A nurse is reading the medical record for a client who has schizophrenia, which indicates that the client exhibits depersonalization. Which of the following statements by the client confirms that she is experiencing depersonalization?
"Everything in this room has changed and I don't recognize it anymore."
"I hear voices telling me that I have been bad."
"I have broken off all my past relationships because my friends and family are trying to kill me."
"My hands and feet are much smaller than they used to be."
The Correct Answer is D
Choice A reason: This statement reflects derealization, which is the experience that the external environment feels unreal or changed, not depersonalization.
Choice B reason: This describes auditory hallucinations, a common symptom of schizophrenia, but not depersonalization.
Choice C reason: This indicates persecutory delusions, not depersonalization.
Choice D reason: This confirms depersonalization, which involves altered perception of one’s own body or sense of self, such as believing body parts are distorted in size or shape.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: Validating the client’s feelings is essential in crisis intervention because it communicates empathy and understanding, reducing the client’s distress.
Choice B reason: Identifying the cause of anxiety helps target the intervention plan and ensures the nurse addresses underlying triggers.
Choice C reason: Establishing rapport builds trust, which is vital for the client to feel supported and safe during a crisis.
Choice D reason: Avoiding eye contact is non-therapeutic and can be interpreted as avoidance or disinterest, worsening the client’s anxiety.
Choice E reason: A flexible crisis intervention plan allows adjustments based on the client’s immediate needs, ensuring care is individualized and effective.
Correct Answer is A
Explanation
Choice A reason: Monitoring lithium levels is essential because of its narrow therapeutic index; toxicity can occur if levels rise slightly above the therapeutic range.
Choice B reason: Weight gain is not an indication of lithium toxicity; instead, toxicity signs include tremors, nausea, diarrhea, and confusion.
Choice C reason: Lithium is not addictive, and therapy is often long-term to prevent relapse of mood episodes.
Choice D reason: Diuretics are contraindicated with lithium because they increase the risk of toxicity by altering sodium and fluid balance.
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
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.