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) Reviewing the healthcare provider's history and physical may provide some background on the client's overall health and medication history, but it won't specifically address the symptoms currently being observed. While this information is useful, it does not directly relate to the assessment of involuntary movements.

B) The baseline nursing admission assessment can offer insights into the client's initial condition and any prior neurological assessments. However, it may not contain the specific details necessary to evaluate the current symptoms of uncontrollable hand movements and tongue protrusion, which are indicative of potential tardive dyskinesia or other movement disorders.

C) Recent urine drug testing (UDT) results could help identify any illicit substance use or non-compliance with prescribed medications. However, UDT results would not provide a clear correlation to the motor symptoms observed. Understanding the client’s current medication compliance is important, but it is not as directly relevant as the assessment of involuntary movements.

D) Reviewing the Abnormal Involuntary Movement Scale (AIMS) is crucial, as it specifically assesses involuntary movements associated with the use of antipsychotic medications and other psychotropic drugs. AIMS can provide baseline data and track any changes in involuntary movements over time. Given the client's symptoms of uncontrollable hand movements and excessive tongue protrusion, AIMS results will be key to determining if the client is experiencing tardive dyskinesia or other medication-related side effects.

A. Offer a referral to pastoral counseling. B. Suggest the need for a psychiatric consultation. C. Explore changes in life that have occurred after the loss. D. Encourage attending a local support group.

Correct Answer is C

Explanation

A) Offering a referral to pastoral counseling can be helpful, but it may not address the immediate emotional needs of the client who is experiencing extreme sadness and difficulty controlling emotions. This option can be considered later in the therapeutic process.

B) Suggesting the need for a psychiatric consultation might be appropriate, but it could be premature at this point. The focus should first be on understanding the client’s current emotional state and helping them process their grief.

C) Exploring changes in life that have occurred after the loss is the first and most important action. This approach allows the nurse to facilitate the client’s expression of feelings, which is crucial in the grieving process. By discussing the impact of the loss, the nurse can provide emotional support and help the client begin to process their grief.

D) Encouraging attendance at a local support group can be beneficial, but it may not be the most immediate action. The client needs to be heard and understood in their current emotional state before considering additional resources or support systems.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When assessing a client who takes psychotropic medications, the nurse notes that the client has uncontrollable hand movements and is excessively protruding the tongue. Which assessment in the client's record should the nurse review?

Correct Answer is D

Explanation

The nurse is caring for client who is experiencing extreme sadness after the passing of a companion of 30 years. The client describes not being able to think of other things and finds it difficult to control emotions. Which action should the nurse take first?

Correct Answer is C

Explanation

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

The nurse is assessing a client with postpartum depression for changes in the mood and cognitive state. Which subjective finding(s) should the nurse identify that are consistent with postpartum depression? Select all that apply.

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

The healthcare provider prescribes lithium carbonate for a client diagnosed with bipolar, manic depression. It is most important for the nurse to review which laboratory finding prior to beginning the drug therapy?

A client with schizophrenia receives a prescription for fluphenazine. Which instruction is most important for the nurse to include when teaching the client about this drug?

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?

A male client with known auditory hallucinations begins talking loudly and gesturing wildly while in the unit's day room. Which action should the nurse implement first?