of the following findings should the nurse expect? (SELECT ALL THAT APPLY)

The nurse is providing discharge instructions to the client taking disulfiram. Which of the following items should the nurse teach the client to avoid?

The nurse believes that a client being admitted for a surgical procedure may have a drinking problem. Which screening tool should the nurse use to further evaluate this possibility?

A nurse is discussing the diathesis-stress model with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the model?

A client with a history of a suicide attempt has been discharged and is being followed in an outpatient clinic. What is/are the most appropriate nursing intervention(s)? (SELECT ALL THAT APPLY)