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A middle-aged adult with major depressive disorder suffers from psychomotor retardation, hypersomnia, and motivation. Which intervention is likely to be most effective in returning this client to a normal level of functioning?
- A. Provide education on methods to enhance sleep.
- B. Teach the client to develop a plan for daily structured activities.
- C. Suggest that the client develop a list of pleasurable activities.
- D. Encourage the client to exercise.
Correct Answer: B
Rationale: The correct answer is B: Teach the client to develop a plan for daily structured activities. This intervention is most effective because it addresses the symptoms of psychomotor retardation, hypersomnia, and lack of motivation commonly seen in major depressive disorder. Structured activities can help the client regain a sense of routine, purpose, and accomplishment, which can improve mood and motivation. Providing education on sleep methods (A) may help with hypersomnia but may not address overall functioning. Developing a list of pleasurable activities (C) can be beneficial, but structured activities are more likely to improve functioning. Encouraging exercise (D) can be helpful but may be challenging for someone with psychomotor retardation.
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Which characteristic presents the greatest risk for injury to others by the patient diagnosed with schizophrenia?
- A. Depersonalization
- B. Pressured speech
- C. Negative symptoms
- D. Paranoia
Correct Answer: D
Rationale: The correct answer is D: Paranoia. Paranoia in schizophrenia poses the greatest risk for injury to others as it can lead to aggressive behaviors driven by fear and mistrust. Individuals experiencing paranoia may perceive others as threats and act out violently in self-defense. Pressured speech (choice B) and negative symptoms (choice C) are not typically associated with direct physical harm to others. Depersonalization (choice A) refers to a sense of detachment from oneself and does not directly result in harm to others. In summary, paranoia is the most concerning characteristic in terms of potential harm to others in individuals diagnosed with schizophrenia.
You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic?
- A. A new psychiatrist is a chance to start fresh; I’m sure it will go well for you.
- B. You say you look forward to the meeting, but you appear anxious or unhappy.
- C. I notice that you frowned and avoided eye contact just now. Don’t you feel well?
- D. I get the impression you don’t really want to see your psychiatrist—can you tell me why?
Correct Answer: B
Rationale: The correct answer is B. This response acknowledges the patient's non-verbal cues and reflects back to the patient what you observed, showing empathy and understanding. It validates the patient's emotions and opens up the opportunity for the patient to further elaborate on their feelings. Choice A minimizes the patient's feelings and may come off as dismissive. Choice C puts the patient on the spot and may make them defensive. Choice D makes an assumption about the patient's feelings without giving them a chance to express themselves.
A nurse is caring for a client who was admitted for alcohol disorder. which one of the following require follow uo by the nurse? select all that apply
- A. Cardiac assessment
- B. Smoking history
- C. Genitourinary assessment
- D. Neurological assessment
- F. Client's recent loss
- G. Gastrointestinal assess,ment
Correct Answer: B
Rationale: The correct answer is B: Smoking history. This requires follow-up by the nurse because smoking can exacerbate alcohol-related health issues. The nurse needs to assess smoking habits to provide comprehensive care and address potential risks.
A: Cardiac assessment is important but not specifically related to alcohol disorder.
C: Genitourinary assessment may be important but is not a priority in this case.
D: Neurological assessment is crucial in alcohol disorder but is not the focus of the question.
F: Client's recent loss is important but not directly related to the client's alcohol disorder.
G: Gastrointestinal assessment is relevant but not a priority in this scenario.
Therapeutic communication is the foundation of a patient-centered interview. Which of the following techniques is not considered therapeutic?
- A. Restating
- B. Encouraging description of perception
- C. Summarizing
- D. Asking 'why' questions
Correct Answer: D
Rationale: As a tutor, the correct answer is D. Asking 'why' questions is not considered a therapeutic communication technique as it can come off as confrontational or judgmental, potentially making the patient feel defensive or pressured to justify their feelings. Therapeutic communication aims to create a safe and supportive environment for patients to express themselves openly without feeling judged. Restating, encouraging description of perceptions, and summarizing are all therapeutic techniques that help patients feel heard and understood, fostering trust and empathy in the patient-provider relationship.
A male client is admitted to the psychiatric unit for recurrent negative symptoms of chronic schizophrenia and medication adjustment of risperidone (Risperdal). When the client walks to the nurse’s station in a laterally contracted position, he states that something has made his body contort into a monster. What action should the nurse take?
- A. Medicate the client with the prescribed antipsychotic thioridazine (Mellaril)
- B. Offer the client a prescribed physical therapy hot pack for muscle spasms.
- C. Administer the prescribed anticholinergic benztropine (Cogentin) for dystonia.
- D. Direct client to occupational therapy to distract him from somatic complaints.
Correct Answer: C
Rationale: The correct action is to administer the prescribed anticholinergic benztropine (Cogentin) for dystonia. Dystonia is a side effect of antipsychotic medications like risperidone and can present as abnormal muscle contractions or postures. Benztropine is commonly used to manage dystonia by blocking excess acetylcholine in the brain. This helps to alleviate the muscle spasms and contractions that the client is experiencing. Mediating with thioridazine may not be appropriate as it is not the prescribed medication and may not effectively address the dystonia. Offering a hot pack for muscle spasms might provide temporary relief but does not address the underlying cause of dystonia. Directing the client to occupational therapy or distracting him may not effectively manage the dystonia symptoms. Administering benztropine is the most appropriate action to address the client's physical symptoms and improve his comfort and well-being.