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If a schizophrenic client says, 'Wing ding, the world is a ring,' which response by the nurse is most therapeutic?
- A. How clever. You've made up a poem.
- B. I don't understand what you mean.
- C. Let's talk about what's happening today.
- D. Tell me more about what you're thinking.
Correct Answer: B
Rationale: Acknowledging the nurse's lack of understanding gently prompts clarification, fostering communication without reinforcing delusional content.
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Which question best assesses the client's long-term memory?
- A. What is your current age?
- B. What is today's date?
- C. What is your date of birth?
- D. What occurred last January?
Correct Answer: C
Rationale: Recalling date of birth tests long-term memory, as it requires retrieving well-established, distant personal information.
When a client with dementia says, 'I want to go home,' which response by the nurse is most appropriate?
- A. You are at home.
- B. You are staying here.
- C. You must be homesick.
- D. You need to call your family.
Correct Answer: C
Rationale: Acknowledging homesickness validates the client's feelings, redirecting the conversation therapeutically without causing distress.
The nurse is teaching the client with a substance abuse disorder about 12-step self-help programs such as AA. The nurse informs the client that the major principle associated with this 12-step program is what principle?
- A. Substance abuse disorders can be cured with total abstinence.
- B. Normal substance use can resume with the guidance and support of others.
- C. Acceptance of powerlessness over a substance is the first step in recovery.
- D. Substance abuse is a weakness that can be overcome through a belief in God.
Correct Answer: C
Rationale: AA’s first step is admitting powerlessness (C). Addiction is a disease not curable (A) or resumable (B) and not a weakness; higher power is personal (D).
The nurse is discharging the client from an inpatient treatment program for cocaine abuse. Which statement by the client indicates an accurate understanding about the disease process of addiction?
- A. “I’m really going to try to stay off cocaine. I’m not worried about alcohol since I’ve never had any problem with a glass or two of wine with dinner.”
- B. “Once my cravings go away I won’t need to go to Narcotics Anonymous (NA) anymore. I’ll be recovered and will be able to stay away from using cocaine.”
- C. “I feel much better after talking to my therapist. I didn’t realize that I was hurting so much emotionally. I must have been using to deal with my emotional problems.”
- D. “I didn’t realize that staying off drugs meant changing my thoughts and emotions. I thought I could just learn to stop using cocaine. NA will help me make these changes.”
Correct Answer: D
Rationale: Lifestyle change via NA (D) is key to recovery. Other substances (A) risk dependency recovery is lifelong (B) and addiction is primary not emotional (C).
Which clients are most likely to be members of an obsessive-compulsive disorder (OCD) support group? Select all that apply.
- A. A 30-year-old who performs handwashing five times per hour
- B. A 35-year-old who wears gloves when touching a public faucet
- C. A 40-year-old who is sexually promiscuous
- D. A 45-year-old who drinks a fifth of whiskey daily
- E. A 50-year-old who cannot throw anything away
- F. A 60-year-old who repeatedly checks the locks on locked doors
Correct Answer: A,B,E,F
Rationale: Compulsive handwashing, glove-wearing, hoarding, and lock-checking are characteristic OCD behaviors involving repetitive actions to reduce anxiety.