The nurse must prepare an oral contrast solution in 850 mL of apple juice. There are 6-ounce containers of apple juice in the pantry. What is the minimum number of containers of juice to make 850 mL? (Round the answer to the nearest whole container)

Choice A Reason:

Manifestation of dyslexia.

Dyslexia is a learning disorder characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. It is not typically associated with the creation of new words or phrases, which is what the term ‘mazurka’ represents in this context. Therefore, the client’s use of ‘mazurka’ is not a manifestation of dyslexia.

Choice B Reason:

Example of loose associations.

Loose associations refer to a thought disorder where ideas are presented with little or no logical connection between them. While this is a common symptom in schizophrenia, it does not specifically involve the creation of new words. The term ‘mazurka’ in this context does not illustrate a lack of logical connection between ideas but rather the invention of a new term.

Choice C Reason:

Neologism.

Neologism refers to the creation of new words or phrases that are often only understood by the person who created them. This is a common symptom in schizophrenia, where individuals may invent words that have meaning only to them. The client’s use of ‘mazurka’ fits this definition, as it is a newly created word that likely holds specific meaning for the client.

Choice D Reason:

Flight of ideas.

Flight of ideas is a symptom characterized by rapid and continuous speech with abrupt changes from topic to topic, usually based on understandable associations, distracting stimuli, or plays on words. This symptom is more commonly associated with manic episodes rather than schizophrenia. The use of ‘mazurka’ does not indicate rapid topic changes but rather the creation of a new word.

The correct answer is a.

Choice A Reason:

The statement “Ask the client, ‘What are the voices saying to you?’” is correct. Engaging the client in a conversation about their hallucinations can help the nurse understand the content and nature of the hallucinations, which is crucial for assessing the client’s risk of harm to themselves or others. This approach also validates the client’s experience and can help build trust and rapport. It is important to approach the client with empathy and without judgment, as this can help in managing the symptoms more effectively.

Choice B Reason:

The statement “Give the client a PRN dose of benztropine” is incorrect. Benztropine is an anticholinergic medication used to treat extrapyramidal symptoms caused by antipsychotic medications. It is not used to manage auditory hallucinations directly. Administering benztropine without a clear indication could lead to unnecessary side effects and does not address the immediate issue of the hallucinations.

Choice C Reason:

The statement “Call and report the behavior to the physician” is incorrect. While it is important to keep the physician informed about significant changes in the client’s condition, the immediate intervention should focus on addressing the client’s current experience. Reporting the behavior without first attempting to understand and manage the hallucinations may delay appropriate care and support for the client.

Choice D Reason:

The statement “Tell the client, ‘Well, I see you’re distracted right now. We’ll talk more later.’” is incorrect. This response dismisses the client’s current experience and may make them feel misunderstood or ignored. It is important to address the client’s immediate needs and provide support rather than postponing the conversation. Acknowledging the client’s experience and offering to discuss it can help in managing the symptoms and providing appropriate care.