Nokea
While sitting in the day-room of the mental health unit, a male adolescent avoids eye contact, looks at the floor, and talks softly when interacting verbally with the nurse. The two trade places, and the nurse demonstrates the client's behaviors. Which is the main goal of this therapeutic technique?
- A. Initiate a non-threatening conversation with the client
- B. Allow the client to identify the way he interacts
- C. Dialog about the ineffectiveness of his interactions
- D. Discuss the client's feelings when he responds
Correct Answer: B
Rationale: The technique aims to allow the client to observe his own behaviors, fostering self-awareness. Initiating conversation, dialoguing about ineffectiveness, or discussing feelings are secondary to promoting insight through self-observation.
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History and physical
The client is a 19-year-old male who is in the emergency room for a leg injury. He states he was returning to his dorm from a party and fell about 5 feet (1.5 meters) into a small ravine on campus.
The client states that he drinks socially and takes no medications for any health condition
In order to help the client disclose a situation that is upsetting to him, what therapeutic communication tools could the nurse use? Select all that apply.
- A. Wait until the client is completely calm
- B. Ask difficult questions first to get them out of the way
- C. Use silence as a tool
- D. Speak with the client in private
- E. Observe nonverbal behavior and react accordingly
- F. Ask several questions in a row
Correct Answer: A,C,D,E
Rationale: A: Waiting until the client is calm fosters a safe environment. C: Silence allows the client time to process thoughts. D: Privacy ensures confidentiality and comfort. E: Observing nonverbal behavior provides emotional cues. B: Difficult questions first may increase anxiety. F: Multiple questions can overwhelm the client.
The nurse continues to care for the patient
The client is a 19-year-old male who is in the emergency room for a leg injury. He states he was returning to his dorm from a party and fell about 5 feet (1.5 meters) into a small ravine on campus. The client states that he drinks socially and takes no medications for any health condition.
The nurse is listening to the client.
Because the client is a male, he is especially at risk for which psychosocial two sequalae of sexual assault?
- A. Suicide
- B. Depression
- C. Post-traumatic stress disorder
- D. Becoming an abuser
- E. Human immunodeficiency virus
- F. Chlamydia
Correct Answer: B,C
Rationale: B: Depression is common post-sexual assault due to psychological trauma. C: PTSD is frequent, with symptoms like flashbacks and anxiety. A: Suicide is a risk but not male-specific. D: Becoming an abuser is less common. E, F: HIV and chlamydia are physical, not psychosocial, risks.
Which is the best approach for the nurse to use when interviewing a client about suicidal ideations?
- A. Share personal values to put the client at ease
- B. Ask questions in a vague, non-specific format
- C. Begin with questions that are less sensitive in nature
- D. Get the most difficult questions over with first
Correct Answer: C
Rationale: Beginning with less sensitive questions allows the client to gradually build trust and rapport with the nurse before addressing more sensitive topics like suicidal ideation. Sharing personal values may blur professional boundaries. Vague questions may not yield accurate information. Starting with difficult questions may overwhelm the client and hinder trust.
A client with schizophrenia returns to the clinic two weeks after receiving a prescription for haloperidol. To assess for neuroleptic malignant syndrome (NMS), which information is most important for the nurse to obtain during this visit?
- A. Current vital signs
- B. White blood cell count
- C. 24-hour urinary output
- D. Blood sugar level
Correct Answer: A
Rationale: Current vital signs are critical for assessing NMS, a life-threatening side effect of haloperidol, indicated by fever, unstable blood pressure, and tachycardia. White blood cell count, urinary output, and blood sugar are less specific to NMS.
A client with a history of alcoholism is admitted for detoxification. Based on treatment protocol, the nurse gives the client a dose of lorazepam 6 mg. Which additional prescription should the nurse administer immediately?
- A. Folic Acid
- B. Haloperidol
- C. Trazodone
- D. Vitamin B1
Correct Answer: D
Rationale: Vitamin B1 (thiamine) is crucial in alcohol detoxification to prevent Wernicke's encephalopathy and Korsakoff's syndrome due to thiamine deficiency. Folic acid is beneficial but not immediate. Haloperidol and trazodone are not indicated for detoxification.