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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A Reason:

Promote interaction with others.

While promoting interaction with others is important for clients with schizophrenia, it is not the primary priority. Social interaction can help improve social skills and reduce isolation, but it should come after establishing a sense of safety and trust. Clients with schizophrenia often experience significant anxiety and mistrust, which need to be addressed first to create a stable foundation for further therapeutic interventions.

Choice B Reason:

Encourage participation in group therapy activities.

Encouraging participation in group therapy activities is beneficial for clients with schizophrenia as it can provide support and help them develop social skills. However, similar to promoting interaction with others, this goal is secondary to decreasing anxiety and building trust. Clients need to feel safe and trust their caregivers before they can effectively engage in group therapy.

Choice C Reason:

Decrease their anxiety and increase trust.

This is the correct response. Decreasing anxiety and increasing trust are fundamental goals in the care of clients with schizophrenia. High levels of anxiety and mistrust can exacerbate symptoms and hinder the effectiveness of other therapeutic interventions. Establishing a trusting relationship and reducing anxiety can create a more stable and supportive environment, which is essential for the client’s overall well-being and progress.

Choice D Reason:

Improve their relationship with their parents.

Improving the client’s relationship with their parents can be an important aspect of their overall treatment plan, especially if family dynamics contribute to their condition. However, this goal is not the immediate priority. Addressing the client’s anxiety and building trust should come first, as these are critical for the client’s stability and ability to engage in family therapy effectively.

A. 23g 1 in (2.54 cm) needle to the right deltoid. Use the acromion process as a landmark. B. 25g 0.5 in (1.3 cm) long needle to the left rectus femoris. Aspirate prior to injection. C. 27g 1.5 in (3.8 cm) long needle to the left vastus lateralis area. Massage area wearing clean gloves after injection. D. 21g 1.5 in (3.8 cm) needle to the right ventrogluteal area. Use Z-track technique.

Correct Answer is D

Explanation

Choice A Reason:

Using a 23-gauge, 1-inch needle for an intramuscular (IM) injection in the deltoid muscle is generally appropriate for adults. The deltoid muscle is a common site for IM injections, especially for small volumes of medication (up to 2 mL). The acromion process is a correct landmark for locating the deltoid muscle. However, the deltoid muscle is not the best site for larger volumes or more viscous medications. Additionally, the needle length might not be sufficient for individuals with more subcutaneous fat, potentially leading to suboptimal medication delivery.

Choice B Reason:

A 25-gauge, 0.5-inch needle is typically used for subcutaneous injections rather than intramuscular injections. The rectus femoris muscle can be used for IM injections, but it is not the preferred site due to the potential for increased pain and discomfort. Aspiration before injection is a debated practice; current guidelines suggest that aspiration is not necessary for most IM injections, except when injecting into the dorsogluteal site, which is not recommended due to the risk of hitting the sciatic nerve.

Choice C Reason:

A 27-gauge, 1.5-inch needle is appropriate for IM injections, and the vastus lateralis is a suitable site, especially for infants and young children. However, massaging the injection site after administering an IM injection is not recommended. Massaging can cause the medication to disperse into the subcutaneous tissue, reducing its effectiveness and potentially causing irritation or bruising.

Choice D Reason:

Using a 21-gauge, 1.5-inch needle for an IM injection in the ventrogluteal area is considered safe and effective. The ventrogluteal site is preferred for IM injections because it is free from major nerves and blood vessels, reducing the risk of injury. The Z-track technique is used to prevent medication from leaking into the subcutaneous tissue, ensuring that it remains in the muscle for proper absorption. This technique is particularly useful for medications that can stain or irritate the skin and subcutaneous tissue.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with schizophrenia. Which of the following would be a priority nursing goal for this client’s care?

Correct Answer is C

Explanation

The nurse calculates that a patient must receive 1.3 mL of an anti-infective agent. The dose is ordered IM. Which of the following choices demonstrates safe, evidence-based practice?

Correct Answer is D

Explanation

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