A nurse is creating a plan of care for a client who has schizophrenia and is experiencing command hallucinations. Which of the following interventions should the nurse include in the plan?
Provide reassurance and comfort for the client through touch.
Encourage increased socialization during group therapy.
Avoid making eye contact when speaking with the client.
Maintain a low level of environmental stimuli.
The Correct Answer is D
Choice A reason: Providing reassurance and comfort through touch can be beneficial in some cases; however, for clients experiencing command hallucinations, physical touch may be misinterpreted and could potentially escalate the situation. It's essential to gauge the client's comfort level with touch and proceed cautiously.
Choice B reason: While socialization is an important aspect of recovery, for a client experiencing command hallucinations, group therapy might be overwhelming and could exacerbate the hallucinations. It's crucial to introduce socialization gradually and in a controlled environment.
Choice C reason: Eye contact can be perceived as threatening or confrontational by clients with schizophrenia, especially when experiencing command hallucinations. It's important to respect the client's space and use non-confrontational body language to communicate effectively.
Choice D reason: Maintaining a low level of environmental stimuli is crucial for clients experiencing command hallucinations. A calm and quiet environment can help reduce the intensity and frequency of hallucinations, providing a sense of safety and reducing stress and anxiety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: While a unit secretary who speaks the same language could potentially communicate with the client, they may not be trained in medical terminology or confidentiality practices. Effective communication in healthcare settings requires more than just language proficiency; it involves understanding the nuances of medical dialogue and ensuring privacy and accuracy.
Choice B reason: Relying on another client for translation is not advisable. This could breach confidentiality, and the other client may not have the necessary skills to translate medical information accurately. Additionally, it places an undue burden on the client, who is there to receive support, not to provide services.
Choice C reason: A professional translator, preferably of the same gender as the client if it makes the client more comfortable, is the best option. Professional translators are trained to handle medical terminology and to navigate the cultural nuances that may arise in communication. They are also bound by confidentiality agreements to protect the client's privacy³.
Choice D reason: While a family member may be able to communicate effectively in the client's language, there are potential issues with privacy, accuracy, and dynamics that could affect the client's comfort and willingness to share openly in a support group setting. Family members may also unintentionally alter or withhold information based on their own biases or desires.
Correct Answer is B
Explanation
Choice A reason: Lack of empathy is not a characteristic finding in OCPD. While individuals with OCPD may appear insensitive or less responsive to the needs and feelings of others due to their focus on rules and productivity, this does not equate to a true lack of empathy.
Choice B reason: Preoccupation with details is a hallmark of OCPD. Individuals with this disorder have an excessive concern with orderliness, perfectionism, and control over their environment and tasks. They may become so involved in making every detail perfect that it can hinder task completion and efficiency.
Choice C reason: Exploitative behavior is more characteristic of other personality disorders, such as narcissistic personality disorder, and is not a typical feature of OCPD. People with OCPD are more likely to be overly conscientious and fair in their dealings with others.
Choice D reason: Excessive clinging is not typically associated with OCPD. Instead, individuals with OCPD may have difficulty delegating tasks or working with others unless things are done precisely their way, which stems from their need for control rather than a need for closeness or reassurance.
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