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When planning care for a client with schizophrenia, which of the following interventions should be included in the plan of care?
- A. Encourage reality testing
- B. Provide opportunities for socialization
- C. Monitor for command hallucinations
- D. Promote adherence to medication regimen
Correct Answer: A
Rationale: When caring for a client with schizophrenia, encouraging reality testing is essential. This intervention assists the client in distinguishing between delusions and reality, aiding in their treatment. While providing opportunities for socialization can help reduce isolation, monitoring for command hallucinations is crucial for the client's safety. Promoting adherence to the medication regimen is vital for symptom management. Addressing delusional thoughts in a therapeutic manner is preferable to outright discouragement, fostering a supportive environment for the client.
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A client has been prescribed diazepam (Valium) for the treatment of anxiety. Which of the following instructions should the nurse include in the discharge teaching?
- A. Avoid drinking alcohol while taking this medication.
- B. Take the medication with food to avoid stomach upset.
- C. Stop taking the medication if you feel better.
- D. Double the dose if you miss a dose.
Correct Answer: A
Rationale: The correct instruction is to avoid drinking alcohol while taking diazepam (Valium) as it can potentiate the sedative effects and increase the risk of side effects such as drowsiness and dizziness. Taking the medication with food may help reduce stomach upset, but avoiding alcohol is crucial to ensure safe and effective use of diazepam. Choice B is partially correct, as taking the medication with food can indeed help with stomach upset, but it is not as crucial as avoiding alcohol. Choice C is incorrect because abruptly stopping diazepam can lead to withdrawal symptoms and should only be done under medical supervision. Choice D is incorrect as doubling the dose is dangerous and should never be done without healthcare provider approval.
A healthcare professional is assessing a client diagnosed with narcissistic personality disorder. Which of the following behaviors should the healthcare professional expect?
- A. Grandiose sense of self-importance
- B. Lack of empathy
- C. Need for excessive admiration
- D. Envy of others
Correct Answer: A
Rationale: Clients with narcissistic personality disorder often exhibit a grandiose sense of self-importance, believing they are special and unique. This behavior is characterized by an exaggerated sense of achievements and talents, expecting to be recognized as superior without commensurate achievements. While individuals with this disorder may lack empathy and have a need for excessive admiration, the prominent feature of grandiosity is a core aspect of narcissistic personality disorder. Therefore, the correct behavior expected in this case is a grandiose sense of self-importance (Choice A). Lack of empathy (Choice B) and need for excessive admiration (Choice C) are also common traits in narcissistic personality disorder, but they are not the primary behavior associated with the disorder. Envy of others (Choice D) is not a characteristic behavior typically seen in individuals with narcissistic personality disorder.
A healthcare professional is assessing a client with major depressive disorder. Which of the following findings should the professional expect? Select one that does not apply.
- A. Anhedonia
- B. Hypersomnia
- C. Fatigue
- D. Flight of ideas
Correct Answer: D
Rationale: In major depressive disorder, common findings include anhedonia (loss of interest or pleasure), hypersomnia (excessive sleepiness), fatigue, and feelings of worthlessness. Flight of ideas, characterized by racing thoughts and rapid speech, is more commonly associated with bipolar disorder, particularly during manic episodes. Therefore, 'Flight of ideas' does not apply to the expected findings in major depressive disorder.
A client is being taught relaxation techniques to manage anxiety. Which of the following techniques should be included in the teaching? Select one that does not apply.
- A. Deep breathing exercises
- B. Progressive muscle relaxation
- C. Mindfulness meditation
- D. Cognitive restructuring
Correct Answer: D
Rationale: Relaxation techniques commonly used to manage anxiety include deep breathing exercises, progressive muscle relaxation, mindfulness meditation, and guided imagery. Cognitive restructuring, on the other hand, is a cognitive-behavioral technique used to challenge and change negative thought patterns, not specifically a relaxation technique. Therefore, choice D, cognitive restructuring, does not apply to relaxation techniques for managing anxiety.
A physically and emotionally healthy client has just been fired. During a routine office visit, he states to a nurse: 'Perhaps this was the best thing to happen. Maybe I'll look into pursuing an art degree.' How should the nurse characterize the client's appraisal of the job loss stressor?
- A. Irrelevant
- B. Harm/loss
- C. Threatening
- D. Challenging
Correct Answer: D
Rationale: The client's statement indicates that he views the job loss as an opportunity for growth and a new direction in life rather than a threat or harm/loss. He sees it as a challenge and is considering it positively, demonstrating resilience and adaptability in the face of adversity. Choice A, 'Irrelevant,' is incorrect as the client's response shows relevance and a positive outlook. Choice B, 'Harm/loss,' is incorrect as the client does not express a sense of harm or loss but rather opportunity. Choice C, 'Threatening,' is incorrect as the client's response does not convey fear or threat but rather a positive reframe of the situation.