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A male client with schizophrenia is admitted to the mental health unit after abruptly stopping his prescription for ziprasidone (Geodon) one month ago. Which question is most important for the RN to ask the client?
- A. Have you lost interest in the activities you once enjoyed?
- B. Is your ability to think or concentrate reduced?
- C. How many consecutive hours do you sleep at night?
- D. Do you hear sounds or voices that others do not hear?
Correct Answer: D
Rationale: In this scenario, the most critical question for the RN to ask the client relates to hallucinations. Hallucinations, such as hearing sounds or voices others do not hear, are a hallmark symptom of schizophrenia. This inquiry is vital for assessing the presence of psychotic symptoms and the potential relapse of the client's condition. Choices A, B, and C, although important in assessing overall mental health, do not directly address the core symptomatology of schizophrenia or the potential impact of discontinuing antipsychotic medication abruptly.
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A client diagnosed with obsessive-compulsive disorder (OCD) engages in repetitive hand washing that lasts for several hours. Which strategy should the nurse use to manage this behavior?
- A. Encourage the client to continue the behavior to alleviate anxiety.
- B. Establish a routine schedule for hand washing.
- C. Gradually reduce the amount of time spent on the behavior.
- D. Ignore the behavior as much as possible.
Correct Answer: C
Rationale: In managing obsessive-compulsive disorder (OCD), it's crucial to gradually reduce the compulsive behavior to help the client learn to manage anxiety in a structured manner. Encouraging the client to continue the behavior (Choice A) would reinforce the cycle of compulsions. While establishing a routine schedule (Choice B) may provide some structure, it doesn't address the core issue of excessive hand washing. Ignoring the behavior (Choice D) may lead to worsening symptoms and does not help the client in managing their OCD effectively.
The RN is leading a group on the inpatient psychiatric unit. Which approach should the RN use during the working phase of group development?
- A. Establishing a rapport with group members.
- B. Clarifying the nurse's role and clients' responsibilities.
- C. Discussing ways to use new coping skills learned.
- D. Helping clients identify areas of problems in their lives.
Correct Answer: C
Rationale: During the working phase of group development, the focus should be on discussing and applying new coping skills to promote progress. This helps group members to practice and implement the skills they have learned, leading to positive outcomes. Choices A, B, and D are not ideal during the working phase. While establishing rapport is important, it is more relevant during the initial orientation phase. Clarifying roles and responsibilities is important at the beginning of group formation, and helping clients identify areas of problem in their lives is often part of the exploration phase, not the working phase.
A male adolescent was admitted to the unit two days ago for depression. When the mental health nurse tries to interview the client to establish rapport, he becomes very irritated and sarcastic. Which action is best for the nurse to take?
- A. Offer to play a game of cards with the client.
- B. Report the behavior to the next shift.
- C. Document the behavior in the chart.
- D. Plan to talk with the client the next day.
Correct Answer: A
Rationale: Offering to play a game of cards with the adolescent is the best action for the nurse to take in this situation. Engaging in an activity like playing a game can help establish rapport with the adolescent as it provides a more relaxed and non-threatening environment for communication. This approach can help the adolescent feel more comfortable and open up, as adolescents often find it easier to communicate when involved in an activity. Reporting the behavior to the next shift, documenting the behavior, or planning to talk with the client the next day do not directly address the immediate need to establish rapport and improve communication with the adolescent.
A male client with schizophrenia is demonstrating echolalia, which is becoming annoying to other clients on the unit. What intervention is best for the nurse to implement?
- A. Avoid acknowledging the behavior.
- B. Isolate the client from other clients.
- C. Administer a PRN sedative.
- D. Escort the client to his room.
Correct Answer: D
Rationale: The best intervention for a male client with schizophrenia displaying echolalia, which is disruptive to others, is for the nurse to escort the client to his room. Echolalia, the constant repetition of others' words, can be disruptive in a communal setting. By guiding the client to a private space like his room, the nurse helps manage the behavior without isolating or medicating the client unnecessarily. Avoiding acknowledging the behavior (Choice A) does not address the issue, isolating the client (Choice B) may exacerbate feelings of exclusion, and administering a PRN sedative (Choice C) should be reserved for situations where there is imminent risk or severe agitation, not for managing echolalia.
A healthcare professional is preparing to provide medication education to a client who has just been prescribed an antipsychotic medication. What should the healthcare professional include in the teaching plan?
- A. "You should have regular eye exams."
- B. "It is important to avoid caffeine while on this medication."
- C. "You may experience dry mouth and blurred vision."
- D. "You should increase your intake of vitamin C to prevent side effects."
Correct Answer: C
Rationale: The correct answer is C. Antipsychotic medications often have anticholinergic side effects like dry mouth and blurred vision. Teaching the client about these potential side effects is essential for their understanding and management. Regular eye exams (Choice A) are not specifically related to antipsychotic medications. While avoiding caffeine (Choice B) might be a general good practice, it is not a specific side effect of antipsychotic medications. Increasing vitamin C intake (Choice D) is not a standard recommendation for preventing antipsychotic medication side effects.