A male client is attending an after-school, adolescent group session because he frequently loses his temper, argues with his teachers, and refuses to comply with classroom rules. During the group session, the adolescent repeatedly blames others regardless of the situation. To help modify the adolescent's behavior, which action should the nurse implement?

Describe the consequences of his behavior in concrete terms.

Encourage the client to verbalize his feelings of anger.

Ignore blaming behavior and praise the client's appropriate behavior.

Explain that blaming others limits his psychological growth.

Answer and Explanation

The Correct Answer is A

A) Describing the consequences of the adolescent's behavior in concrete terms is the best action. This approach helps the client understand the direct impact of his actions on himself and others. Clear and specific explanations can facilitate accountability and encourage the adolescent to reflect on how his behavior affects his relationships and environment, which is essential for behavior modification.

B) Encouraging the client to verbalize his feelings of anger may provide an outlet for his emotions, but it does not directly address the problematic behavior of blaming others. While exploring feelings is important, it should be paired with teaching responsibility and consequences for behavior.

C) Ignoring blaming behavior and praising appropriate behavior might reinforce a lack of accountability. While positive reinforcement is beneficial, it is crucial to address negative behaviors directly to facilitate change. Ignoring the blaming behavior could lead to its continuation.

D) Explaining that blaming others limits his psychological growth could be insightful, but it may not resonate with the adolescent or lead to immediate behavior change. The focus should be on concrete consequences that he can understand and relate to, which can encourage more constructive behaviors.

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Correct Answer is D

Explanation

A) Sitting within two feet of the client may enhance feelings of safety and security for some individuals, but for others, it could feel intrusive or overwhelming. Establishing an appropriate personal distance is essential, and too close of a proximity might create discomfort, especially in a mental health setting where clients may already feel vulnerable.

B) Dimming the lights in the room can create a calming atmosphere; however, excessive dimness might hinder visibility and affect communication. While lighting can influence mood, it’s crucial to strike a balance that allows the client to feel comfortable without compromising the ability to engage effectively during the interview.

C) Positioning a table between the client and the nurse may provide a sense of personal space, but it can also create a physical barrier that may hinder open communication and rapport-building. Establishing a connection is important in mental health interviews, and a table might inadvertently foster feelings of separation or defensiveness.

D) Reducing the noise level in the room by turning off the television and radio is the most effective approach to facilitate the interview. A quiet environment minimizes distractions, allowing both the nurse and the client to focus on the conversation. This fosters a safe and supportive atmosphere where the client feels heard and respected, which is crucial for building trust and promoting an effective therapeutic interaction.

A. Move to a quiet area and provide peanut butter with crackers. B. Encourage the spouse to eat lunch with the client. C. Walk with the client to the cafeteria and stay while client eats. D. Request a full lunch tray from the dietary department.

Correct Answer is C

Explanation

A) Moving to a quiet area and providing peanut butter with crackers may help address the client’s nutritional needs, but it may not adequately address the client’s agitation and pacing. The immediate priority is to stabilize the client’s behavior before focusing on nutrition.

B) Encouraging the spouse to eat lunch with the client may create an opportunity for social interaction, but it might not be effective in calming the client’s agitation. If the client is already highly agitated, the spouse's presence alone may not help diffuse the situation.

C) Walking with the client to the cafeteria and staying while the client eats is the best intervention at this time. This approach allows the nurse to provide a calming presence and guidance while encouraging the client to eat. It also helps redirect the client's energy and agitation into a structured activity, promoting both physical movement and nutrition, which is crucial after several days without food.

D) Requesting a full lunch tray from the dietary department could provide a more substantial meal; however, it might not address the immediate need for calming the client. If the client remains agitated and loud, it may be challenging to ensure that they can eat peacefully, making this intervention less effective than accompanying the client directly to eat.

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Naxlex Comprehensive Predictor Exams

The nurse is preparing the physical environment to interview a new client for admission to the mental health unit. Which environmental setting facilitates the best outcome of the interview?

Correct Answer is D

Explanation

A client with bipolar disorder has not slept or eaten in four days. The client is pacing and becomes increasingly agitated and loud while the nurse talks to the client's spouse. Which intervention is best for the nurse to implement at this time?

Correct Answer is C

Explanation

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When responding to a call light, the nurse finds a client with aggressive behaviors pacing and restless in the room. The client shouts, "What took you so long to get in here!" Which action should the nurse implement?

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