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A nurse is planning care for a client who has chronic substance use disorder. Which of the following is the most therapeutic response to help the client cease alcohol consumption?

A.

"Let me tell you how I struggled to stop drinking whiskey over the years, but finally succeeded."

B.

"You have stopped drinking, haven't you?"

C.

"The physician has ordered you to stop drinking all alcoholic beverages. Are you going to make us happy?"

D.

"Let's work together on a plan that includes medication, group support, and counseling."

Answer and Explanation

The Correct Answer is D

Rationale:

 

A. Sharing personal experiences can be supportive, but it may not be the most therapeutic or professional approach in this situation.

 

B. This question is leading and doesn't encourage an open dialogue. It may also induce guilt or defensiveness in the client.

 

C. This statement is authoritative and may come across as coercive, which can be counterproductive in encouraging the client to take responsibility for their recovery.

 

D. Collaborating with the client on a comprehensive plan that includes medication, group support, and counseling is a therapeutic approach that empowers the client to actively participate in their recovery, offering them the best chance of success.


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Correct Answer is D

Explanation

Rationale:

A. An elevated heart rate alone is not commonly associated with depression.

B. While renal dysfunction can impact mood, the direct link between it and depression is not as strong as other factors.

C. High blood pressure is not a direct cause of depression, though it can contribute to overall health issues.

D. Stress from a new job is a common and recognizable factor that can lead to or exacerbate depressive symptoms, showing an understanding of how situational stress can impact mood.

Correct Answer is ["A","C","D"]

Explanation

Rationale:

A. Protein intake should be limited in clients with CKD to reduce the burden on the kidneys, as excessive protein can accelerate kidney damage.

B. Caloric intake typically needs to be adequate to meet energy requirements, not necessarily limited unless advised by a healthcare provider based on specific health needs.

C. Sodium intake should be restricted to prevent fluid retention and hypertension, which can worsen kidney function.

D. Phosphorous should be limited to avoid hyperphosphatemia, which can lead to bone and cardiovascular problems in CKD patients.

E. Calcium intake is usually maintained or adjusted carefully, rather than broadly limited, to manage bone health and prevent complications associated with CKD.

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