The nurse is assessing a client who has a history of heavy drinking and who lost his wife to cancer during the previous year. He reports that he isn't getting as much sleep as he used to when he was younger. Which question would be most appropriate to ask the client to determine if the change in his sleep pattern is related to normal aging or depression?

Correct Answer: B

Rationale: The correct answer is B: "Is it hard for you to fall asleep or remain asleep during the night?" This question is most appropriate because it directly addresses the client's current sleep issues and can provide insights into whether he is experiencing symptoms of depression, such as insomnia or disrupted sleep patterns. By focusing on the client's sleep difficulties, the nurse can better assess if the changes are related to normal aging or if they are indicative of an underlying mood disorder like depression. Choice A is incorrect as it does not address the client's current sleep problems. Choice C is not relevant to the client's sleep patterns and focuses on alcohol consumption. Choice D is also irrelevant to the client's sleep issues and does not directly assess potential depressive symptoms.

Correct Answer: A

Rationale: The correct answer is A: Glaucoma. Isosorbide mononitrate is contraindicated in patients with glaucoma due to the potential for worsening of intraocular pressure. Glaucoma is a condition where the optic nerve is damaged due to increased intraocular pressure, and isosorbide mononitrate can further elevate intraocular pressure. Choices B, C, and D are incorrect as hypertension, polycythemia, and migraine headaches are not contraindications for isosorbide mononitrate.

Correct Answer: B

Rationale: The correct answer is B because it reflects active listening and empathy by summarizing the patient's statement. This statement shows the nurse's attempt to understand the patient's perspective on life's meaning. Choice A is about the nurse's own thought process, not reflecting the patient's feelings. Choice C shows uncertainty, not reflective listening. Choice D is an observation, not reflective of the patient's emotions or thoughts.

Correct Answer: A

Rationale: The correct answer is A because the sudden onset of confusion is a key characteristic of delirium, whereas dementia typically has a gradual progression. Choice B suggests a symptom of dementia - progressive memory loss. Choice C indicates a hallucination, which can occur in both delirium and dementia. Choice D describes memory and cognitive impairment, which can be seen in both conditions but is more indicative of dementia due to the chronic nature of forgetfulness.

Correct Answer: C

Rationale: The correct answer is C because family members are often the primary support system for individuals with serious mental illness. In treatment planning, involving the family can provide crucial insights into the patient's social and emotional needs, enhance communication between the patient and healthcare providers, and increase the likelihood of treatment adherence. Family support can also help in crisis situations and promote better outcomes for the patient. Choice A is incorrect because while family members may have valuable insights, they may not always know the patient's struggles comprehensively. Choice B is incorrect as willingness to listen is not a guarantee, especially in cases where mental illness may affect the patient's judgment. Choice D is incorrect as the patient may not always turn to family first, especially if the relationship is strained or if the family is not supportive.