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A nurse is performing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom?
- A. Affective flattening.
- B. Bizarre behavior.
- C. Illogicality.
- D. Somatic delusions.
Correct Answer: A
Rationale: The correct answer is A: Affective flattening. Negative symptoms in schizophrenia refer to deficits in normal emotional responses or behaviors. Affective flattening specifically involves a reduction in the expression of emotions, such as reduced facial expressions and tone of voice. This is a core negative symptom in schizophrenia. Bizarre behavior (choice B) is associated with positive symptoms, such as hallucinations and delusions. Illogicality (choice C) is a cognitive symptom related to disorganized thinking. Somatic delusions (choice D) are also positive symptoms involving false beliefs about the body. By process of elimination, Affective flattening is the correct answer.
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A nurse is making a home visit for a 16-year-old adolescent who attempted suicide. Which of the following behaviors should alert the nurse that the adolescent still has suicidal intent?
- A. Telling his parents that he doesn't want to talk about the suicide attempt.
- B. Stating that he wants to be with his peers more than with his parents.
- C. Preferring to eat his meals while watching TV.
- D. Planning to give his CD collection to his girlfriend.
Correct Answer: D
Rationale: The correct answer is D: Planning to give his CD collection to his girlfriend. This behavior indicates the adolescent is making future plans involving giving away possessions, which could be a sign of continued suicidal ideation. Giving away prized possessions is often seen as a way of saying goodbye or preparing for death. Choices A, B, and C do not necessarily indicate ongoing suicidal intent. A may suggest avoidance, B may indicate a desire for peer support, and C may be a personal preference. Therefore, D is the most concerning behavior that warrants immediate attention.
A nurse observes a client's spouse sitting alone in the waiting room crying. When approached, the spouse says, "I am really concerned about my husband." Which of the following is a therapeutic nursing response?
- A. "Your husband is making really good progress."
- B. "Crying helps us let things out and we feel better."
- C. "Did your husband say something to upset you?"
- D. "Tell me what’s concerning you."
Correct Answer: D
Rationale: Encouraging the spouse to verbalize concerns supports therapeutic communication.
A client awaiting surgery expresses fear of having cancer. Which response by the nurse is most appropriate?
- A. "Why do you think you have cancer?"
- B. "I don't see any reason for you to worry."
- C. "That's something to discuss with your provider."
- D. "I hear that you are concerned about this."
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the client's feelings and shows empathy. By saying, "I hear that you are concerned about this," the nurse validates the client's emotions and creates a supportive environment. Choice A is incorrect as it may come off as dismissive. Choice B is inappropriate as it invalidates the client's fear. Choice C passes the responsibility back to the client's provider instead of addressing the immediate concern.
A home health nurse drives up to the house of her client, who has schizophrenia with manic episodes. The client is sitting on his front porch with a shotgun in his arms. Which of the following actions should the nurse take?
- A. Honk the car horn to get the client's attention.
- B. Calmly speak the client's name out of the car window.
- C. Keep driving in a path that is going away from the client's house.
- D. Stop the car in the client's driveway and call the authorities.
Correct Answer: C
Rationale: Leaving the situation and seeking help from authorities is the safest course of action.
A nurse on an acute mental health unit is caring for a client who has major depressive disorder. Which of the following interventions is the nurse’s priority?
- A. Monitor for risk of self-harm.
- B. Administer prescribed antidepressants.
- C. Encourage adequate fluid intake.
- D. Assist with activities of daily living.
Correct Answer: A
Rationale: The correct answer is A: Monitor for risk of self-harm. This is the priority because individuals with major depressive disorder are at an increased risk for suicide. The nurse must ensure the client's safety by closely monitoring for any signs of self-harm or suicidal ideation. Administering antidepressants (B) may be important for long-term management but ensuring immediate safety takes precedence. Encouraging fluid intake (C) and assisting with activities of daily living (D) are important aspects of care but do not address the immediate risk of self-harm.