A client on an acute mental health unit states to a nurse. "Tie a bow. Row the boat. Now I know. Whoa! I see you, yo." The nurse should document that the client is exhibiting which of the following speech alterations?

Echolalia

Word salad

Clang association

Neologisms

Answer and Explanation

The Correct Answer is C

A. Echolalia refers to the repetition of words spoken by another person.

B. Word salad is a mix of random, unrelated words with no logical connection.

C. This is the correct answer. Clang association involves rhyming words that are spoken together without meaningful connections, as seen in the client's statement.

D. Neologisms are made-up words that have meaning only to the individual.

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Correct Answer is D

Explanation

A. Close the doors and windows on the unit – While containing the fire is important, it is not the first priority. Activating the fire alarm ensures facility-wide response and safety protocols.

B. Activate the fire alarm system – This is the first action because it alerts emergency responders and allows evacuation protocols to begin. Timely activation prevents the fire from spreading and ensures prompt intervention.

C. Obtain and use a fire extinguisher – Fire extinguishers are used only for small, contained fires and should be handled by trained personnel after activating the alarm.

D. Evacuate clients from the area – While evacuation is critical, activating the fire alarm ensures a coordinated evacuation plan rather than causing panic.

A. Empty the collection chamber every 8 hr. B. Check the patency of the tubing every 2 hr. C. Keep the drainage system above the level of the client's chest. D. Ensure 2 cm (0.8 in) of water is in the water seal chamber.

Correct Answer is D

Explanation

A. Empty the collection chamber every 8 hr – Incorrect. The collection chamber is not emptied; instead, it is replaced when full to prevent air re-entry.

B. Check the patency of the tubing every 2 hr – While monitoring the tubing is essential, checking patency is not the most specific nursing priority.

C. Keep the drainage system above the level of the client's chest – Incorrect. The system should remain below chest level to prevent backflow of drainage.

D. Ensure 2 cm (0.8 in) of water is in the water seal chamber – Correct. The water seal chamber maintains negative pressure and prevents air from entering the pleural space, making this a crucial step in chest tube management.

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A client on an acute mental health unit states to a nurse. "Tie a bow. Row the boat. Now I know. Whoa! I see you, yo." The nurse should document that the client is exhibiting which of the following speech alterations?

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