A 16-year-old client diagnosed with schizophrenia disorder experiences command hallucinations to harm others. The client's parents ask a nurse, "Where do the voices come from?" Which is the appropriate nursing response?

"There is a chemical imbalance of the brain, which leads to altered perceptions."

"The hallucinations are caused by medication interactions."

"There is too little serotonin in the brain, causing delusions and hallucinations."

Abnormal hormonal changes have precipitated auditory hallucinations."

Answer and Explanation

The Correct Answer is A

a. "There is a chemical imbalance of the brain, which leads to altered perceptions." Schizophrenia is a complex mental health disorder with a strong biological component. While the exact cause is unknown, it's believed to involve abnormalities in brain chemistry and neurotransmitters. This is a general explanation that avoids going into too much detail but acknowledges the biological basis of hallucinations.
b. "The hallucinations are caused by medication interactions." Hallucinations are a core symptom of schizophrenia and not necessarily caused by medication interactions.
c. "There is too little serotonin in the brain, causing delusions and hallucinations." While serotonin might be involved in schizophrenia, it's not the only neurotransmitter implicated.
d. Abnormal hormonal changes have precipitated auditory hallucinations." Hormonal changes might influence mood, but they are not the primary cause of auditory hallucinations in schizophrenia.

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Correct Answer is C

Explanation

a. "Where do you buy your food?" While this provides information about food access, it doesn’t directly assess nutritional intake.
b. "Does someone else prepare your meals?" This might provide insight into the client's independence, but it doesn't directly assess nutritional intake.
c. "Tell me what you eat in a typical day." This directly assesses the client’s dietary intake and provides a comprehensive view of their nutrition status.
d. "Are you taking any medications that change your taste of foods?" This is relevant but more specific to one aspect of dietary intake. It does not provide a full picture of the client’s nutritional status like option c.

A. question the client about choices. B. explore problem-solving alternatives. C. express approval or disapproval of the client's thoughts. D. give the client good advice.

Correct Answer is B

Explanation

a. question the client about choices: This might seem confrontational and does not directly help the client with stressors.
b. explore problem-solving alternatives. This is the most therapeutic purpose. Providing feedback helps the client to consider different ways to address and manage their stressors.
c. express approval or disapproval of the client's thoughts: Expressing approval or disapproval is not therapeutic and can inhibit open communication.
d. give the client good advice: Giving advice is not as effective as helping the client develop their own problem-solving skills.

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A 16-year-old client diagnosed with schizophrenia disorder experiences command hallucinations to harm others. The client's parents ask a nurse, "Where do the voices come from?" Which is the appropriate nursing response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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