The nurse notices a client wandering in the hospital hall giggling, with bizarre behavior that is annoying and frightening other clients. A priority in caring for her is to:

Encourage social interaction.

Discuss the bizarre behavior.

Give the client information about her illness.

Provide a safe environment.

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Encouraging social interaction might not be appropriate in this situation. The client’s bizarre behavior is already causing distress to others, and encouraging more interaction could exacerbate the problem. The priority should be to address the immediate safety and well-being of both the client and others. Once the client is in a safe environment, social interaction can be encouraged in a controlled and therapeutic manner.

Choice B Reason:

Discussing the bizarre behavior with the client might not be effective in the moment, especially if the client is not in a state to understand or engage in such a discussion. The primary focus should be on ensuring safety and stability before addressing specific behaviors. Once the client is calm and in a safe environment, discussions about behavior can be more productive.

Choice C Reason:

Providing information about the client’s illness is important for long-term management and understanding, but it is not the immediate priority in this situation. The client’s current state requires immediate intervention to ensure safety. Education about the illness can be provided once the client is stabilized and in a better position to comprehend the information.

Choice D Reason:

Providing a safe environment is the most immediate and crucial priority. The client’s behavior is not only distressing to others but could also pose a risk to herself and others. Ensuring the client is in a safe, controlled environment helps to prevent harm and allows for further assessment and appropriate interventions. Safety is always the first priority in managing acute behavioral disturbances.

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Correct Answer is C

Explanation

Choice A Reason: Assess regularly for self-harm during treatment

Regular assessment for self-harm is crucial in any psychiatric care plan, especially for clients with conversion disorder who may experience significant distress. However, this action alone does not address the underlying issues or provide the client with tools to manage their symptoms. Continuous monitoring is important, but it should be part of a broader, more comprehensive care plan.

Choice B Reason: Allow for unlimited discussion on physical symptoms

While it is important to validate the client’s experiences and provide a space for them to discuss their symptoms, allowing unlimited discussion can sometimes reinforce the symptoms and lead to increased focus on physical complaints. This approach may not be beneficial in the long term and can detract from addressing the psychological aspects of the disorder.

Choice C Reason: Discuss alternative coping strategies with the client

This is the correct answer. Discussing alternative coping strategies helps the client develop skills to manage their symptoms more effectively. Techniques such as cognitive-behavioral therapy (CBT), relaxation exercises, and stress management can be very beneficial. These strategies empower the client to handle stress and reduce the impact of their symptoms. Providing education on coping mechanisms is a proactive approach that can lead to better outcomes.

Choice D Reason: Encourage alone time for the client in seclusion

Encouraging alone time in seclusion is generally not recommended for clients with conversion disorder. Seclusion can increase feelings of isolation and distress, potentially exacerbating symptoms. Instead, supportive and interactive interventions are preferred to help the client feel connected and understood.

A. Word salad. B. Loose association. C. Clang association. D. Ideas of reference.

Correct Answer is C

Explanation

Choice A Reason:

Word salad.

Word salad refers to a jumble of words and phrases that lack logical coherence, often seen in severe cases of schizophrenia. The speech is typically incomprehensible and does not follow any recognizable pattern. In this case, the client’s response, while unusual, follows a pattern based on sound rather than meaning, which does not fit the definition of word salad.

Choice B Reason:

Loose association.

Loose association involves a series of thoughts that are only loosely connected to each other. This is a common symptom in schizophrenia, where the person’s thoughts may drift from one topic to another with little logical connection. However, the client’s response in this scenario is more structured and based on rhyming, which is characteristic of clang associations rather than loose associations.

Choice C Reason:

Clang association.

Clang association is a type of thought disorder where the person’s speech is governed by the sound of words rather than their meaning. This often results in rhyming or punning speech. The client’s response, “A match is a catch. A catch is a batch. The batch started to hatch,” is a clear example of clang association because the words are linked by their similar sounds rather than their meanings.

Choice D Reason:

Ideas of reference.

Ideas of reference involve the belief that ordinary events, objects, or behaviors of others have particular and unusual significance specifically for the person. This is often seen in paranoid schizophrenia. The client’s response does not indicate that they believe the words have special personal significance; instead, it shows a pattern of rhyming, which is more indicative of clang association.

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The nurse notices a client wandering in the hospital hall giggling, with bizarre behavior that is annoying and frightening other clients. A priority in caring for her is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is diagnosed with Functional Neurologic Symptom Disorder (conversion disorder). What action should the nurse include in the plan of care?

Correct Answer is C

Explanation

The client hears the word “match.” The client replies, “A match is a catch. A catch is a batch. The batch started to hatch.” Which communication pattern does the nurse identify?

Correct Answer is C

Explanation

A client tells the nurse, “I feel bad because my mother does not want me to return home after I leave the hospital.” Which nursing response is most therapeutic?

A nurse is assessing a client who is disoriented to time and place. What additional findings would support a diagnosis of delirium? (Select all that apply.)

Which of the following interventions would a nurse use when caring for an inpatient client who expresses anger inappropriately?

After being in the hospital for one month, a client with schizophrenia states that voices are telling them they will die tonight. The client asks the nurse if this is true. The client’s statement and question indicate that they:

A client diagnosed with an Anxiety Disorder tells a nurse that being in crowds creates thoughts of losing control and the need to suddenly leave. What should the nurse recommend as an effective, non-pharmacological therapy for managing the client’s symptoms of anxiety?

A client on an acute psychiatric inpatient unit approaches the nurse’s station every 10-15 minutes with various requests. The nurse intervenes by stating, “You may approach the nurse’s station only once an hour.” Which nursing intervention has been employed?

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