The nurse is caring for a client with schizotypal personality disorder who was experiencing transient psychotic episodes that led to admission. The client was unkempt and appeared not to have bathed for quite some time. When planning the care of this client, which will be the focus of the nursing interventions? Select all that apply.

Encourage the client to seek a hobby.

Establishing close relationships with others.

Improve functioning in the community.

Development of social skills.

Development of self-care skills.

Answer and Explanation

Correct Answer : C,D,E

Choice A reason: While hobbies can be therapeutic, they are not the primary focus of nursing interventions for a client with schizotypal personality disorder and hygiene issues.

Choice B reason: Establishing close relationships is beneficial but may not be the immediate focus for a client who is struggling with basic self-care.

Choice C reason: Improving functioning in the community is a key goal for clients with schizotypal personality disorder to help them integrate better into society.

Choice D reason: Developing social skills is essential for clients with schizotypal personality disorder to interact more effectively with others.

Choice E reason: Development of self-care skills is crucial, especially given the client's unkempt appearance and lack of bathing, indicating a need for better personal hygiene practices.

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Correct Answer is B

Explanation

Choice A reason:

Informed consent is a critical component of many medical treatments, including ECT. It involves the patient's understanding and agreement to the procedure after being fully informed of the risks, benefits, and alternatives. Cognitive deficits can impair a patient's ability to provide informed consent, but they do not automatically waive the requirement for such consent. In fact, additional safeguards are often put in place to protect the rights of individuals with cognitive impairments.

Choice B reason:

ECT is a medical procedure that requires informed consent due to the potential risks and side effects associated with it. If a client has cognitive deficits severe enough to impact their decision-making capacity, they may not be able to provide informed consent. In such cases, treatment options would need to be reconsidered, and alternative methods of obtaining consent, such as through a legal guardian or a court order, might be necessary.

Choice C reason:

While it is true that ECT is considered an effective treatment for severe depression and suicidality, the decision to use ECT should not be based solely on these criteria². The ability of the client to understand and consent to the treatment is also a crucial factor. Therefore, the extremity of the client's suicidal ideation alone does not make ECT automatically the appropriate option without considering the consent issue.

Choice D reason:

ECT is indeed an alternative treatment when antidepressant medications have been ineffective, especially in cases of severe depression and suicidality². However, the effectiveness of ECT does not negate the need for informed consent. The client's cognitive ability to provide consent remains a determining factor in the feasibility of ECT as a treatment option.

A. Talking in rapid, continuous speech. B. Interacting with others in a flirtatious way. C. Dressing in black or grey clothing. D. Sleeping for long periods of time. E. Spending large sums of money.

Correct Answer is ["A","B","E"]

Explanation

Choice A reason: Rapid, continuous speech is a common symptom of manic behavior, as individuals may feel an increased pressure to speak.

Choice B reason: Flirtatious interaction can be part of the increased sociability and decreased inhibition associated with mania.

Choice C reason: Dressing in black or grey clothing is not specifically indicative of manic behavior.

Choice D reason: Sleeping for long periods is more commonly associated with depressive episodes, not manic behavior.

Choice E reason: Spending large sums of money recklessly can be a sign of the impulsivity and poor judgment that accompany manic episodes.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with cognitive deficits is extremely suicidal and has not responded to antidepressants. The treatment team is considering electroconvulsive therapy (ECT). Which client information would impact the feasibility of this treatment option?

Correct Answer is B

Explanation

A nurse is caring for a client who has bipolar disorder. Which of the following actions by the client should the nurse interpret as displaying manic behavior? Select all that apply.

Correct Answer is ["A","B","E"]

Explanation

Laboratory results reveal elevated levels of prolactin in a client diagnosed with Schizophrenia. Which symptoms should the nurse expect to observe? Select all that apply.

A nurse is performing a psychosocial assessment on an adolescent client. Which of the following should indicate to the nurse a potential risk for suicide? Select all that apply.

A nurse at a college campus mental health counseling center is caring for a student who just failed an examination. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as which of the following defense mechanisms?

The nurse is working with clients with personality disorders that are having problems with relationships and other parts of their life. Which barrier(s) is the nurse experiencing when working with this group of clients? Select all that apply.

A nurse is planning discharge for a client who has borderline personality disorder. Which of the following interventions should be included for this client?

A nurse at a college campus mental health counseling center is caring for a student who just failed an examination. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as which of the following defense mechanisms?

The nurse is educating a client and family about strategies to minimize the side effects of antipsychotic drugs. Which will be included in the plan? Select all that apply.

When engaging with clients, which techniques should the nurse avoid using to foster more therapeutic responses? Select all that apply.