Which entry made my nurse most accurately documents a client's mood?
The client has a pleasant affect
The client appears happy with an elevated mood
The client self-isolated today
The client rate their mood 4 out of 10
The Correct Answer is D
A. The client has a pleasant affect: "Affect" refers to outward emotional expression, whereas "mood" is the client's internal emotional state.
B. The client appears happy with an elevated mood: The nurse should document objective data rather than interpreting the client’s emotions.
C. The client self-isolated today: While self-isolation may indicate mood disturbances, it does not directly document the client’s reported mood.
D. The client rates their mood 4 out of 10: This entry reflects the client’s subjective report using a measurable scale, making it the most accurate documentation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Restricts the client's ability to eat, speak, or drink: Unlike a mask, a nasal cannula allows the client to eat, drink, and speak freely.
B. Delivers a low concentration of oxygen: A nasal cannula delivers a low oxygen concentration (24%-44%) at flow rates of 1-6 L/min.
C. Delivers a constant rate of a specific concentration of oxygen: Oxygen concentration varies depending on the client's breathing pattern with a nasal cannula, making it not a fixed concentration delivery system.
D. Delivers a high concentration of oxygen: High-flow oxygen delivery systems like a non-rebreather mask or Venturi mask are needed for high oxygen concentrations.
Correct Answer is D
Explanation
A. Chronic confusion r/t ECT treatment. Memory impairment may occur but is not the immediate priority.
B. Activity intolerance r/t weakness. Weakness can occur but is not the most urgent concern post-ECT.
C. Impaired social interaction r/t confusion. Social interaction is a lower priority compared to physical safety.
D. Risk for injury r/t altered mental status. Post-ECT, clients may be confused or disoriented, increasing their risk of falls or injury. Ensuring safety is the top priority.
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