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Which of the following attitudes would be best for the nurse when the client who has schizophrenia acts as though the nurse is not trustworthy or that his or her integrity is being questioned?
- A. That the client is correct and the nurse is not trustworthy
- B. That the client wants to insult the nurse
- C. That the client's behavior is a part of the illness
- D. That the nurse's actions have failed
Correct Answer: C
Rationale: Recognizing suspicious behavior as part of schizophrenia avoids personalizing it, maintaining therapeutic objectivity, unlike assuming distrust or failure.
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One evening, a client with schizophrenia leaves his room and begins marching in the hall. When approached by the nurse, the client says, 'Goodays I'm supposed to guard the area.' Which of the following responses would be best?
- A. I understand you hear a voice. You and I are the only ones in the hall, and I don't hear a voice.
- B. The voices are part of your illness, and they will leave in time.
- C. This guarding responsibility can make you tired. You rest for now, and I'll guard a while.
- D. You are just imagining these things. Do not pay any attention to the voices.
Correct Answer: A
Rationale: Acknowledging the client's experience while presenting reality validates their perception without reinforcing the delusion, unlike dismissive or reinforcing responses.
A client with schizophrenia is attending a follow-up appointment at the community mental health clinic. The client reports to the nurse, 'I stopped taking the antipsychotic medication because I can't get a hard-on with my girlfriend anymore.' Which of the following should the nurse recommend to enhance the client's well-being?
- A. It sounds like that is a problem for you. Don't you still find her to be sexy enough?
- B. Sexual dysfunction is a temporary side effect and should get better once your body is used to the medication.
- C. You should avoid having sex with your girlfriend anyway. Do you really want her to get pregnant?
- D. It is important for you to take an antipsychotic medication. You may need a different type that will be less likely to affect your sexual functioning. I would like to call your physician about this.
Correct Answer: D
Rationale: Suggesting a medication change addresses sexual dysfunction, a common side effect, promoting adherence and well-being, unlike dismissive or inappropriate responses.
A client diagnosed with schizophrenia is laughing and talking while sitting alone. Which of the following is the best response by the nurse?
- A. Can you share your joke with me?
- B. To sit with the client quietly until the client is ready to talk
- C. Tell me what's happening.
- D. You look lonely here. Let's join the others in the day room.
Correct Answer: C
Rationale: Asking what's happening explores the client's experience, engaging them in reality-based interaction, unlike assuming loneliness, humor, or waiting silently.
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 college freshman is admitted to the hospital with a diagnosis of schizophrenia. Friends reported that she had been in her room for 2 days in a trance-like state, not eating nor speaking to anyone. Which of the following is the highest priority for this client?
- A. Assessing fluid intake and output
- B. Completing an assessment of mental status
- C. Obtaining more data about her college experiences
- D. Providing for adequate rest
Correct Answer: A
Rationale: Assessing fluid intake and output prioritizes physiologic homeostasis, critical for a client not eating, over mental status, rest, or background data.