A patient with melancholic depression paces and wrings her hands ...

[CORALGRILL2014]

A patient with melancholic depression paces and wrings her hands for hours at a time while repeating, I'm a bad person. Staff members have been unsuccessful in their at-tempts to promote rest.
 
  Which intervention is most appropriate in promoting rest?
  a. Instructing the patient to lie down for 15 minutes of every hour
  b. Asking the patient to fold and stack bath towels and washcloths
  c. Making the patient aware of the negative effects of fatigue on mood
  d. Reassuring the patient that she is accepted and not considered a bad person

Question 2

What measure will facilitate communication with a patient who is depressed and evi-dencing psychomotor retardation and withdrawal?
 
  a. Ask the patient to indicate yes or no with finger signals.
  b. Arrange to spend time with the patient at prearranged intervals.
  c. Give concrete and concise directions rather than asking questions.
  d. Speak loudly and rapidly to the patient to focus his or her attention.

[macybarnes]

Answer to Question 1

ANS: B
The psychomotor energy of agitation must be expended; it may be channeled into simple, re-petitive activity. Standing in one place to fold towels is an improvement over pacing. This patient will be unable to comply with the request to lie down. A severely depressed patient will not be able to cognitively process this sort of information. Reassurance will not apprecia-bly affect the need for psychomotor activity.

Answer to Question 2

ANS: B
This measure will promote the establishment of rapport and demonstrate respect and ac-ceptance of the patient. It will facilitate patient willingness to communicate thoughts and feelings without making unnecessary demands on the patient; a headshake or nod would work as well. Patients should not simply be ordered about; they should be asked to respond without placing excessive demands. Patients with psychomotor retardation have the ability to hear, but their ability to process information may be slowed, requiring well-paced simple communication.

[CORALGRILL2014]

TYSM

[nanny]

Excellent