HESISaundersOnlineReviewfortheNclex-RNExamination 2
Year, 3rd Edition Module 4 Exam
mm(CapscareAcademyforHealthCareEducation)
ScantoopenonStudocu
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, HESI/SaundersOnlineReviewfortheNCLEX-RNExamination(2Year),3rd
EditionModule4Exam
1. Module4Exam
1. 1.ID:21083973130
Aclient with schizophrenia says, “I’m away for the day ... but don’t think
we shouldplayordowehavefeetofclay?”Whichalterationintheclient’sspeech
does the nurse document?
▪ Neologism
▪ Wordsalad
▪ ClangassociationCorrect
▪ Associativelooseness
Rationale:Clang association is the meaningless rhyming of words in
which the
rhymingismoreimportantthanthecontextofthewords.Aneologismisamade-
up word that has meaning only to theclient.Word salad is thetermfor
amixture of meaningless phrases, either to the client or to the
listener.Associative looseness is a term used to describe schizophrenic
speech in which connections and threads are interrupted or missing.
Test-TakingStrategy:Knowledge of the speech patterns exhibited by the
client
withschizophreniaisneededtoanswerthisquestion.Focusonthesubjectinth
e question, the meaningless rhyming of words.
Review:thesespeechpatterns.
Reference:Varcarolis,E.,&Halter,M.(2009).
Essentialsofpsychiatricmentalhealthnursing:Acommunicationapproacht
oevidence-basedcare(p.281).St. Louis: Saunders.
LevelofCognitiveAbility:Applying
ClientNeeds:PsychosocialIntegrity
IntegratedProcess:CommunicationandDocumentation
ContentArea:MentalHealth
GiddensConcepts:Communication,Psychosis
HESIConcepts:Cognition
Awarded100.0pointsoutof100.0possiblepoints.
Downloaded by david murimi ()
,2. 2.ID:21083973127
Aclientwithschizophreniaandhisparentsaremeetingwiththenurse.Oneofthe
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?
▪
Tellingtheparents,“Medicationnoncomplianceisthemostfrequent
reason that people with this diagnosis relapse.”
▪ Tellingtheparents,“Well,it’shisdecisiontotakehismedicine,but
it’s yours to have him live with you if he stops the medication.”
▪ Askingtheclient,“Howcanwehelpyoutotakeyourmedicineorto
tell us when you’re having problems so that your medication can
be adjusted?” Correct
▪ Saying to the parents, “Your concerns are appropriate, but I
wonder
whetheryoursonwashavingtroubletellingsomeonethathehadconcer
ns about his medication.”
Rationale:The therapeutic response is the one in which the nurse models
speaking directly to the client. This facilitates further assessment of the
situation
andhelpselicitthecausesofandmotivationsfortheclient’sbehaviorforboththe
nurseandthefamily.Inthecorrectoption,thenursealsoseeksclarificationofthe
degree of openness and mutuality felt by the client and his family toward
each other. The nurse provides information to the family when stating that
noncompliance is the most frequent reason for relapse in people with this
diagnosis. However, the statement is nontherapeutic at this time because
it does not facilitate the expression of feelings. The nurse uses a
superego style of
communicationwhenstating,“Well,it’shisdecisiontotakehismedicine,butit’s
yours to have him live with you if he stops the medication.” The content of
this statement may be true, but it is nontherapeutic in that it carries a
threatening message and may prevent the family from trusting the nurse.
By stating, “Your concerns are appropriate, but I wonder whether your son
was having trouble telling someone that he had concerns about his
medication,” the nurse gives approval and prematurely analyzes the
client’s motivation without sufficient assessment.
Test-TakingStrategy:Use your knowledge of
therapeuticcommunicationtechniquesand remember to focus on the
client’s feelings.Also note that the
correctoptionistheonlyoptioninwhichthenursedirectlyaddressestheclient.
Review:therapeutic communication techniques .
Reference:Stuart,G.(2009).Principles&practiceofpsychiatricnursing(9th
ed., pp. 27-31). St. Louis: Mosby.
Varcarolis, E., & Halter, M. (2009).
Essentialsofpsychiatricmentalhealthnursing:Acommunicationapproachto
Downloaded by david murimi ()
, evidence-basedcare(p.297).St.Louis:
Downloaded by david murimi ()
Year, 3rd Edition Module 4 Exam
mm(CapscareAcademyforHealthCareEducation)
ScantoopenonStudocu
Downloaded by david murimi ()
, HESI/SaundersOnlineReviewfortheNCLEX-RNExamination(2Year),3rd
EditionModule4Exam
1. Module4Exam
1. 1.ID:21083973130
Aclient with schizophrenia says, “I’m away for the day ... but don’t think
we shouldplayordowehavefeetofclay?”Whichalterationintheclient’sspeech
does the nurse document?
▪ Neologism
▪ Wordsalad
▪ ClangassociationCorrect
▪ Associativelooseness
Rationale:Clang association is the meaningless rhyming of words in
which the
rhymingismoreimportantthanthecontextofthewords.Aneologismisamade-
up word that has meaning only to theclient.Word salad is thetermfor
amixture of meaningless phrases, either to the client or to the
listener.Associative looseness is a term used to describe schizophrenic
speech in which connections and threads are interrupted or missing.
Test-TakingStrategy:Knowledge of the speech patterns exhibited by the
client
withschizophreniaisneededtoanswerthisquestion.Focusonthesubjectinth
e question, the meaningless rhyming of words.
Review:thesespeechpatterns.
Reference:Varcarolis,E.,&Halter,M.(2009).
Essentialsofpsychiatricmentalhealthnursing:Acommunicationapproacht
oevidence-basedcare(p.281).St. Louis: Saunders.
LevelofCognitiveAbility:Applying
ClientNeeds:PsychosocialIntegrity
IntegratedProcess:CommunicationandDocumentation
ContentArea:MentalHealth
GiddensConcepts:Communication,Psychosis
HESIConcepts:Cognition
Awarded100.0pointsoutof100.0possiblepoints.
Downloaded by david murimi ()
,2. 2.ID:21083973127
Aclientwithschizophreniaandhisparentsaremeetingwiththenurse.Oneofthe
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?
▪
Tellingtheparents,“Medicationnoncomplianceisthemostfrequent
reason that people with this diagnosis relapse.”
▪ Tellingtheparents,“Well,it’shisdecisiontotakehismedicine,but
it’s yours to have him live with you if he stops the medication.”
▪ Askingtheclient,“Howcanwehelpyoutotakeyourmedicineorto
tell us when you’re having problems so that your medication can
be adjusted?” Correct
▪ Saying to the parents, “Your concerns are appropriate, but I
wonder
whetheryoursonwashavingtroubletellingsomeonethathehadconcer
ns about his medication.”
Rationale:The therapeutic response is the one in which the nurse models
speaking directly to the client. This facilitates further assessment of the
situation
andhelpselicitthecausesofandmotivationsfortheclient’sbehaviorforboththe
nurseandthefamily.Inthecorrectoption,thenursealsoseeksclarificationofthe
degree of openness and mutuality felt by the client and his family toward
each other. The nurse provides information to the family when stating that
noncompliance is the most frequent reason for relapse in people with this
diagnosis. However, the statement is nontherapeutic at this time because
it does not facilitate the expression of feelings. The nurse uses a
superego style of
communicationwhenstating,“Well,it’shisdecisiontotakehismedicine,butit’s
yours to have him live with you if he stops the medication.” The content of
this statement may be true, but it is nontherapeutic in that it carries a
threatening message and may prevent the family from trusting the nurse.
By stating, “Your concerns are appropriate, but I wonder whether your son
was having trouble telling someone that he had concerns about his
medication,” the nurse gives approval and prematurely analyzes the
client’s motivation without sufficient assessment.
Test-TakingStrategy:Use your knowledge of
therapeuticcommunicationtechniquesand remember to focus on the
client’s feelings.Also note that the
correctoptionistheonlyoptioninwhichthenursedirectlyaddressestheclient.
Review:therapeutic communication techniques .
Reference:Stuart,G.(2009).Principles&practiceofpsychiatricnursing(9th
ed., pp. 27-31). St. Louis: Mosby.
Varcarolis, E., & Halter, M. (2009).
Essentialsofpsychiatricmentalhealthnursing:Acommunicationapproachto
Downloaded by david murimi ()
, evidence-basedcare(p.297).St.Louis:
Downloaded by david murimi ()
