A nurse is caring for a client who has schizophrenia. The client tells the nurse, "Government agents are out to get me." Which of the following responses should the nurse make?
"You will be okay."
"Feelings of persecution are normal with your condition."
"It must be frightening to believe that someone is after you."
"Let me check to see if it's time to take your medication."
The Correct Answer is C
A. Incorrect. This response dismisses the client's concerns and does not acknowledge the distress the client may be experiencing.
B. Incorrect. While it's true that paranoia is a common symptom of schizophrenia, stating that it is "normal" may invalidate the client's feelings and does not address the underlying distress. C. Correct. This response validates the client's feelings and demonstrates empathy by acknowledging the distress associated with the belief that government agents are after them.
D. Incorrect. While medication management is important in the treatment of schizophrenia, this response does not address the client's immediate concerns or validate their feelings of persecution.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Hemoglobin (Hgb) of 12 g/dL is within the normal range for a pregnant individual and does not typically require notification of the provider.
B. Platelet count of 90,000/mm3 is below the normal range (typically 150,000 to 400,000/mm3) and may indicate thrombocytopenia, which can be associated with conditions such as preeclampsia or HELLP syndrome. The nurse should notify the provider about this result.
C. Hematocrit of 37% is within the normal range for a pregnant individual and does not typically require notification of the provider.
D. Creatinine level of 0.7 mg/dL is within the normal range and does not typically require notification of the provider.
Correct Answer is C
Explanation
A. Constipation is not a common or expected side effect of cefazolin and is not typically associated with this medication.
B. Elevated skin patches are not a known side effect of cefazolin and would not typically occur as a result of taking this medication.
C. Ringing in the ears (tinnitus) is a potential adverse effect of cefazolin and should be reported to the provider because it may indicate ototoxicity, which can be serious.
D. Depression is not a common side effect of cefazolin and is not typically associated with this medication.
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