A 70yearold client is admitted to the locked psychiatric unit, diagnosed with delirium. Later in the day, he tries to get out of the locked unit several times. He yells, "I have to leave and get to my barber. I see him every Wednesday. Let me out!"
Which of the following would be the most therapeutic response by the nurse?
"You need to come and take a shower before you can go get your hair cut."
"Please stop banging on the door. Your room is right over there."
"The door is locked so that you don't leave and get hurt."
"You are in the hospital, and I'm your nurse."
The Correct Answer is C
A. This response does not directly address the client's concern and may be perceived as dismissive.
B. This response does not provide a clear explanation for the locked door and may not effectively address the client's agitation.
C. This response provides a clear and honest explanation for the locked door, ensuring the client's safety, which is the priority.
D. This response acknowledges the situation but does not provide a clear explanation for the locked door.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Correct. Ecstasy, also known as MDMA (3,4methylenedioxymethamphetamine), belongs to the hallucinogen class of drugs. It produces altered perceptions and sensations.
B) Incorrect. Hypnotics are drugs that promote sleep.
C) Incorrect. Opioids are a class of drugs that include substances like heroin and prescription pain medications.
D) Incorrect. Sedatives are drugs that calm or soothe and can also induce sleep.
Correct Answer is C
Explanation
A) Incorrect. Thyroxine is a hormone produced by the thyroid gland and is not directly implicated in the etiology of schizophrenia.
B) Incorrect. Erythropoietin is a hormone that stimulates the production of red blood cells and is not directly implicated in the etiology of schizophrenia.
C) Correct. Glutamate, an excitatory neurotransmitter, has been implicated in the development of schizophrenia. Abnormalities in glutamate signaling have been identified in individuals with schizophrenia.
D) Incorrect. While serotonin abnormalities have been associated with mood disorders such as depression, they are not considered a primary factor in the etiology of schizophrenia.
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