Nokea
A nurse is assessing a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom?
- A. Delusions
- B. Hallucinations
- C. Social withdrawal
- D. Agitation
Correct Answer: C
Rationale: The correct answer is C: Social withdrawal. Negative symptoms in schizophrenia involve a decrease or absence of normal functions. Social withdrawal is a classic negative symptom, as it reflects a reduction in social interactions and interest. Delusions (A) and hallucinations (B) are positive symptoms, characterized by the presence of abnormal behaviors. Agitation (D) is associated with agitation and restlessness, not with negative symptoms. In summary, social withdrawal is the correct answer because it aligns with the definition of negative symptoms in schizophrenia.
You may also like to solve these questions
A nurse is counseling an adult client whose parent just died. The client states, 'My son is 4, and I don’t know how he’ll react when he finds out that grandpa died.' The nurse should inform the client that the preschool-age child commonly has which of the following concepts of death?
- A. Death is not permanent and the loved one may come back to life
- B. Death is contagious and can cause other people he loves to die
- C. Death creates an interest in the physical aspects of dying
- D. Death is a part of life that eventually happens to everyone
Correct Answer: A
Rationale: The correct answer is A: Death is not permanent and the loved one may come back to life. Preschool-age children often have an understanding of death as temporary, believing that the deceased may come back to life. This is due to their cognitive development and limited understanding of the finality of death. Other choices are incorrect: B is incorrect as children do not typically view death as contagious; C is incorrect as preschoolers often lack a detailed interest in the physical aspects of dying; D is incorrect as preschoolers may not fully grasp the concept of death being a natural part of life.
A nurse is caring for a client who is involuntarily admitted for major depressive disorder and refuses to take prescribed antianxiety medication. Which of the following actions should the nurse take?
- A. Inform the client that he does not have the right to refuse medication
- B. Administer the medication to the client via IM injection
- C. Offer the client the medication at the next scheduled dose time
- D. Implement consequences until the client takes the medication
Correct Answer: D
Rationale: Correct Answer: D
Rationale: Implementing consequences until the client takes the medication is the most appropriate action as the client is involuntarily admitted. This approach ensures the client's safety and well-being by addressing the refusal to take prescribed medication. Administering medication via IM injection (B) may escalate the situation and violate the client's rights. Informing the client that he does not have the right to refuse medication (A) is inaccurate and may lead to resistance. Offering the medication at the next scheduled dose time (C) does not address the client's refusal.
A nurse is developing a plan of care for a client who has borderline personality disorder and exhibits manipulative behavior. Which of the following interventions should the nurse include?
- A. Encourage flexibility with unit rules
- B. Implement consistent limit-setting
- C. Allow the client to negotiate consequences
- D. Avoid addressing manipulative behavior
Correct Answer: B
Rationale: The correct answer is B: Implement consistent limit-setting. For clients with borderline personality disorder and manipulative behavior, consistent limit-setting helps establish boundaries and promote a sense of security. By enforcing clear and consistent rules, the nurse can prevent manipulation and maintain a therapeutic environment. Encouraging flexibility with unit rules (choice A) may enable manipulation and disrupt the treatment process. Allowing the client to negotiate consequences (choice C) can reinforce manipulative behaviors. Avoiding addressing manipulative behavior (choice D) can lead to escalation and reinforcement of maladaptive behaviors.
A nurse is caring for a client who has depression following a recent job loss. Which of the following questions should the nurse ask to assess the client’s personal coping skills?
- A. How does this situation affect your life?
- B. Do you see your current situation affecting your future?
- C. Can you describe how you are currently feeling?
- D. How have you dealt with similar situations in the past?
Correct Answer: D
Rationale: The correct answer is D: How have you dealt with similar situations in the past? This question assesses the client's personal coping skills by exploring their past strategies for managing challenging situations. By understanding their previous coping mechanisms, the nurse can identify effective approaches to support the client in managing their current depression.
A: How does this situation affect your life? - This question focuses on the impact of the current situation but does not directly assess the client's coping skills.
B: Do you see your current situation affecting your future? - This question explores the client's perspective on the influence of the situation on their future, but it does not specifically address coping skills.
C: Can you describe how you are currently feeling? - This question evaluates the client's emotional state but does not directly assess coping skills.
A nurse in an inpatient mental health facility is assessing a client who has schizophrenia and is taking haloperidol. Which of the following clinical findings is the nurse’s priority?
- A. High fever
- B. Insomnia
- C. Urinary hesitancy
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: High fever. The priority finding is high fever because it could indicate a potentially serious adverse reaction called neuroleptic malignant syndrome (NMS) associated with haloperidol use. NMS is a life-threatening condition characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction. Prompt recognition and treatment of NMS are crucial to prevent complications. Insomnia (B), urinary hesitancy (C), and headache (D) are common side effects of haloperidol but are not as urgent as high fever, which could signify a medical emergency.