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When caring for a client experiencing alcohol withdrawal, which intervention should the nurse implement to prevent complications?
- A. Provide a well-lit environment.
- B. Administer antipsychotic medication as prescribed.
- C. Monitor the client's vital signs closely.
- D. Encourage the client to express their feelings.
Correct Answer: D
Rationale: Encouraging the client to express their feelings is essential during alcohol withdrawal as it can help them cope with the emotional and psychological stress associated with the process. This intervention promotes open communication, allows the client to verbalize their emotions, and may prevent escalating anxiety or agitation, ultimately reducing the risk of complications. Providing a well-lit environment (Choice A) is not directly related to preventing complications of alcohol withdrawal. Administering antipsychotic medication (Choice B) is not the standard treatment for alcohol withdrawal; medications such as benzodiazepines are more commonly used. While monitoring vital signs (Choice C) is important, encouraging the client to express their feelings (Choice D) directly addresses emotional well-being, which is crucial during this vulnerable time.
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A client with obsessive-compulsive disorder (OCD) is being cared for by a nurse. Which intervention should the nurse implement to help the client manage compulsive behaviors?
- A. Encourage the client to suppress compulsive behaviors.
- B. Allow the client to perform compulsive behaviors with limits.
- C. Teach the client relaxation techniques to manage anxiety.
- D. Discourage the client from performing compulsive behaviors.
Correct Answer: B
Rationale: Allowing the client to perform compulsive behaviors with limits is a therapeutic intervention for managing OCD. This approach grants the client some autonomy while ensuring that the behaviors do not excessively disrupt daily life. Setting boundaries helps structure the behaviors, decreasing anxiety and distress associated with OCD. Encouraging the client to suppress compulsive behaviors (choice A) may lead to increased anxiety and potential worsening of symptoms. Teaching relaxation techniques (choice C) is beneficial for managing anxiety in general but may not directly address the compulsive behaviors. Discouraging the client from performing compulsive behaviors (choice D) without providing alternative strategies or support may increase distress and resistance.
A client diagnosed with paranoid schizophrenia states, 'The FBI is watching me. I see their agents everywhere.' Which is the nurse's most appropriate response?
- A. You shouldn't worry about that. It's not real.
- B. I don't see any FBI agents, but it sounds like you're feeling frightened.
- C. Let's talk about something else to take your mind off of it.
- D. Why do you think the FBI is watching you?
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When educating the family of a client diagnosed with dissociative identity disorder, which of the following instructions should the nurse include?
- A. Encourage the client to avoid stressful situations.
- B. Encourage the client to participate in daily activities.
- C. Encourage the client to express their feelings.
- D. Encourage the client to develop a daily routine.
Correct Answer: D
Rationale: In cases of dissociative identity disorder, it is beneficial for the client to establish a daily routine. This structure can enhance symptom management and provide a sense of stability, which is particularly important for individuals with this condition. Encouraging the client to avoid stressful situations (Choice A) may not always be possible and does not address the need for structure. While encouraging the client to participate in daily activities (Choice B) is important, having a routine is more crucial for managing dissociative identity disorder. Expressing feelings (Choice C) is valuable but establishing a routine takes precedence in this situation.
A client with generalized anxiety disorder is prescribed buspirone. Which statement by the client indicates a need for further teaching?
- A. I can stop taking this medication once I feel less anxious.
- B. I should avoid drinking alcohol while taking this medication.
- C. It may take several weeks for this medication to take full effect.
- D. This medication can cause dependency.
Correct Answer: A
Rationale: The correct answer is A because it indicates a misunderstanding about buspirone. Buspirone should not be abruptly stopped, and patients should follow the prescribed regimen consistently. Stopping the medication without proper guidance can lead to adverse effects or a return of anxiety symptoms. Choices B, C, and D demonstrate an understanding of important aspects of buspirone therapy: avoiding alcohol due to interactions, being patient for the medication to reach full effectiveness, and being aware of the potential for dependency with this medication.
A healthcare professional is assessing a client who has been diagnosed with schizophrenia and is exhibiting negative symptoms. Which of the following is an example of a negative symptom?
- A. Hallucinations
- B. Delusions
- C. Apathy
- D. Disorganized speech
Correct Answer: C
Rationale: Apathy is a negative symptom of schizophrenia characterized by a lack of interest or motivation. Negative symptoms involve a decrease or absence of normal functions, such as emotions, motivation, or socialization, rather than the presence of abnormal behaviors like hallucinations or delusions. Hallucinations (choice A) and delusions (choice B) are positive symptoms, which involve the presence of abnormal behaviors. Disorganized speech (choice D) is an example of a disorganized symptom, not a negative symptom.