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A 45-year-old client with severe schizophrenia is deemed incapable of making informed decisions about their treatment due to cognitive impairment and psychosis. The healthcare team recommends appointing a legal guardian. As the nurse, which of the following actions is most appropriate to support the client’s rights and care during this process?

Collaborate with the healthcare team and family to ensure the guardian acts in the client’s best interest while advocating for the client’s preferences.

Explain to the client that they will have limited control over their treatment decisions once the guardian is appointed.

Omit communication with the client until legal guardianship is finalized to avoid confusion.

Immediately initiate treatment without client consent once guardianship is recommended.

Answer and Explanation

The Correct Answer is A

Choice A reason: The nurse’s role is to advocate for the client by collaborating with the healthcare team and ensuring the guardian respects the client’s best interests and personal preferences. This balances autonomy and protection.

Choice B reason: While explaining changes in decision-making is part of education, focusing only on the loss of control without emphasizing advocacy may increase fear and distress.

Choice C reason: Avoiding communication violates therapeutic principles and disregards the client’s dignity. Even if incapable of informed consent, clients should remain included in discussions.

Choice D reason: Treatment cannot proceed without proper consent unless there is an emergency. Acting before guardianship is finalized would violate legal and ethical standards.

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Correct Answer is C

Explanation

Choice A reason: Rationalization involves creating logical explanations to justify behavior or feelings. In this case, the client is not justifying but outright rejecting the diagnosis, so this does not apply.

Choice B reason: Regression occurs when an individual reverts to earlier developmental behaviors, such as childish actions, to cope with stress. The client is not reverting to earlier behaviors but refusing to accept reality.

Choice C reason: Denial is the refusal to accept reality or facts, blocking external events from conscious awareness. The client’s insistence that the diagnosis is a mistake demonstrates denial, making this the correct defense mechanism.

Choice D reason: Projection occurs when a person attributes their unacceptable thoughts or feelings to someone else. The client is not attributing their illness to others but rejecting its existence altogether.

A. Social withdrawal B. Delusional thinking C. Bizarre or disorganized behavior D. Flat affect E. Auditory hallucinations

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

Explanation

Choice A reason: Social withdrawal is a negative symptom of schizophrenia, reflecting reduced engagement rather than an excess or distortion of normal function.

Choice B reason: Delusional thinking is a hallmark positive symptom, representing a distortion of reality through fixed false beliefs.

Choice C reason: Bizarre or disorganized behavior, such as unusual movements or incoherent actions, is a positive symptom reflecting disruption in normal functioning.

Choice D reason: Flat affect is a negative symptom, reflecting diminished emotional expression rather than an added or distorted behavior.

Choice E reason: Auditory hallucinations are classic positive symptoms, involving perception of voices or sounds that are not present in reality.

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Naxlex Comprehensive Predictor Exams

A client recently diagnosed with cancer continues to miss follow-up appointments and states, "The doctors must have made a mistake—there’s no way I’m that sick." According to Freud’s psychoanalytic theory, which defense mechanism is the client most likely using?

Correct Answer is C

Explanation

A nurse is assessing a client diagnosed with schizophrenia who is exhibiting positive symptoms. Which of the following findings should the nurse expect? (Select all that apply.)

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

Explanation

A 6-year-old child is showing behaviors such as excessive handwashing and reluctance to use the bathroom independently. According to Freud’s psychosexual theory, fixation at which stage is most likely contributing to these behaviors?

During an interview, a patient attempts to shift the focus from self to the nurse by asking personal questions. The nurse should respond by saying:

A nurse is caring for a client recently diagnosed with panic disorder. The provider has prescribed pharmacologic treatment. Which of the following medications are commonly used in the treatment of panic disorder? (Select all that apply.)

A patient diagnosed with schizophrenia tells the nurse, "The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say." Which response by the nurse would be most therapeutic?

A nurse is caring for a client newly prescribed aripiprazole, a third-generation antipsychotic, for the treatment of schizophrenia. Which nursing observation would require the most immediate intervention?

Which of the following best describes the primary function of the parietal lobe of the brain?

A 25-year-old client is hospitalized for severe anxiety. During the assessment, the nurse notices the client clutches a childhood stuffed animal and speaks in a childlike voice when discussing stressful life events. Which defense mechanism is the client most likely using?