The client hears the word "match." The client replies, "A match. I like matches. They are the light of the world. God will light the world. Let your light shine." Which communication pattern does the nurse identify?

Clang association

Word salad

Ideas of reference

Loose association

Answer and Explanation

The Correct Answer is D

a. Clang association: Clang associations involve the use of words based on their sound rather than their meaning, often rhyming or having a similar sound. This pattern is not evident in the client’s response.
b. Word salad: Word salad refers to a jumble of words or phrases that lack logical coherence, which is not characteristic of the given response. The client's speech, while disorganized, still contains recognizable connections.
c. Ideas of reference: Ideas of reference involve the belief that common elements of the environment are directly related to oneself. This pattern is not shown in the client's response.
d. Loose association: Loose associations involve thoughts that are not logically connected to one another. The client’s response shows a series of loosely connected ideas, fitting the pattern of loose associations

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Correct Answer is A

Explanation

a. experience no loss of contact with reality. The key difference is reality testing. Clients with neurosis (anxiety disorders, OCD) generally maintain contact with reality, even though their thoughts or behaviours might be distressing. Clients with psychosis (schizophrenia) experience a break with reality, such as hallucinations or delusions.
b. Never have mood or personality changes. Not true. Mood and personality changes can occur in both neurosis and psychosis.
c. Have conflict but only use adaptive defence mechanisms to cope. Défense mechanisms are used by everyone to cope with anxiety, but in neurosis, they might be less healthy or maladaptive.
d. Are always aware that their behaviours are maladaptive. Not necessarily. Clients with neurosis might have limited insight into how their behaviours affect themselves or others.

A. "Focus on the feelings generated by the hallucinations and present reality." B. Ignore what they are saying, while attempting to discover the underlying cause." C. "Present objective evidence that the voices are not real." D. Tell them to stop discussing the voices.

Correct Answer is A

Explanation

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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The client hears the word "match." The client replies, "A match. I like matches. They are the light of the world. God will light the world. Let your light shine." Which communication pattern does the nurse identify?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse's approach to a client with neurotic vs. psychotic behavior is different mainly because clients with neurotic behavior.

Correct Answer is A

Explanation

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?

Correct Answer is A

Explanation

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