A nurse is caring for a client who has schizophrenia. The client suddenly moves to the corner of the room and shouts, "Get it away from me!" Which of the following actions should the nurse take?

Tell the client that there is nothing there.

Ask the client to describe what is being seen.

Touch the client's arm reassuringly.

Remove the client from the room.

Answer and Explanation

The Correct Answer is B

A. Tell the client that there is nothing there. Dismissing the client's perception may increase distress and reduce trust in the nurse-client relationship. A therapeutic approach acknowledges the client’s experience without reinforcing or denying hallucinations.
B. Ask the client to describe what is being seen. Encouraging the client to describe the hallucination helps assess its nature and severity. Understanding the content allows the nurse to provide appropriate support, ensure safety, and guide interventions.
C. Touch the client's arm reassuringly. Touching the client without consent, especially during a distressing hallucination, may escalate fear or agitation. Maintaining a calm and non-threatening presence is more appropriate.
D. Remove the client from the room. Relocating the client without assessing the hallucination may not address the underlying distress. Identifying triggers and using therapeutic communication are more effective initial interventions.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is B

Explanation

A. School-age: Schizophrenia is rare in children, and early-onset cases before adolescence are uncommon. Symptoms that resemble schizophrenia in children often require further evaluation for other neurodevelopmental disorders.
B. Young adulthood: Schizophrenia typically manifests between late adolescence and early adulthood, usually between ages 18 and 25 in men and slightly later in women. This period is when individuals experience their first psychotic episode.
C. Preschooler: Schizophrenia is extremely rare in preschool-aged children. Symptoms such as hallucinations or disorganized behavior at this age are more likely related to other developmental disorders or trauma.
D. Older adulthood: Late-onset schizophrenia is rare, and when psychotic symptoms emerge in older adults, they are often due to conditions such as dementia, delirium, or medication effects rather than primary schizophrenia.

A. Dialectical behavior therapy B. Antipsychotic medications C. Interpersonal therapy D. Antidepressant medications

Correct Answer is C

Explanation

A. Dialectical behavior therapy. Dialectical behavior therapy is primarily used for borderline personality disorder, focusing on emotional regulation, distress tolerance, and mindfulness. It is not the primary therapy for avoidant personality disorder.
B. Antipsychotic medications. Antipsychotic medications are typically used to manage symptoms of psychotic disorders such as schizophrenia. Avoidant personality disorder does not involve psychosis and is better managed with psychotherapy.
C. Interpersonal therapy. Interpersonal therapy is beneficial for avoidant personality disorder as it focuses on improving social skills, self-esteem, and communication. This therapy helps clients develop healthier relationships and overcome fears of rejection.
D. Antidepressant medications. While antidepressants may be used to treat co-occurring conditions such as depression or anxiety, they do not directly address the core features of avoidant personality disorder. Psychotherapy remains the primary treatment.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is caring for a client who has schizophrenia. The client suddenly moves to the corner of the room and shouts, "Get it away from me!" Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with an in-service to a group of staff members about schizophrenia. Which of the following age groups should the nurse include as the age when schizophrenia is typically diagnosed?

Correct Answer is B

Explanation

A nurse is caring for a client who has avoidant personality disorder. Which of the following types of therapy should the nurse anticipate for the client?

Correct Answer is C

Explanation

A nurse is caring for a client who has been diagnosed with schizophrenia and appears confused and has distortions in their thinking and speech patterns. Which of the following is the priority nursing intervention for this client?

A nurse is preparing to interview a client and is reviewing therapeutic communication techniques. Which of the following should the nurse include in the interview to invite the client to clarify feelings?

A nurse is caring for a client who has a substance use disorder. Which of the following statements by the nurse is an example of patient-centered care?

A nurse in a mental health clinic is taking a medical history on a client. The nurse should recognize that which of the following factors in the client's history increases their risk for mental illness?

A nurse is assisting in the care of a client who has persistent depressive disorder. When reinforcing education to the client about their illness, which of the following statements should the nurse make?

Which of the following phases of Selye's General Adaptation Syndrome (GAS) reflects a nurse's ability to successfully perform duties during a prolonged period of stress lasting weeks to months without any indication of observable impairment?

A nurse is preparing to discharge a client who has been diagnosed with schizophrenia. The client asks, "I am not sure why I need to have a relapse plan." Which of the following responses should the nurse make?