A nurse working on a psychiatric unit is providing care for a client that reports feeling irritable and distressed. The client states, “I just feel so helpless.” Which of the following statements most aligns with the client’s presentation of neurotic behavior?
The client is always aware that their behaviors are maladaptive.
The client uses adaptive defense mechanisms to cope.
The client never has mood or personality changes.
The client does not experience loss of contact with reality.
The Correct Answer is D
Choice A Reason:
The statement “The client is always aware that their behaviors are maladaptive” is incorrect. While individuals with neurotic behavior may sometimes recognize that their behaviors are maladaptive, this awareness is not consistent. Neurotic behaviors are often automatic and unconscious efforts to manage deep anxiety. Therefore, the client may not always be aware of the maladaptive nature of their actions.
Choice B Reason:
The statement “The client uses adaptive defense mechanisms to cope” is incorrect. Neurotic behavior typically involves the use of maladaptive defense mechanisms rather than adaptive ones. These mechanisms, such as denial, repression, or projection, are employed to manage anxiety and stress but do not effectively resolve the underlying issues. Adaptive defense mechanisms, on the other hand, are more constructive and promote healthier coping strategies.
Choice C Reason:
The statement “The client never has mood or personality changes” is incorrect. Neurotic behavior is often associated with mood swings and emotional instability. Clients with neurotic tendencies may experience frequent changes in mood and may struggle with regulating their emotions. Therefore, it is inaccurate to state that the client never has mood or personality changes.
Choice D Reason:
The statement “The client does not experience loss of contact with reality” is correct. Neurotic behavior, unlike psychotic behavior, does not involve a loss of contact with reality4. Clients with neurotic tendencies remain aware of their surroundings and can distinguish between reality and their internal experiences4. This characteristic differentiates neurotic behavior from more severe mental health conditions such as schizophrenia, where a loss of reality is a key feature.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Obtunded describes a state where the patient has a decreased level of consciousness and is difficult to arouse. They may respond slowly and be somewhat confused. This level of consciousness is more severe than lethargy and typically requires more vigorous stimulation to elicit a response. The client’s ability to answer questions appropriately before falling back to sleep suggests a less severe impairment than obtundation.
Choice B Reason:
Stuporous refers to a condition where the patient is almost entirely unresponsive and can only be aroused by vigorous and repeated stimuli. This state is more severe than lethargy and obtundation. The client’s ability to respond appropriately to questions indicates a higher level of consciousness than stupor. Therefore, stuporous is not the correct description of the client’s condition.
Choice C Reason:
Lethargic describes a state where the patient is very drowsy but can be aroused to respond to questions and then falls back to sleep. This matches the client’s presentation as they are able to answer questions appropriately but fall asleep immediately afterward. Lethargy is a common level of altered consciousness in various medical conditions and is less severe than obtundation or stupor.
Choice D Reason:
Alert describes a state where the patient is fully awake, aware, and responsive to stimuli. The client’s tendency to fall back to sleep immediately after responding to questions indicates that they are not fully alert. Therefore, this term does not accurately describe the client’s level of consciousness.
Correct Answer is C
Explanation
The correct answer is c.
Choice A Reason:
The statement “I am glad I’m getting out of here. I shouldn’t be here anyway.” indicates a lack of insight into the need for treatment and does not demonstrate readiness for discharge. Clients who are ready for discharge typically acknowledge their condition and the importance of ongoing care. This statement suggests denial or minimization of the issues that led to hospitalization, which can be a barrier to successful discharge and continued recovery1.
Choice B Reason:
The statement “I know I’m ready to go. I’ve got everything under control.” can be misleading. While it may seem positive, it lacks specific details about the client’s discharge plan and follow-up care. Readiness for discharge involves more than just feeling ready; it requires a concrete plan for managing medications, follow-up appointments, and support systems. Without these details, the statement does not fully indicate readiness for discharge.
Choice C Reason:
The statement “I have a list of my medications and have made an appointment with my doctor.” is correct. This statement demonstrates that the client has a clear understanding of their medication regimen and has taken proactive steps to ensure continuity of care after discharge. Having a follow-up appointment scheduled is a critical component of discharge planning, as it helps ensure that the client will continue to receive necessary support and monitoring. This level of preparation indicates that the client is ready for discharge.
Choice D Reason:
The statement “I just can’t get rid of these thoughts about dying.” is a serious concern and indicates that the client is not ready for discharge. Persistent thoughts of dying or suicidal ideation require immediate attention and intervention. Discharging a client with these thoughts would be unsafe and could lead to severe consequences. The client needs further evaluation and treatment to address these thoughts before being considered for discharge.
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