A 79-year-old white male tells a nurse, “I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.” The nurse should analyze this comment as:

Correct Answer: C

Rationale: The correct answer is C: Evidence of risks for suicide. The statement contains indicators such as feeling very sad, lack of purpose, isolation, and declining health, which are red flags for suicide risk in older adults. It is crucial for healthcare providers to assess and intervene promptly in such cases to prevent harm. Choices A, B, and D are incorrect because they do not address the seriousness of the situation or the potential risk for self-harm.

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Reporting the findings to the health care provider is the next best action because elevated BUN and creatinine levels indicate possible renal dysfunction, which could be causing the psychiatric symptoms. The health care provider needs this information to determine appropriate treatment and further evaluation. Summary of Incorrect Choices: B: Assessing the patient for a history of renal problems is not the next best action because the lab results already indicate potential renal issues. C: Assessing the patient’s family history for cardiac problems is irrelevant to the elevated BUN and creatinine levels and the psychiatric symptoms. D: Arranging for the patient’s hospitalization on the psychiatric unit is premature without addressing the underlying medical issue indicated by the lab results.

Correct Answer: B

Rationale: The correct answer is B, clarifying with the patient whenever there is doubt. This action shows active listening, respect, and a willingness to understand the patient's needs. By seeking clarification, the nurse demonstrates genuine interest in the patient's perspective, which helps build trust. Responding positively to demands (A) may not always be appropriate or feasible. Staying available for the entire shift (C) is important but not the sole factor in trust-building. Following through with promises (D) is crucial but does not address the patient's concerns or doubts directly. Clarifying doubts fosters clear communication and mutual understanding, establishing a foundation of trust.

Correct Answer: D

Rationale: The correct answer is D because expressing a wish for getting help sooner implies a sense of responsibility and guilt for not doing so. This indicates unresolved feelings of guilt. Choice A refers to sadness during a specific time of the year, not guilt. Choice B reflects acceptance and closure. Choice C indicates a natural progression of grief, not necessarily guilt.

Correct Answer: D

Rationale: The correct answer is D because showing no emotion when discussing a personal tragedy is indicative of blunted affect, a negative symptom commonly seen in residual schizophrenia. This behavior aligns with the diagnostic criteria for residual schizophrenia, which includes the presence of negative symptoms like flat affect. Choices A, B, and C do not directly relate to negative symptoms of schizophrenia. A communicating style or claims about worms do not specifically indicate negative symptoms, and maintaining arms awkwardly overhead is not a typical symptom of residual schizophrenia.

Correct Answer: B

Rationale: The correct answer is B: Enroll the patient in an exercise program that meets regularly. Regular exercise has been shown to have numerous benefits for brain health, including improving cognitive function and reducing the risk of cognitive decline. Exercise also helps in maintaining a healthy immune system by promoting the circulation of immune cells throughout the body. This can help support the protective abilities of immune cells related to Alzheimer's disease. Minimizing contact with the public during cold and flu season (Choice A) may reduce the risk of infections but does not directly address immune cell function. Providing supplements to enhance the patient's immune system (Choice C) may not be supported by scientific evidence and can potentially have adverse effects. Identifying creative ways to keep the patient mentally challenged (Choice D) is beneficial for cognitive health but does not directly target immune cell function as effectively as regular exercise.

Correct Answer: C

Rationale: Rationale for Correct Answer (C): Multidisciplinary collaboration in therapeutic activities involves the input of professionals from various disciplines, leading to a holistic approach that considers all aspects of a patient's condition. This approach is more likely to result in better outcomes because it combines diverse perspectives, expertise, and skills to address complex patient needs comprehensively. Summary of Incorrect Choices: A: Reducing aggressive behavior is not the primary goal of multidisciplinary collaboration in therapeutic activities. B: While multidisciplinary collaboration may lead to efficient care, the primary focus is on achieving better outcomes rather than quicker discharge. D: Although improving staffing efficiency and resource allocation may be benefits of multidisciplinary collaboration, the main purpose is to enhance patient care outcomes through diverse perspectives and expertise.

Correct Answer: A

Rationale: The correct answer is A because anticipatory grief allows individuals to gradually accept the impending loss, leading to fewer feelings of guilt. This process helps the individual prepare emotionally and psychologically for the eventual loss, reducing guilt related to not being able to prevent it. Choice B is incorrect because anticipatory grief does not prevent symptoms of depression, but rather helps individuals cope with them. Choice C is incorrect as anticipatory grief does not necessarily require a longer period of time for resolution; it varies for each individual. Choice D is incorrect, as mentioned earlier, because anticipatory grief does not prevent symptoms of depression but helps individuals navigate through them.

Correct Answer: A

Rationale: The correct answer is A because stating the goals of the group is reflective of the forming stage where members clarify the purpose and direction. Choice B is incorrect as determining leadership roles typically occurs during the storming stage. Choice C is incorrect as involving family members is not part of the group development process. Choice D is incorrect as discussing personal situations usually happens during the norming or performing stages, not in the initial forming stage.