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 D

Explanation

The correct answer is d.

Choice A Reason:

The statement “Bureaucratic” is incorrect. Bureaucratic leadership is characterized by strict adherence to rules and procedures, with decisions made based on established policies. While this style ensures consistency and compliance, it does not typically involve the direct and decisive intervention seen in the scenario described. Bureaucratic leaders focus more on following protocols rather than making quick, authoritative decisions.

Choice B Reason:

The statement “Laissez-Faire” is incorrect. Laissez-Faire leadership is a hands-off approach where leaders provide minimal direction and allow team members to make their own decisions. This style is the opposite of what is demonstrated in the scenario, where the nurse takes immediate control of the situation. Laissez-Faire leaders typically avoid intervening directly and prefer to let issues resolve themselves.

Choice C Reason:

The statement “Democratic” is incorrect. Democratic leadership involves participative decision-making, where leaders seek input and feedback from team members before making decisions. In the scenario, the nurse does not seek input from the group but instead makes a unilateral decision to handle the matter and move on. This approach is not characteristic of democratic leadership, which values collaboration and consensus.

Choice D Reason:

The statement “Autocratic” is correct. Autocratic leadership is characterized by individual control over decisions, with little input from group members. The nurse’s behavior in the scenario—taking charge of the situation and making a quick decision without consulting the group—is indicative of an autocratic leadership style. Autocratic leaders are decisive and often make decisions independently, focusing on efficiency and control.

A. Increase external stimuli. B. Stay with the client and speak to them in a calm manner. C. Allow the client to have their requested space. D. Review the updated problem list with the client.

Correct Answer is B

Explanation

Choice A Reason:

Increase external stimuli.

Increasing external stimuli is not appropriate during a panic attack. Panic attacks are characterized by intense fear and anxiety, often accompanied by physical symptoms such as rapid heartbeat, sweating, and shortness of breath. Increasing external stimuli can exacerbate these symptoms and heighten the client’s distress. The goal during a panic attack is to reduce stimuli and create a calming environment to help the client regain control.

Choice B Reason:

Stay with the client and speak to them in a calm manner.

This is the correct response. Staying with the client and speaking to them in a calm manner provides reassurance and helps to ground them during the panic attack. The presence of a calm and supportive nurse can help reduce the client’s anxiety and provide a sense of safety. This approach aligns with therapeutic communication techniques and is effective in managing acute anxiety episodes.

Choice C Reason:

Allow the client to have their requested space.

While it is important to respect a client’s need for space, leaving them alone during a panic attack may not be the best approach. Clients experiencing panic attacks may feel overwhelmed and frightened, and the presence of a supportive nurse can help them feel safer and more secure. It is important to balance the client’s need for space with the need for support and reassurance.

Choice D Reason:

Review the updated problem list with the client.

Reviewing the updated problem list is not appropriate during a panic attack. This action requires cognitive engagement and focus, which the client may not be capable of during an acute anxiety episode. The priority during a panic attack is to help the client calm down and manage their immediate symptoms, not to discuss or review problems.

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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

During a morning group meeting, a client raises concern that they cannot sleep at night due to the noises coming from the nurse’s station. The nurse in the meeting interrupts and states, “I’ll handle this matter. Let’s move on.” The nurse is demonstrating which type of leadership style?

Correct Answer is D

Explanation

An inpatient on the psychiatric unit is having a panic attack. An appropriate nursing intervention at this time would be to:

Correct Answer is B

Explanation

The nurse must give 25 micrograms of fentanyl IVP X1 dose. Fentanyl is available in an ampule 100 micrograms per 2m How many mL will the nurse give for the correct dose? round to the nearest tenth. Use a preceding zero if necessary. Do not use trailing zeros.

Group therapy is strongly encouraged, but not mandatory, in an inpatient psychiatric unit. The unit manager’s policy is that clients can make a choice about whether or not to attend group therapy. Which ethical principle does the unit manager’s policy preserve?

A client is admitted to an inpatient unit with a diagnosis of frontotemporal dementia. Which of the following aspects of a medical history would the nurse expect to see with this client? (Select All that Apply.)

A client diagnosed with generalized anxiety disorder (GAD) is started on buspirone. Which statement made by the client indicates teaching has been effective? The client verbalizes that:

A client is having trouble remembering to take his antipsychotic medication, risperidone 3 mg PO, BID. The treatment team at the clinic he attends is considering starting him on risperidone 10 mg IM every 2 weeks. The rationale for this is:

The nurse who has been caring for a client with generalized anxiety disorder (GAD) recognizes that care has been effective when the client is able to: (SELECT ALL THAT APPLY)

A client asks the nurse to promise to keep confidential a plan they have to kill their father. Which of the following statements would be the best response for the nurse to make?

A client diagnosed with Illness Anxiety Disorder is prescribed clonazepam for underlying anxiety. Of the following, which is of utmost importance when caring for this client?