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 B

Explanation

A. Pour cool water over the client's perineum – Warm, not cool, water is more effective in relaxing the urinary sphincter to promote urination.

B. Turn on the faucets in the client's sink – The sound of running water can trigger the urge to urinate through a reflex mechanism, making this the best option.

C. Tell the client to gently stroke her lower abdomen – This is not an effective technique for stimulating urination.

D. Instruct the client to lean slightly backward – Positioning does not significantly influence urination while using a bedpan.

A. Warm skin B. Tachypnea C. Nervousness D. Ketonuria

Correct Answer is C

Explanation

A. Warm skin – Hypoglycemia typically presents with cool, clammy skin due to vasoconstriction, not warm skin.

B. Tachypnea – Tachypnea is a sign of diabetic ketoacidosis (DKA), which occurs with hyperglycemia, not hypoglycemia.

C. Nervousness – This is the correct answer because hypoglycemia triggers the release of epinephrine, leading to symptoms such as nervousness, tremors, sweating, and palpitations.

D. Ketonuria – Ketonuria is associated with DKA, which occurs in severe hyperglycemia, not hypoglycemia.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a female client who requires bed rest and reports difficulty urinating into a bedpan. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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