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The nurse is leading a group on the inpatient psychiatric unit. Which approach should the nurse use during the working phase of group development?
- A. Helping clients identify areas of problem in their lives.
- B. Discussing ways to use new coping skills learned.
- C. Establishing a rapport with group members.
- D. Clarifying the nurse's role and clients' responsibilities.
Correct Answer: B
Rationale: Discussing ways to use new coping skills learned is appropriate during the working phase, focusing on problem-solving and achieving goals identified earlier.
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An adult client presents to the community mental health center accompanied by the client's spouse who reports that the client has been acting impulsively. The client has spent a large amount of money lately, made several last-minute decisions to take trips, sleeps only 2 to 4 hours a night, and has lost 33 pounds (15 kg) in the last 2 months. Which nursing problem has the greatest nursing priority?
- A. Sleep deprivation related to state of hyperactivity.
- B. Ineffective coping related to biochemical changes.
- C. Risk for self-directed violence related to impulsive behavior.
- D. Imbalanced nutrition related to caloric expenditure.
Correct Answer: C
Rationale: The client's impulsive behavior increases the risk of self-directed violence, making it the most urgent nursing priority due to potential immediate harm.
While assessing a client with the diagnosis of schizophrenia who wears dentures, the nurse observes that the client's tongue is “wormingâ€. The client also demonstrates an inability to articulate words clearly. Which additional assessment is most important for the nurse to obtain?
- A. Usual level of activity and average sleep pattern.
- B. Blood pressure when sitting and standing.
- C. Dentures to determine if they are poorly fitted.
- D. Body weight over the past three months.
Correct Answer: C
Rationale: Assessing the fit of dentures is crucial, as poorly fitted dentures could contribute to speech difficulties and tongue abnormalities observed.
A male client with schizophrenia continues to talk to others on the mental health unit using tangential speech. What intervention should the nurse implement?
- A. Tell the client to discuss his ideas with others when his thoughts are more clear.
- B. Teach the client to slow down and focus on the topic by listening to his words.
- C. Ask the client to repeat his comments.
- D. Confront the client when he talks rapidly.
Correct Answer: B
Rationale: Teaching the client to slow down and focus on the topic by listening to his words is a therapeutic intervention to address tangential speech and improve communication.
The nurse is preparing medications for a client with bipolar disorder and notices that the antipsychotic medication was discontinued several days ago. Which medication should also be discontinued?
- A. Alprazolam.
- B. Lithium.
- C. Benztropine.
- D. Magnesium.
Correct Answer: C
Rationale: Benztropine is used to manage extrapyramidal symptoms associated with antipsychotics, so it should be discontinued if the antipsychotic is stopped.
A client who is admitted with a closed head injury after a fall has a blood alcohol level (BAL) of 0.28 (28%) and is difficult to arouse. Which intervention during the first 6 hours following admission should the nurse identify as the priority?
- A. Administer disulfiram immediately.
- B. Place in a side-lying position with the head of the bed elevated.
- C. Give lorazepam PRN for signs of withdrawal.
- D. Provide thiamine and folate supplements as prescribed.
Correct Answer: B
Rationale: Placing the client in a side-lying position with the head elevated prevents aspiration and maintains airway patency, critical for a client with altered consciousness.