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Exam (elaborations)

Module 4 Exam Questions With Correct Answers

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A schizophrenic client says, "I'm away for the day ... but don't think we should play ... or do we have feet of clay?" Which alteration in the client's speech does the nurse document? CORRECT ANSWER Clang association A client with schizophrenia and his parents are meeting with the nurse. One of the young man's parents says to the nurse, "We were stunned when we learned that our son had schizophrenia. He was no different than from his older brother when they were growing up. Now he's had another relapse, and we can't understand why he stopped his medication." Which response by the nurse is appropriate? CORRECT ANSWER Client, "How can we help you to take your medicine or to tell us when you're having problems so that your medication can be adjusted?" An acutely ill schizophrenic client says to the nurse, "He keeps saying that he likes you, and I keep telling him you're married, but he won't listen, and I think he's going to get fresh with you." Once the nurse has determined that the client is hallucinating, which response to the client would be most appropriate statement? CORRECT ANSWER A "Try not to listen to the voices right now so that I can talk with you." Rationale: The appropriate statement by the nurse is the one that does not acknowledge the client's hallucinations. By responding, "I think that you can help him stop his behavior if you concentrate" or "Tell him I said to mind his p's and q's or I'll call the police on him," the nurse acknowledges the hallucinations. The nurse attempts to interpret the client's thinking with a statement such as "I think that you're trying to share your own feelings toward me, but you're shy." A client says to the nurse, "It's over for me — the whole thing is over." Which response by the nurse would be therapeutic? CORRECT ANSWER "Let's talk more about your feeling that the whole thing is over for you. This is important, and I may need to share your feelings with other staff members." Rationale: The therapeutic response seeks clarification, employs paraphrasing, and informs the client that the nurse needs to share any information that requires crisis intervention with other staff members. Asking, "What do you mean, 'The whole thing is over'?" employs paraphrasing, but the message is blunt and closed-ended. In stating, "Over? Well, that sounds pretty drastic to me. Let's discuss this in the strictest confidence," the nurse uses hysterical exaggeration (at an inappropriate time) and gives incorrect information regarding confidentiality. In stating, "Can you tell me more about why it's over for you? I'll keep your thoughts strictly confidential," the nurse uses the therapeutic technique of seeking clarification but does not clarify with the client that the information might need to be shared.


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