Unit 4: Foundations of Psychiatric Nursing

During the mental status examination, a client may be asked to explain such proverbs as "Don't cry over spilled milk." The purpose of this is to evaluate the client's ability to think: - answer-abstractly. Abstract thinking is the ability to conceptualize and interpret meaning. It's a higher level of intellectual functioning than concrete thinking, in which the client explains the proverb by its literal meaning. Rational thinking involves the ability to think logically, make judgments, and be goal-directed. Tangential thinking is scattered, non-goal-directed, and hard to follow. Clients with such conditions as organic brain disease and schizophrenia typically can't conceptualize and comprehend abstract meaning. They interpret such statements as "Don't cry over spilled milk" in a literal sense, such as "Even if you spill your milk, you shouldn't cry about it." A client is complaining to other clients about not being allowed by staff to keep food in the client's room. What should the nurse do? - answer-Set limits on the behavior. The nurse needs to set limits on the client's manipulative behavior to help the client control dysfunctional behavior. The manipulative client bends rules to have needs met without regard for rules or the needs or rights of others. A consistent approach by the staff is necessary to decrease manipulation. Ignoring the client's behavior reinforces or promotes the continuation of the client's manipulative behavior. Reprimanding the client may be perceived as a threat, resulting in aggressive behavior. Allowing the client to keep a snack in the client's room reinforces the dysfunctional behavior. A nurse is counseling a married woman who has two children under 4 years of age and is a victim of spousal abuse. Before the client leaves the clinic, what is the most important thing the nurse should do? - answer-Help the client develop a safety plan. It is most important for the nurse to help the client develop a safety plan because the abuse will occur again, and the client will need a plan to seek a safe environment for