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A healthcare provider is assessing a client who has been diagnosed with factitious disorder. Which of the following behaviors should the healthcare provider expect?
- A. Intentional production of false symptoms
- B. Lack of concern about symptoms
- C. Fear of gaining weight
- D. Unintentional production of false symptoms
Correct Answer: A
Rationale: Individuals with factitious disorder deliberately fabricate or exaggerate symptoms to assume the sick role and garner attention. They may show a lack of concern about their symptoms, a phenomenon known as la belle indiff©rence. Fear of gaining weight is not typically associated with factitious disorder. Therefore, the correct behavior to expect in a client with factitious disorder is the intentional production of false symptoms. Choices B, C, and D are incorrect as lack of concern about symptoms and fear of gaining weight are not characteristic of factitious disorder. Additionally, factitious disorder involves the intentional, not unintentional, production of false symptoms.
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A client with bipolar disorder is prescribed lithium. Which dietary instruction should the nurse provide?
- A. Avoid foods high in potassium.
- B. Increase intake of caffeinated beverages.
- C. Maintain consistent sodium intake.
- D. Follow a low-protein diet.
Correct Answer: C
Rationale: The correct instruction for a client with bipolar disorder prescribed lithium is to maintain consistent sodium intake. Fluctuations in sodium levels can impact lithium levels, potentially leading to toxicity. Therefore, it is crucial to advise the client to keep their sodium intake consistent to ensure the effectiveness and safety of the lithium therapy. Choices A, B, and D are incorrect. Avoiding foods high in potassium is not directly related to lithium therapy. Increasing intake of caffeinated beverages can interfere with the action of lithium. Following a low-protein diet is not a standard recommendation for clients prescribed lithium.
A client with obsessive-compulsive disorder (OCD) spends several hours each day washing her hands. Which intervention should the nurse implement?
- A. Encourage the client to wash her hands less frequently.
- B. Set a time limit for hand washing.
- C. Teach the client relaxation techniques.
- D. Discourage the client from washing her hands.
Correct Answer: B
Rationale: Setting a time limit for hand washing is an appropriate intervention for a client with OCD who spends excessive time on this compulsive behavior. By setting a time limit, the nurse can help the client gradually reduce the compulsive behavior, promoting a more manageable approach to hand washing without completely discouraging it. Encouraging the client to wash her hands less frequently (Choice A) may not address the root of the issue and could lead to increased anxiety. Teaching relaxation techniques (Choice C) may be helpful for overall anxiety management but may not directly address the excessive hand washing behavior. Discouraging the client from washing her hands (Choice D) may increase anxiety and resistance, making it a less effective intervention.
A client states, 'I am the only one who can hear voices.' Which is the nurse's best response?
- A. Tell me more about these voices.
- B. Let's explore these voices together.
- C. How long have you been hearing these voices?
- D. Have you told anyone else about these voices?
Correct Answer: A
Rationale: The best response for the nurse is to encourage the client to talk about their experiences with hearing voices. By asking the client to share more details about the voices, the nurse can gain insight into the nature of the auditory hallucinations and better understand the client's condition. This open-ended question allows the client to express themselves freely and helps build rapport and trust between the client and the nurse. Choices B, C, and D do not directly address the client's statement or encourage further elaboration, making them less effective responses in this context.
A client with obsessive-compulsive disorder (OCD) spends hours each day washing her hands. Which intervention should the nurse implement to help the client reduce this behavior?
- A. Encourage the client to set a time limit for washing hands.
- B. Encourage the client to wash hands only when necessary.
- C. Encourage the client to use hand sanitizer instead of washing.
- D. Encourage the client to explore the reasons behind the hand washing.
Correct Answer: A
Rationale: Setting a time limit for hand washing is an effective intervention in managing obsessive-compulsive disorder (OCD) symptoms. By establishing boundaries around the behavior, the client can gradually work towards reducing the excessive hand washing and regaining control over the compulsion. Choice B is not as effective because it does not address the underlying compulsion. Choice C may not be helpful as it may not satisfy the client's need for cleanliness and could reinforce the behavior. Choice D, while important in therapy, may not be the most immediate intervention needed to address the excessive hand washing behavior.
When assessing a client's behavior for potential aggression, what behavior would be recognized as the highest predictor of future violence?
- A. Pacing and restlessness
- B. Verbal threats
- C. History of violence
- D. Substance abuse
Correct Answer: C
Rationale: A history of violence is considered the highest predictor of future violence. Clients who have a history of violent behavior are more likely to engage in violent acts in the future compared to those who exhibit other behaviors such as pacing, making verbal threats, or having substance abuse issues. Understanding a client's history of violence is crucial in assessing the risk of potential aggression and violence. Pacing and restlessness, verbal threats, and substance abuse can be concerning behaviors but do not carry the same predictive value for future violence as a documented history of violent behavior.