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A nurse is caring for an adolescent client who has a new diagnosis of schizophrenia. The client's parents are tearful and express feelings of guilt. Which of the following statements should the nurse make?
- A. "You said that you feel guilty about your daughter's diagnosis. Let's talk about what is causing you to feel this way."
- B. "You should not feel guilty about your daughter's diagnosis. Schizophrenia is unpreventable."
- C. "I’m sure your daughter’s diagnosis is very difficult to deal with, but everything will be all right once she receives the proper treatment."
- D. "Your provider has explained the causes of schizophrenia. Why do you feel guilty about your daughter's diagnosis?"
Correct Answer: A
Rationale: Encouraging the parents to discuss their feelings helps with emotional processing and coping.
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A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client's compulsive behaviors?
- A. Isolate the client for a period of time.
- B. Confront the client about the senseless nature of the repetitive behaviors.
- C. Plan the client's schedule to allow time for rituals.
- D. Set strict limits on the behaviors so that the client can conform to the unit rules and schedules.
Correct Answer: C
Rationale: The correct answer is C: Plan the client's schedule to allow time for rituals. This is the most appropriate action as it acknowledges the client's need for engaging in compulsive behaviors while also structuring the time effectively. Isolating the client (Choice A) would be counterproductive, as social isolation can exacerbate OCD symptoms. Confronting the client (Choice B) may lead to increased anxiety and resistance. Setting strict limits (Choice D) can cause distress and potential non-compliance. The key is to support the client by incorporating their rituals into the schedule while working towards gradually reducing them in a therapeutic manner.
A nurse is assessing a family as a system. Which of the following factors should the nurse include when assessing sociocultural context?
- A. The sense of self among individual family members
- B. The future goals of the family
- C. The roles of family members
- D. The family's religious practices
Correct Answer: D
Rationale: The correct answer is D: The family's religious practices. When assessing sociocultural context, understanding the family's religious practices is essential as it influences beliefs, values, behaviors, and interactions within the family system. Religious practices can shape decision-making processes and coping strategies. A: The sense of self focuses on individual identity rather than the collective family system. B: Future goals pertain to the family's aspirations and plans, which are important but not directly related to sociocultural context. C: Roles of family members are significant in understanding family dynamics but do not capture the broader sociocultural influences.
A nurse in an acute care mental health facility is admitting a client who reports feeling depressed, sad, moody, and overly anxious. Which of the following is the nurse’s assessment priority?
- A. Coping abilities
- B. Support systems
- C. Suicide risk
- D. Psychiatric history
Correct Answer: C
Rationale: The correct answer is C: Suicide risk. This is the priority assessment because the client is reporting symptoms of depression and anxiety, which are risk factors for suicide. Assessing suicide risk is crucial for ensuring the client's safety. Coping abilities (A) and support systems (B) are important, but assessing suicide risk takes precedence in this situation. Psychiatric history (D) may provide valuable information, but it is not the priority when the client is actively reporting symptoms of depression and anxiety.
A nurse is speaking with a client experiencing anxiety. Which of the following responses is most therapeutic?
- A. "Most clients with anxiety benefit from lying down."
- B. "Come with me to an area where we can talk without interruption."
- C. "Providers usually recommend relaxation exercises for clients who are upset."
- D. "An antianxiety pill works best for situations like this."
Correct Answer: B
Rationale: The correct answer is B. Bringing the client to an area for uninterrupted conversation shows active listening and support. It promotes a safe space for the client to express feelings and reduces anxiety. Choice A is incorrect as it assumes all clients benefit from lying down, which may not be true. Choice C is incorrect because recommending relaxation exercises may not address the client's immediate needs. Choice D is incorrect as medication should not be the first response for managing anxiety without exploring other options first.
A nurse notices that a client who has moderate anxiety is pacing the hall and mumbling. As the nurse approaches the client, he states, 'I am at the end of my rope. I don't think I can take any more bad news.' Which of the following responses should the nurse make?
- A. "Most clients with anxiety issues benefit from lying down."
- B. "Come with me to an area where we can talk without interruption."
- C. "Providers usually recommend relaxation exercises for clients who are as upset as you are."
- D. "An antianxiety pill works best for situations like this."
Correct Answer: B
Rationale: Correct Answer: B. "Come with me to an area where we can talk without interruption."
Rationale: By inviting the client to a private area for a conversation, the nurse demonstrates empathy, active listening, and a willingness to provide support. This response acknowledges the client's distress and creates a safe space for the client to express their feelings and concerns openly. It also allows the nurse to assess the client's current state and provide appropriate interventions or referrals. This approach promotes therapeutic communication and helps establish trust between the client and the nurse.
Summary of other choices:
A: Incorrect. Lying down may not be suitable for a client experiencing moderate anxiety and distress.
C: Incorrect. While relaxation exercises can be beneficial, they may not be the immediate priority in this situation.
D: Incorrect. Offering medication as the first response without further assessment or therapeutic communication is not ideal and may not address the client's underlying concerns effectively.