A nurse is assisting in a group therapy meeting and is sharing a humorous story unrelated to anyone in the group.
When the group laughs at the story, a client who has schizophrenia jumps up and runs out while yelling “You are all making fun of me!” Which of the following behaviors is this client displaying?

Ideas of reference.

Grandeur.

Somatic delusion.

Erotomania.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Ideas of reference are a type of delusion in which a person believes that unrelated events, objects, or actions in the environment have personal significance or meaning specifically directed towards them. In this case, the client with schizophrenia misinterpreted the group's laughter as mockery directed specifically at them, even though the story was unrelated to them.

Here's a detailed explanation of why the other choices are incorrect: B. Grandeur:

Grandiosity involves an inflated sense of self-importance, power, or identity. It's not evident in this scenario, as the client isn't expressing beliefs of exceptional abilities or status. C. Somatic delusion:

Somatic delusions focus on bodily functions or sensations, such as believing organs are rotting or insects are crawling under the skin. The client's outburst isn't related to bodily concerns. D. Erotomania:

Erotomania is a delusion where a person believes someone of higher status is in love with them. It's not applicable in this situation as the client's belief isn't about romantic interest.

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Correct Answer is D

Explanation

A rationale:

Spending time with friends can be a protective factor against suicide, as it provides social support and connection.

While isolation can be a risk factor, spending time with friends does not inherently indicate suicide risk.

It's important to assess the quality of relationships and the presence of other risk factors.

Choice B rationale:

Regular sleep patterns often indicate healthy mental health.

Significant changes in sleep patterns (either too much or too little) can be warning signs, but consistent sleep of 9 hours is not typically a concern.

It's essential to evaluate sleep quality and any recent changes.

Choice C rationale:

Religious involvement can provide a sense of purpose, belonging, and support, which can be protective against suicide.

While it's not a guarantee of protection, it's generally a positive factor.

It's crucial to assess the individual's level of engagement and any potential conflicts within their religious beliefs.

Choice D rationale:

Exposure to suicide, especially in a close connection like a coach, can significantly increase a person's risk for suicide.

It can lead to normalization of suicide as a coping mechanism, imitation of behavior, or triggering of underlying mental health issues.

This is a strong risk factor that warrants immediate attention and assessment.

A. “If I wake up at night, I go to another room and read for 20 minutes.” B. “I have stopped taking naps in the afternoon.” C. “I watch the television in my bedroom to help me sleep.” D. “I eat my evening meal at least 3 hours before I go to bed.”

Correct Answer is C

Explanation

A rationale:

Going to another room and reading for 20 minutes when waking up at night is a recommended strategy for managing insomnia. This technique helps to break the cycle of lying in bed awake and worrying, which can worsen insomnia. Reading can be a relaxing activity that can help to promote sleepiness. It's important to choose a book that is not too stimulating and to avoid reading in bright light.

Choice B rationale:

Stopping napping in the afternoon is also a recommended strategy for managing insomnia. Napping can interfere with nighttime sleep by reducing sleep drive. It's best to avoid napping altogether or to limit naps to 30 minutes or less early in the afternoon.

Choice C rationale:

Watching television in the bedroom is not recommended for managing insomnia. The light from the television can suppress the production of melatonin, a hormone that helps to regulate sleep. The noise from the television can also be stimulating and make it difficult to fall asleep. It's best to avoid watching television in the bedroom or to turn off the television at least 30 minutes before bedtime.

Choice D rationale:

Eating the evening meal at least 3 hours before bed is generally a good practice for sleep hygiene. Eating too close to bedtime can lead to indigestion, which can make it difficult to fall asleep. It's best to avoid heavy, fatty, or spicy foods before bed.

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Naxlex Comprehensive Predictor Exams

A nurse in a community clinic is speaking to a parent who expresses concern for her adolescent son. Which of the following statements by the mother should indicate to the nurse that the adolescent is at risk for suicide?

Correct Answer is D

Explanation

A nurse is discussing insomnia management techniques with a group of clients who have anxiety disorders. Which of the following techniques mentioned by a client requires further teaching?

Correct Answer is C

Explanation

A nurse is reinforcing discharge teaching with a client who has several new prescriptions for psychotropic medications. The client tells the nurse that she has always had trouble following a medication regimen. What should the nurse respond?

A nurse is caring for a client who is experiencing auditory hallucinations. What should the nurse say first?

A nurse is planning care for a client who is in the manic phase of bipolar disorder. Which of the following interventions should the nurse include in the client's plan of care?.

A nurse is reinforcing dietary teaching with a client who has a new prescription for a monoamine oxidase Inhibitor (MAOI). Which of the following foods should the nurse instruct the client to avoid while taking an MAOI?

A nurse in an acute care mental health facility is caring for a client who has major depression and states, “Everyone will be much better off when I’m gone.” Which of the following actions should the nurse take first?

A nurse is reinforcing teaching with a client who has a history of depression about a new prescription for fluoxetine. Which statement by the client indicates understanding of the teaching?

A nurse is conversing with a client diagnosed with schizophrenia. Suddenly, the client expresses fear, stating, “I’m scared. Can you hear that? The voices are instructing me to do awful things.” Which of the following responses from the nurse would be suitable?

A nurse is caring for a client who has schizophrenia and notices changes in the client’s behavior. Which of the following behaviors is the nurse’s priority to report to the provider?