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

experience no loss of contact with reality.

never have mood or personality changes.

have conflict but only use adaptive defense mechanisms to cope.

are always aware that their behaviors are maladaptive.

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is B

Explanation

a. Psychotic disorder: Schizophrenia is a well-defined psychotic disorder characterized by delusions, hallucinations, and disorganized thinking, but it doesn't specifically address the mood component present in this case.
b. Schizoaffective disorder: Schizoaffective disorder is characterized by symptoms of both schizophrenia (such as delusions and hallucinations) and mood disorders (such as depression or mania). The presence of delusional thinking and visual hallucinations, combined with periods of depression and suicidal ideations, fits the profile of schizoaffective disorder.
c. Paranoid disorder: Paranoid disorder is characterized by a pervasive pattern of suspicion and distrust, but it doesn't necessarily involve hallucinations or disorganized thinking like schizophrenia.
d. Schizophreniform disorder: Schizophreniform disorder is similar to schizophrenia but with a shorter duration of symptoms (less than 6 months). The prompt doesn't specify the duration, making schizophrenia a more likely diagnosis.

A. stop the client in the hall and tell them that they must pace in the day room instead. B. keep hands in pockets so as not to appear threatening. C. speak softly and calmly, D. offer the client a cup of coffee.

Correct Answer is C

Explanation

a. Stop the client in the hall and tell them that they must pace in the day room instead. This can be confrontational and might escalate the situation.
b. Keep hands in pockets so as not to appear threatening. While non-threatening body language is important, the focus should be on verbal communication.
c. Speak softly and calmly. De-escalation is key in such situations. A calm and non-threatening approach is essential to build rapport and assess the situation.
d. Offer the client a cup of coffee. Stimulants like caffeine might worsen anxiety.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a schizophrenic client who is exhibiting delusional thinking, visual hallucinations, suicidal ideations, and periods of depression. The nurse would recognize that the client is displaying which category of schizophrenia?

Correct Answer is B

Explanation

A client is noted to be pacing on the unit with their hands clenched and mumbling curses. The nurse knows that the initial approach to this client would be to:

Correct Answer is C

Explanation

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