On a substance abuse unit, a client diagnosed with cirrhosis of the liver tells the nurse,"I really don't believe that drinking a couple of cocktails every night has anything to do with my liver problems." Which is the best nursing response?

Correct Answer: A

Rationale: The correct answer is A. This response uses therapeutic communication by reflecting the client's statement back to them. By doing so, the nurse acknowledges the client's perspective without being confrontational. It opens the door for further discussion and exploration of the client's beliefs around alcohol and liver damage. This approach helps build rapport and trust with the client, allowing for a more effective therapeutic relationship. Choices B, C, and D are incorrect because they do not address the client's denial or beliefs directly. Choice B focuses on gathering more information about the client's drinking habits without addressing the client's statement. Choice C asks for an explanation without validating the client's feelings. Choice D is a general statement that may come across as judgmental and does not address the client's specific belief.

Correct Answer: B

Rationale: The correct answer is B because it follows the SOAP (Subjective, Objective, Assessment, Plan) format for problem-oriented charting. In choice B, the subjective information is the patient's statement, the objective information includes the observed behavior, assessment is the diagnosis of auditory hallucinations, and the plan includes offering medication and the outcome. Choice A lacks a clear assessment and plan, focusing more on the intervention and outcome. Choice C does not clearly link the assessment to the plan and lacks details in the subjective and objective sections. Choice D does not provide a clear separation between subjective and objective information and lacks a formal assessment section.

Correct Answer: C

Rationale: The correct answer is C because individuals with bipolar disorder have an increased risk of suicide during both depressive and manic episodes. This is important for families to be aware of in order to provide appropriate support and interventions. Choice A is incorrect as bipolar disorder is a chronic condition that typically requires ongoing management, episodes may not necessarily decrease with age. Choice B is incorrect because while environmental stressors can contribute to the development and exacerbation of bipolar disorder, they are not the sole cause. Choice D is incorrect as risk-taking behaviors are more commonly associated with manic episodes rather than depressive episodes in bipolar disorder.

Correct Answer: A

Rationale: The correct answer is A because in a nontherapeutic relationship, the first step would be the nurse failing to recognize the patient as a person with a need. This sets the foundation for the relationship to be unhelpful and potentially harmful. B, C, and D are incorrect as they are consequences or outcomes of a nontherapeutic relationship, not the initial cause. The nurse-patient relationship starts with the nurse acknowledging the patient's needs to establish trust and promote therapeutic communication.

Correct Answer: C

Rationale: The correct answer is C because an alteration in mood or thinking is a key characteristic of mental disorders. This indicates a disruption in normal cognitive or emotional processes, which is a defining feature of mental illnesses. Choices A, B, and D are incorrect because they do not specifically address the core symptoms of mental disorders. Capacity to interact with others (A) and ability to deal with stress (B) are important aspects of mental health but do not necessarily indicate the presence of a mental disorder. Lack of impaired functioning (D) does not capture the complexity of mental disorders, as individuals can still experience mental health issues even if they are able to function in certain areas of their life.