A client that is homeless, well-educated, and has chronic schizophrenia is admitted to the mental health unit when found by the police walking in the middle of the street. The client presents with a strong body odor, dirty clothes, and avolition. After a week of neuroleptic drug therapy, the client discusses with the nurse thoughts about bathing. Which statement suggests that the client is progressing?

I know that bathing helps prevent infectious diseases.

Others say I am dirty and smell badly, so I will bathe.

I will take a bath today as requested.

I feel good when I take care of myself.

Answer and Explanation

The Correct Answer is D

Choice A rationale: "I know that bathing helps prevent infectious diseases" is a factual statement but may not necessarily reflect progress in the client's overall functioning and engagement in self-care. It focuses on the practical aspect of bathing rather than the client's motivation and insight.

Choice B rationale: "Others say I am dirty and smell badly, so I will bathe" suggests an external motivation rather than intrinsic motivation. Progress is better indicated when the client expresses a personal desire to engage in self-care activities.

Choice C rationale: "I will take a bath today as requested" indicates compliance with external requests rather than an internal desire to care for oneself. It is essential to foster the client's intrinsic motivation for self-care.

Choice D rationale: "I feel good when I take care of myself" reflects an internal motivation and positive reinforcement associated with self-care. This statement suggests progress in the client's willingness to engage in personal hygiene activities.

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Correct Answer is B

Explanation

Choice A rationale: Telling the client they are out of control may escalate the situation and provoke further aggression. It is not a therapeutic or de-escalation technique.

Choice B rationale: Staying quietly with the client is a calm and non-confrontational approach. It allows the client to express emotions while conveying a supportive presence.

Choice C rationale: Distracting the client by offering finger foods may not be appropriate during a shouting episode, as it may be perceived as dismissive of the client's feelings or concerns.

Choice D rationale: Ignoring the client's acting-out behavior is not the best option. The nurse should acknowledge the client's emotions and provide support rather than ignoring the distress.

A. Changes thought patterns related to problem solving. B. Describes how the family can resolve problems. C. Relates insight into problematic relationships. D. Demonstrates a healthy relationship with husband.

Correct Answer is A

Explanation

Choice A rationale: Changes in thought patterns related to problem-solving demonstrate the effectiveness of cognitive-behavioral techniques. Shifting from hopelessness to active problem-solving reflects positive progress.

Choice B rationale: Describing how the family can resolve problems may involve other therapeutic modalities, but it is not specific to evaluating the effectiveness of cognitive behavioral techniques.

Choice C rationale: Relating insight into problematic relationships is a broad goal and may not specifically measure the impact of cognitive-behavioral techniques. Choice D rationale: Demonstrating a healthy relationship with the husband is an important goal but is not directly related to the evaluation of cognitive-behavioral techniques.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client admitted to the mental health unit starts to shout and scream at the nurse. Which approach is best for the nurse to take?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

A client who has been taking clozapine reports experiencing a sore throat and has a temperature of 101.9° F (38.8° C). Which action should the nurse take?

The nurse is providing care for a client diagnosed with a borderline personality disorder who has self-inflicted lacerations on the abdomen. Which approach should the nurse use when changing this client's dressings?

A client who experiences memory loss is diagnosed with Wernicke encephalopathy caused by alcohol addiction. Which intervention is most important for the nurse to implement?

Which goal has the highest priority for an adolescent client who is hospitalized for weight loss related to anorexia nervosa?

The nurse is reviewing an intake mental health assessment with a client who is seeking services for depression. The client reports feeling dizzy, excessively tired, experiencing headaches, and back pain. Which symptom should the nurse suspect is related to the client's feelings of depression?

A college student is admitted to the mental health unit following a drug overdose. The student tells the nurse about the overdose following the end of a romantic relationship. Which is the primary goal for hospitalization that should be included in this client's plan of care?

A client with chronic alcoholism receives a prescription for disulfiram. Which client statement indicates that this medication teaching has been effective?