Parents ask a nurse how they should reply when their child, diagnosed with schizophrenia disorder, tells them that voices command the child to harm others. Which is the appropriate nursing response?

"Focus on the feelings generated by the hallucinations and present reality."

Ignore what they are saying, while attempting to discover the underlying cause."

"Present objective evidence that the voices are not real."

Tell them to stop discussing the voices.

Answer and Explanation

The Correct Answer is A

a. "Focus on the feelings generated by the hallucinations and present reality." This approach validates the child's experience and feelings while gently orienting them to reality, which is a therapeutic communication technique.
b. "Ignore what they are saying, while attempting to discover the underlying cause." Ignoring the child’s statements can make them feel dismissed and could increase their distress. It is important to address their experience directly and compassionately.
c. "Present objective evidence that the voices are not real." Presenting objective evidence may not be effective as the child’s belief in the voices can be very strong, and this approach may lead to further agitation.
d. "Tell them to stop discussing the voices." This approach is dismissive and does not help the child manage their symptoms or feel understood. It is important to engage with the child’s experience constructively.

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Correct Answer is C

Explanation

a. Administer the 6mg Benztropine orally with a full glass of water on an empty stomach: Benztropine is an anticholinergic medication used to manage the extrapyramidal side effects (EPS) of antipsychotics. However, it's important to consult the healthcare provider before administering any additional medications.
b. Ask the healthcare provider to increase the dose of Haloperidol to assist with the side effect: Increasing the dose of Haloperidol might worsen the tardive dyskinesia symptoms.
c. Hold the dose of Haloperidol and notify the healthcare provider. (Correct) Haloperidol is an antipsychotic medication with a known side effect of tardive dyskinesia, which manifests as involuntary facial and body movements. Stopping the medication and informing the provider is crucial to determine the best course of action, which might involve dose adjustment or switching medications

d. Explain to the client that the side effects should diminish in one to two weeks: Tardive dyskinesia can be a persistent side effect, and reassurance without addressing the medication is not helpful.

A. "I know I can't use physical force anymore, but I can intimidate someone with my words." B. "Because my wife seems to be the one to set me off, I've decided never to see her again." C. "It's bad to feel as angry as I feel. I'm working on eliminating this evil feeling completely." D. "I realize I have a problem expressing my anger appropriately."

Correct Answer is D

Explanation

a. "I know I can't use physical force anymore, but I can intimidate someone with my words." This indicates that the client still considers using intimidation, which is not a healthy way of managing anger or aggression.
b. "Because my wife seems to be the one to set me off, I've decided never to see her again." Avoiding a trigger rather than managing the response to it does not indicate progress in anger and aggression management.
c. "It's bad to feel as angry as I feel. I'm working on eliminating this evil feeling completely." Viewing anger as entirely negative and trying to eliminate it rather than managing it constructively does not show effective anger management.
d. "I realize I have a problem expressing my anger appropriately." This is correct because recognizing and admitting the problem is a critical first step toward making meaningful changes in managing anger and aggression.

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Parents ask a nurse how they should reply when their child, diagnosed with schizophrenia disorder, tells them that voices command the child to harm others. Which is the appropriate nursing response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client diagnosed with schizophrenia, who has been prescribed Haloperidol for the past year. On assessment, the nurse notices that the client is demonstrating bizarre facial and tongue movements. What is the priority nursing intervention?

Correct Answer is C

Explanation

Which statement, made by the client in group therapy, would demonstrate to the nurse that the client has made progress with anger and aggression management?

Correct Answer is D

Explanation

An aging client diagnosed with schizophrenia disorder takes an antipsychotic and a beta-adrenergic blocking agent for hypertension. Understanding the combined side effects of these drugs, which statement by a nurse is most appropriate?

A client exhibiting dependent behaviors says, "Do you think I should move from my parent's house and get a job?" Which nursing response is most appropriate?

A nurse working in a mental health unit reviews therapeutic and non-therapeutic communication techniques with a student nurse. All of the following are therapeutic communication techniques except:

If a client demonstrates transference towards the nurse, how should the nurse respond?

A client with schizophrenia is receiving teaching from the nurse about their prescribed medication, Chlorpromazine. Which of the following client statements indicates an understanding of the teaching?

What is the mental health nurse's purpose for providing feedback to a client on a psychiatric unit who is verbalizing concerns about stressors? To:

A client diagnosed with Alzheimer's Disorder has impairments of memory and judgement and is incapable of performing activities of daily living. Which nursing intervention should take priority?

A nurse is providing discharge teaching to a client prescribed diazepam. Which client statement would indicate that the client teaching was effective? "