After being in the hospital for one month, a client with schizophrenia states that voices are telling them they will die tonight. The client asks the nurse if this is true. The client’s statement and question indicate that they:

Have a poor prognosis.

Are not improving and may be getting worse.

Are questioning the hallucination and want reassurance from the nurse.

Will begin to enter the manic phase of their illness.

Answer and Explanation

The Correct Answer is C

Choice A Reason: Have a poor prognosis

A poor prognosis in schizophrenia is typically associated with persistent and severe symptoms, lack of response to treatment, and significant functional impairment. While the client’s statement about hearing voices is concerning, it does not necessarily indicate a poor prognosis on its own. Prognosis in schizophrenia is multifactorial and depends on various factors, including the duration of untreated psychosis, adherence to treatment, and the presence of supportive social networks.

Choice B Reason: Are not improving and may be getting worse

This choice suggests that the client’s condition is deteriorating. While the presence of hallucinations can indicate a lack of improvement, it is important to consider the context. The client’s ability to question the hallucination and seek reassurance from the nurse suggests a level of insight that is often associated with better outcomes. Insight into one’s condition is a positive prognostic factor in schizophrenia.

Choice C Reason: Are questioning the hallucination and want reassurance from the nurse

This is the correct answer. The client’s question indicates that they are aware that the voices might not be real and are seeking reassurance from the nurse. This level of insight is crucial in managing schizophrenia, as it can lead to better adherence to treatment and improved outcomes. Insight into the nature of hallucinations and delusions is often a sign of a more favorable prognosis.

Choice D Reason: Will begin to enter the manic phase of their illness

Mania is characterized by elevated mood, increased activity, and other symptoms such as decreased need for sleep and grandiosity. It is more commonly associated with bipolar disorder than schizophrenia. The client’s statement about hearing voices predicting their death does not align with the typical presentation of mania. Therefore, this choice is not applicable in this context.

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Correct Answer is C

Explanation

Choice A Reason:

Acupuncture.

Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to balance energy flow and promote healing. While it is a form of manual therapy, it is not part of chiropractic medicine. Chiropractors focus on the musculoskeletal system, particularly the spine, and do not typically use acupuncture as a primary treatment modality.

Choice B Reason:

Surgical procedures.

Surgical procedures are not part of chiropractic medicine. Chiropractors are not licensed to perform surgeries. Their practice is centered around non-invasive treatments, primarily involving manual adjustments and manipulations of the spine and other joints. Surgery is outside the scope of chiropractic care and is typically handled by medical doctors or surgeons.

Choice C Reason:

Spinal manipulation.

This is the correct response. Spinal manipulation, also known as chiropractic adjustment, is a core component of chiropractic medicine. Chiropractors use their hands or specialized instruments to apply controlled force to spinal joints, aiming to improve spinal alignment, reduce pain, and enhance physical function. This technique is fundamental to chiropractic care and distinguishes it from other forms of manual therapy.

Choice D Reason:

Prescription medications.

Prescription medications are not part of chiropractic medicine. Chiropractors do not prescribe medications; instead, they focus on manual therapies, exercise, and lifestyle counseling to manage and prevent musculoskeletal issues. The use of medications is typically managed by medical doctors or other healthcare providers.

A. Draws attention and approval from significant others. B. Provides temporary and partial relief from anxiety. C. Increases the inhibitory powers of their superego. D. Blocks delusions and hallucinations from awareness.

Correct Answer is B

Explanation

Choice A Reason:

Draws attention and approval from significant others.

This statement is incorrect. Compulsive washing rituals in Obsessive-Compulsive Disorder (OCD) are not typically performed to draw attention or gain approval from others. Instead, these rituals are driven by an internal need to reduce anxiety and distress associated with obsessive thoughts. The primary function of these behaviors is to manage the individual’s own anxiety rather than to seek external validation.

Choice B Reason:

Provides temporary and partial relief from anxiety.

This is the correct response. Compulsive washing rituals in OCD are performed to alleviate the intense anxiety and distress caused by obsessive thoughts. Although the relief is temporary and partial, it reinforces the behavior, creating a cycle where the individual feels compelled to repeat the ritual to manage their anxiety. This temporary relief is a key characteristic of compulsive behaviors in OCD.

Choice C Reason:

Increases the inhibitory powers of their superego.

This statement is incorrect. The concept of the superego is related to Freud’s psychoanalytic theory, where it represents the internalized moral standards and ideals. Compulsive washing rituals in OCD are not performed to increase the inhibitory powers of the superego but rather to reduce anxiety and distress. The rituals are a response to obsessive thoughts rather than a means of enhancing moral inhibition.

Choice D Reason:

Blocks delusions and hallucinations from awareness.

This statement is incorrect. Delusions and hallucinations are more commonly associated with psychotic disorders, such as schizophrenia, rather than OCD. Compulsive washing rituals in OCD are not intended to block delusions or hallucinations but to manage anxiety related to obsessive thoughts. The focus of these rituals is on reducing distress rather than addressing psychotic symptoms.

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After being in the hospital for one month, a client with schizophrenia states that voices are telling them they will die tonight. The client asks the nurse if this is true. The client’s statement and question indicate that they:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

A client diagnosed with Obsessive-Compulsive Disorder has developed a number of compulsive washing rituals over the years. The nurse recognizes that these behavioral rituals serve which purpose?

Correct Answer is B

Explanation

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