A client on an acute mental health unit states to a nurse. "Tie a bow. Row the boat. Now I know. Whoa! I see you, yo." The nurse should document that the client is exhibiting which of the following speech alterations?

Echolalia

Word salad

Clang association

Neologisms

Answer and Explanation

The Correct Answer is C

A. Echolalia refers to the repetition of words spoken by another person.

B. Word salad is a mix of random, unrelated words with no logical connection.

C. This is the correct answer. Clang association involves rhyming words that are spoken together without meaningful connections, as seen in the client's statement.

D. Neologisms are made-up words that have meaning only to the individual.

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Correct Answer is A

Explanation

A. A child who has acute epiglottitis and is drooling – This is the priority because drooling, stridor, and respiratory distress suggest airway obstruction, which is life-threatening. Immediate intervention is required to secure the airway.

B. A child who has a urinary tract infection and bright red blood in her urine – Hematuria can be concerning but is not immediately life-threatening.

C. A child who has mononucleosis and reports severe fatigue – Fatigue is common with mononucleosis but does not require immediate intervention.

D. A child who has Wilms' tumor and an abdominal mass – While Wilms' tumor is serious, it does not present an immediate airway or hemodynamic emergency.

A. Irritability B. Increased head circumference C. Hypotonicity D. Decreased auditory startle response

Correct Answer is A

Explanation

A. Irritability – This is the expected finding. Newborns exposed to cocaine in utero often exhibit irritability, hypertonia, tremors, and a high-pitched cry due to withdrawal symptoms and central nervous system excitability.

B. Increased head circumference – Cocaine use is associated with intrauterine growth restriction (IUGR), leading to smaller head circumferences rather than increased head size.

C. Hypotonicity – Cocaine-exposed newborns typically exhibit hypertonicity (increased muscle tone) rather than hypotonia.

D. Decreased auditory startle response – These newborns usually have an exaggerated Moro (startle) reflex rather than a decreased response.

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A client on an acute mental health unit states to a nurse. "Tie a bow. Row the boat. Now I know. Whoa! I see you, yo." The nurse should document that the client is exhibiting which of the following speech alterations?

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