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The nurse is preparing a client with schizophrenia for discharge. The nurse asks the client, 'How are you going to care for yourself at home?' The purpose of the nurse's question is to assess the client's
- A. Self concept
- B. Judgment
- C. Insight
- D. Social support system
Correct Answer: C
Rationale: Asking about self-care plans assesses insight, the client's awareness of their illness and ability to manage it, unlike self-concept, judgment, or social support.
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The nurse enters the room of a client with schizophrenia the day after he has been admitted to an inpatient setting and says, 'I would like to spend some time talking with you.' The client stares straight ahead and remains silent. The best response by the nurse is,
- A. I can see you want to be alone. I'll come back another time.
- B. If you don't need to talk right now, I'll just sit here for a few minutes.
- C. I've got some other things I can do now. I hope you'll feel like talking later.
- D. You would feel better if you would tell me what you're thinking.
Correct Answer: B
Rationale: Sitting quietly shows acceptance and builds trust, supporting the client's limited tolerance for interaction, unlike leaving or assuming feelings.
The client with schizophrenia tells the nurse that rats have started to eat his brain. The best response by the nurse would be.
- A. Have you discussed this with your physician?
- B. How could that be possible?
- C. You cannot have rats in your brain.
- D. You look OK to me.
Correct Answer: A
Rationale: Referring to the physician for a new symptom like a delusion prompts potential medication review, unlike defensive, dismissive, or non-therapeutic responses.
A client with schizophrenia is reluctant to take his prescribed oral medication. The most therapeutic response by the nurse to this refusal is,
- A. I can see that you're uncomfortable now, so we can wait until tomorrow.
- B. If you refuse these pills, you'll have to get an injection.
- C. What is it about the medicine that you don't like?
- D. You know you have to take this medicine for your own good.
Correct Answer: C
Rationale: Exploring reasons for medication refusal addresses barriers to compliance, fostering collaboration, unlike threats, delays, or non-therapeutic insistence.
A student nurse is having a first experience in an inpatient psychiatric unit and is frightened by the behaviors of the clients with schizophrenia. The student should take which of the following actions to deal with fear?
- A. Express fear to the psychiatrist during rounds
- B. Pretend to not be afraid
- C. Stay in an open area while talking with the clients
- D. Insist that the clients behave appropriately
Correct Answer: C
Rationale: Staying in an open area ensures safety, addressing fear constructively, unlike pretending, expressing fear publicly, or demanding client behavior changes.
A client asks the nurse upon discharge, 'What should I do if I forget to take my medicine?' The nurse should explain to the client which of the following?
- A. Just double the dose next time it is scheduled.
- B. Skip that dose and resume your regular with the next dose.
- C. Don't miss doses, or you will not maintain therapeutic drug levels.
- D. If you remember within 3 to 4 hours later than it is due, take it then. If you remember more than 4 hours after it was due, do not take that dose.
Correct Answer: D
Rationale: Taking a missed dose within 3-4 hours maintains therapeutic levels, but skipping it if later avoids disruption, unlike doubling doses or vague warnings.