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.
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After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, 'You are incompetent!' Which is the nurse's best response?
- A. Do you believe that I was the cause of your blood test being canceled?
- B. I see that you are upset, but I feel uncomfortable when you swear at me.
- C. Have you ever thought about ways to express anger appropriately?
- D. I'll give you some space. Let me know if you need anything.
Correct Answer: B
Rationale: In this scenario, the most appropriate response for the nurse is option B. By acknowledging the client's feelings and setting a boundary regarding inappropriate behavior, the nurse addresses the situation with empathy. This response demonstrates understanding of the client's emotions while also maintaining a professional standard by expressing discomfort with swearing. Option A could come off as defensive and may escalate the situation. Option C may be perceived as condescending and not immediately address the client's behavior. Option D, although offering space, does not directly address the inappropriate behavior and misses an opportunity to set a professional boundary.
After a client with major depressive disorder undergoes electroconvulsive therapy (ECT), which of the following is a priority assessment for the nurse?
- A. Monitoring for signs of infection
- B. Monitoring for signs of respiratory distress
- C. Monitoring for signs of hypotension
- D. Monitoring for signs of bleeding
Correct Answer: B
Rationale: The priority assessment for the nurse after a client undergoes electroconvulsive therapy (ECT) is monitoring for signs of respiratory distress. This is crucial due to the potential risk of complications from anesthesia, such as airway compromise or respiratory depression. Prompt identification and intervention in case of respiratory distress are essential to ensure the client's safety and well-being. Monitoring for signs of infection (Choice A) is important but not the priority immediately post-ECT. Hypotension (Choice C) and bleeding (Choice D) are also potential concerns but assessing respiratory distress takes precedence due to the immediate risk it poses to the client's well-being.
A healthcare provider is evaluating the effectiveness of medication therapy for a client diagnosed with bipolar disorder. Which outcome should indicate that the medication has been effective?
- A. The client reports a decrease in manic episodes.
- B. The client experiences fewer mood swings.
- C. The client sleeps for 8 hours each night.
- D. The client maintains a stable weight.
Correct Answer: A
Rationale: A decrease in manic episodes is a key indicator of the effectiveness of medication therapy for bipolar disorder. Manic episodes are a hallmark of bipolar disorder, and a decrease in their frequency or intensity suggests that the medication is helping to stabilize the client's mood and manage their symptoms. While choices B, C, and D are important aspects of overall health and well-being, they are not specific indicators of the effectiveness of medication therapy for bipolar disorder. Choice B focuses on mood swings in general, which may include depressive episodes as well, while choice C addresses sleep patterns and choice D relates to weight stability, which can be influenced by various factors unrelated to bipolar disorder treatment.
When caring for a client with anorexia nervosa in a psychiatric unit, which intervention should the nurse implement to address the client's nutritional needs?
- A. Provide small, frequent meals throughout the day.
- B. Monitor the client's weight daily.
- C. Offer a liquid supplement if the client refuses solid food.
- D. Encourage the client to choose from a variety of food options.
Correct Answer: A
Rationale: Providing small, frequent meals throughout the day is a crucial intervention when caring for a client with anorexia nervosa. This approach helps in gradually increasing caloric intake and meeting the client's nutritional needs. Offering large meals can be overwhelming and may contribute to anxiety in these clients. By providing small, frequent meals, the nurse supports the client in establishing a healthier eating pattern and aids in the restoration of adequate nutrition levels. Monitoring the client's weight daily (Choice B) may exacerbate anxiety related to body image and weight, which are common concerns in anorexia nervosa. Offering a liquid supplement if the client refuses solid food (Choice C) may not address the underlying issues related to food aversion and may not provide the necessary nutrients in a balanced way. Encouraging the client to choose from a variety of food options (Choice D) may be overwhelming for someone with anorexia nervosa and could lead to increased anxiety around food choices.
A healthcare provider is caring for a client diagnosed with schizophrenia. Which intervention is most appropriate to address the client's delusions?
- A. Challenge the client's delusions directly.
- B. Provide evidence to disprove the delusions.
- C. Acknowledge the client's feelings without reinforcing the delusions.
- D. Ignore the client's delusions.
Correct Answer: C
Rationale: When caring for a client with schizophrenia experiencing delusions, the most appropriate intervention is to acknowledge the client's feelings without reinforcing the delusions. This approach helps maintain trust and communication, fostering a therapeutic relationship. Challenging the delusions directly can lead to increased distress and resistance from the client. Providing evidence to disprove the delusions may not be effective due to the deeply ingrained nature of the client's beliefs. Ignoring the delusions may make the client feel dismissed or unheard, which can hinder the therapeutic process.