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A nurse is teaching a group of clients with a diagnosis of Schizophrenia who are nearing discharge from a residential care facility. An essential topic to include is:
- A. pathophysiology of the disease and expected symptoms.
- B. how to recognize and manage symptoms of relapse.
- C. the need to take extra medication when feeling stressed.
- D. the importance of contact with follow-up care daily.
Correct Answer: B
Rationale: Clients are usually aware of the symptoms that indicate relapse is occurring. The client needs to know how to find a safe environment and to seek help. The first two stages of relapse are more difficult to recognize because they do not present symptoms that indicate psychosis. Initially, the client feels anxious and overwhelmed, and might become withdrawn. This is the crucial period to intervene. The client needs to go to a safe environment with someone who is trusted, avoid negative people, and decrease stimuli and stress.
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A client tells the nurse that his wife's nagging really gets on his nerves. He asks the nurse to talk with her about her nagging during their family session tomorrow afternoon. Which of the following responses is the most therapeutic for the client?
- A. Tell me more specifically about her complaints.
- B. Can you think why she might nag you so much?
- C. I'll help you think about how to bring this up yourself tomorrow afternoon.
- D. Why do you want me to initiate this in tomorrow's session rather than you?
Correct Answer: C
Rationale: The client needs to learn how to communicate directly with his wife about her behavior. The nurse's assistance enables him to practice a new skill and communicates confidence in his ability to confront this situation. Choices 1 and 2 inappropriately direct attention away from the client and toward his wife, who isn't present. Choice 4 implies that there might be a legitimate reason for the nurse to assume responsibility for something that rightfully belongs to the client. Instead of focusing on his problems, he'll waste precious time convincing the nurse that he or she should do his work.
An effective intervention for a client diagnosed with Obsessive-Compulsive Disorder is:
- A. discussing the repetitive action
- B. insisting the client not perform the repetitive act
- C. informing the client that the act is not necessary
- D. encouraging daily exercise
Correct Answer: D
Rationale: Exercise reduces anxiety and redirects attention in OCD, serving as a non-confrontational intervention to decrease compulsive behaviors.
When assessing a client in the Emergency Department whose membranes have ruptured, the nurse notes that the fluid is a greenish color. What is the cause of this greenish coloration?
- A. blood
- B. meconium
- C. hydramnios
- D. caput
Correct Answer: B
Rationale: Greenish amniotic fluid passed when the fetus is in a cephalic (head) presentation might indicate fetal distress. A fetus in the breech presentation passes meconium due to compression on the intestinal tract.
A nurse is reviewing a patient's serum glucose levels. Which of the following scenarios would indicate abnormal serum glucose values for a 30 year-old male.
- A. 70 mg/dl
- B. 55 mg/dl
- C. 110 mg/dl
- D. 100 mg/dl
Correct Answer: B
Rationale: 60-115 mg/dl is standard range for serum glucose levels.
The nurse suspects an elderly client has been the victim of abuse. The client denies abuse and declines assistance. The nurse's next action should be to:
- A. do nothing; the client has the right to refuse treatment.
- B. report the incident to the police.
- C. arrange an appointment with the client's next of kin.
- D. educate the client about available services.
Correct Answer: D
Rationale: Although clients do have the right to refuse treatment, the nurse should remain nonjudgmental and inform the client of available services. Frequently elders are not aware of existing programs.