A nurse is caring for a client diagnosed with schizophrenia and is experiencing hallucinations. Which of the following actions should the nurse take?

Ask the client direct questions about the hallucination.

Act to the client as if the hallucination is real.

Tell the client to go to their room and they should go away.

Instruct the client to argue with the voices that are a part of the hallucination.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. Ask the client direct questions about the hallucination.

Choice A rationale:

Asking direct questions about the hallucination helps the nurse understand the client’s experience and assess the content and intensity of the hallucinations. This approach also allows the nurse to provide appropriate support and interventions.

Choice B rationale:

Acting as if the hallucination is real can reinforce the client’s distorted perception of reality, which is not therapeutic. The nurse should acknowledge the client’s experience without validating the hallucination as real.

Choice C rationale:

Telling the client to go to their room and that the hallucinations should go away is dismissive and does not address the client’s immediate needs. It is important to engage with the client and provide support rather than dismiss their experience.

Choice D rationale:

Instructing the client to argue with the voices can increase the client’s distress and is not a recommended therapeutic approach. Instead, the nurse should help the client find ways to cope with and manage the hallucinations.

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Correct Answer is D

Explanation

Choice A rationale:

Risperidone (Risperdal) is an atypical antipsychotic commonly used to manage symptoms of schizophrenia and bipolar disorder. It is not indicated for opioid withdrawal, making it an inappropriate choice.

Choice B rationale:

Lithium carbonate (Eskalith) is a mood stabilizer used primarily for bipolar disorder. It has no direct impact on opioid withdrawal symptoms, so it would not be the correct choice for managing opioid withdrawal.

Choice C rationale:

Disulfiram (Antabuse) is used to deter alcohol consumption by inducing unpleasant reactions when alcohol is consumed. It is not used to manage opioid withdrawal symptoms and is therefore not the correct choice.

Choice D rationale:

Methadone (Methadose) is a synthetic opioid agonist often used in medication-assisted treatment for opioid dependence and withdrawal. It helps alleviate withdrawal symptoms and cravings, promoting a smoother and safer withdrawal process.

A. A room without a window. B. A room containing personal belongings. C. A room adjacent to the nursing station. D. A room with dim lighting.

Correct Answer is B

Explanation

The correct answer is choice B. A room containing personal belongings.

Choice A rationale:

A room without a window would likely be isolating and could contribute to feelings of confusion and disorientation in a cognitively impaired individual. Natural light from windows helps regulate the circadian rhythm and provides a sense of time, which is crucial for maintaining a therapeutic environment.

Choice B rationale:

A room containing personal belongings is the correct choice. Familiar items from home can provide comfort and a sense of familiarity, reducing anxiety and agitation in cognitively impaired individuals. These belongings can act as cues for memory recall and assist in maintaining a connection to their personal identity.

Choice C rationale:

A room adjacent to the nursing station might lead to increased noise and disruption for the client. Cognitively impaired individuals often benefit from a quiet and calm environment, which would not be ensured in a room close to a potentially busy nursing station.

Choice D rationale:

A room with dim lighting can exacerbate confusion and disorientation in cognitively impaired individuals. Adequate lighting is essential for maintaining a safe and structured environment, as poor lighting can lead to falls and increased disorientation.

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A nurse is caring for a client diagnosed with schizophrenia and is experiencing hallucinations. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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Correct Answer is B

Explanation

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