A client diagnosed with schizophrenia states, Can't you hear him? Its the devil. He's telling me I'm going to hell. Which is the most appropriate nursing reply?
Did you take your medicine this morning?
i'm sure the voices sound scary, I don't hear any voices speaking
The devil only talks to people who are receptive to his influence
You are not going to hell. You are a good person
The Correct Answer is B
A. "Did you take your medicine this morning?": While medication adherence is important, this response does not directly address the client's distress or validate their experience. It may come across as dismissive.
B. "I'm sure the voices sound scary, I don't hear any voices speaking.": This response acknowledges the client's experience without confirming or denying the presence of the voices. It expresses empathy and provides reassurance, fostering a therapeutic relationship.
C. "The devil only talks to people who are receptive to his influence": This response introduces a belief system that may not align with the client's reality and could be perceived as judgmental. It's important to avoid imposing personal beliefs on clients experiencing hallucinations.
D. "You are not going to hell. You are a good person": While expressing support and reassurance is positive, making definitive statements about the client's fate or goodness may not be helpful. It's more effective to acknowledge the distress without making absolute affirmations.
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Related Questions
Correct Answer is D
Explanation
A. Tactile hallucinations: Benztropine is not typically indicated for the treatment of tactile hallucinations. It is primarily used to manage extrapyramidal symptoms (EPS) associated with antipsychotic medications.
B. Reports of hearing disturbing voices: Benztropine is not the first-line treatment for auditory hallucinations in schizophrenia. Antipsychotic medications, such as haloperidol, are more commonly used for this purpose.
C. Hypotension: Benztropine is not used to treat hypotension. It is used to manage extrapyramidal symptoms, such as rigidity and restlessness, that may result from antipsychotic medication use.
D. Restlessness and muticle rigidity: This is the correct answer. Benztropine is an anticholinergic medication that can help alleviate extrapyramidal symptoms (EPS) caused by antipsychotic drugs like haloperidol. Restlessness and muticle rigidity are symptoms of EPS, and benztropine can be used to counteract these side effects.
Correct Answer is A
Explanation
Orientation: When a nurse asks a client to identify their name, date, residential address, and situation, they are assessing the client's orientation. Orientation refers to an individual's awareness of time, place, person, and situation.
B. Affect: Affect refers to the observable expression of emotions. It involves the client's emotional tone, such as being happy, sad, angry, or flat. It is not directly assessed by asking about personal information.
C. Perception: Perception involves the way individuals interpret and make sense of sensory information. Asking about personal information is more related to orientation than perception.
D. Mood: Mood refers to a more sustained emotional state. It is not directly assessed by asking for specific personal information about the current situation or location.
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