A nurse is caring for a patient with mania. She knows this person would experience issues with disorganized thoughts and speech patterns. Select the evident ways in which disorganized speech might be manifested. (Select all that apply).
Flight of ideas
Delusions of grandeur
Tangential speech
Circumstantial speech
Pressured speech
Correct Answer : A,C,D,E
Rationale:
A. This is a form of disorganized speech where the person rapidly shifts from one topic to another, often without logical connection.
B. This is a type of delusional thinking, not a speech pattern. It involves an inflated sense of self-importance or abilities.
C. This occurs when the person begins to answer a question but veers off-topic and never returns to the original point.
D. This involves including excessive and unnecessary detail but eventually returning to the point, demonstrating disorganized but not completely illogical thought.
E. This is rapid, excessive speech that is difficult to interrupt, common in manic episodes and a sign of disorganized communication.Top of Form
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. A lithium serum level between 0.6 and 1.2 mEq/L is generally considered within the therapeutic range for maintenance treatment.
B. Above therapeutic limits would typically be >1.5 mEq/L, which increases toxicity risk.
C. While timing of blood draw is important, an 8-hour interval is acceptable for monitoring lithium levels (usually drawn 12 hours post-dose but 8 hours is still interpretable).
D. A level of 1 mEq/L is not below therapeutic limits.
Correct Answer is B
Explanation
Rationale:
A. This approach is confrontational and accusatory, which may escalate agitation in a hyperactive or manic patient.
B. This response sets clear limits in a calm, supportive, and non-threatening manner, while also offering assistance with impulse control.
C. This statement is shaming and could escalate aggression rather than de-escalate the situation.
D. This is a threat rather than a therapeutic intervention, and it may increase the patient's agitation or resistance.
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