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The LPN/LVN is caring for a client who was recently diagnosed with a mental illness. The client asks, 'Will I be able to live a normal life?' What is the best response for the nurse to provide?
- A. Yes, you will be able to live a normal life.
- B. Many people with mental illness lead full and productive lives.
- C. It will depend on your treatment and the choices you make.
- D. There is no normal; everyone is unique in their own way.
Correct Answer: C
Rationale: The best response for the nurse is to provide the client with hope while acknowledging the importance of their treatment and choices. Choice C addresses the client's concern by highlighting the impact of their treatment and personal choices on their future. It encourages personal responsibility and active participation in their recovery. Choices A and B may sound reassuring, but they do not empower the client to take an active role in their well-being. Choice D, while promoting individuality, does not directly address the client's question about living a normal life after a mental illness diagnosis.
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A client with obsessive-compulsive disorder (OCD) spends hours each day washing their hands. Which nursing intervention is most appropriate initially?
- A. Allow the client to continue the behavior to reduce anxiety.
- B. Set strict limits on the time allowed for handwashing.
- C. Distract the client with other activities.
- D. Encourage the client to participate in a support group.
Correct Answer: A
Rationale: Initially, it is most appropriate to allow the client to continue the behavior to reduce anxiety (A). For clients with OCD, abruptly stopping compulsive behaviors can lead to increased anxiety and distress. Setting strict limits (B) may exacerbate anxiety at first. Distraction with other activities (C) may not address the underlying issue effectively. While support groups (D) can be beneficial, they are typically introduced after establishing trust and gradually working on reducing compulsive behaviors.
A male client with schizophrenia who is taking fluphenazine decanoate (Prolixin decanoate) is being discharged in the morning. A repeat dose of medication is scheduled for 20 days after discharge. The client tells the nurse that he is going on vacation in the Bahamas and will return in 18 days. Which statement by the client indicates a need for health teaching?
- A. "When I return from my tropical island vacation, I will go to the clinic to get my Prolixin injection."
- B. "While I am on vacation and when I return, I will not consume any alcohol-containing food or beverages."
- C. "I will inform the healthcare provider if I develop a sore throat or flu-like symptoms."
- D. "I will maintain my daily intake of benztropine mesylate (Cogentin)."
Correct Answer: A
Rationale: Photosensitivity is a side effect of Prolixin, and a vacation in the Bahamas (with its tropical island climate) increases the client's risk of experiencing this side effect. Therefore, the client should be advised to avoid direct sun exposure. Choice A indicates a need for health teaching as the client plans to return from vacation in 18 days, which is earlier than the scheduled dose of Prolixin at 20 days after discharge. Choices B, C, and D demonstrate accurate knowledge. Choice B is important because alcohol can interact with Prolixin. Choice C is relevant as it mentions signs of agranulocytosis, a potential side effect of Prolixin. Choice D is correct as benztropine mesylate is used to prevent extrapyramidal symptoms associated with Prolixin.
A male client turns over a table in the dayroom of a psychiatric unit and threatens to throw a chair at another client. Which action is most important for the nurse to implement?
- A. Calmly approach the client and remove the chair from the client.
- B. Obtain staff assistance to help diffuse the escalating situation.
- C. Offer feedback about the client's behavior.
- D. Summon the hospital security guards as a 'show of force.'
Correct Answer: B
Rationale: In a situation where a client is displaying aggressive behavior, the most important action for the nurse to implement is to obtain staff assistance to help diffuse the escalating situation. This approach ensures the safety of all individuals involved and prevents the situation from escalating further. Calmly approaching the client and removing the chair directly could agitate the client further and pose a risk to the nurse. Offering feedback about the client's behavior may not address the immediate safety concerns. Summoning hospital security guards as a 'show of force' should be a last resort after other de-escalation attempts have failed, as it may further provoke the client.
A male client with bipolar disorder has not slept or eaten in four days. He paces and becomes increasingly agitated and loud while the nurse talks to his spouse. What intervention is the best for the nurse to implement at this time?
- A. Move to a quiet area and provide peanut butter with crackers.
- B. Walk with the client to the cafeteria and star as he eats lunch.
- C. Request a full lunch tray from the dietary department.
- D. Encourage the spouse to eat lunch with the client.
Correct Answer: A
Rationale: In this situation, the best intervention for the nurse to implement is to move the client to a quiet area and provide peanut butter with crackers. The client's behavior indicates increasing agitation and loudness, which could be exacerbated by a noisy environment. Providing a quiet space can help reduce stimuli and promote a sense of calm. Additionally, offering a small, manageable snack like peanut butter with crackers can address the client's immediate needs for sustenance without overwhelming him. Choices B, C, and D do not address the client's current agitation and lack of sleep or food effectively, making them less appropriate interventions in this scenario.
Which interventions should the nurse include in the plan of care for a severely depressed client with neurovegetative symptoms? (select one that does not apply.)
- A. Permit rest periods as needed.
- B. Speaking slowly and simply.
- C. Place the client on suicide precautions.
- D. Allow the client extra time to complete tasks.
Correct Answer: C
Rationale: The correct answer is C, 'Place the client on suicide precautions.' When caring for a severely depressed client with neurovegetative symptoms, it is crucial to permit rest periods as needed, speak slowly and simply, and allow the client extra time to complete tasks. These interventions help in promoting the client's comfort and well-being. Placing the client on suicide precautions may not always be necessary and should be based on a thorough assessment of the client's risk of self-harm. Therefore, it is the intervention that does not universally apply to all clients in this situation.