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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?

 

A.

Neologisms.

B.

Echolalia.

C.

Word salad.

D.

Clang associations.

Answer and Explanation

The Correct Answer is D

A. Neologisms involve the creation of new, meaningless words that are not understood by others. The client is using real words, so this pattern does not reflect newly invented language.

B. Echolalia refers to the repetition of words or phrases spoken by others. The client’s speech is not repeating another person’s words but instead shows a pattern based on sound.

C. Word salad is characterized by completely disorganized, incoherent speech with no logical or grammatical connection between words. Although unusual, the client’s speech maintains structure and is linked by sound patterns rather than being entirely random.

D. Clang associations occur when speech is driven by the sound of words, such as rhyming or punning, rather than meaning. The client’s use of rhyming phrases like “bow,” “boat,” “know,” and “yo” demonstrates this pattern clearly.


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Related Questions

Correct Answer is A

Explanation

A. Performing gastrostomy feedings through an established gastrostomy tube is within the scope of practice for an AP, as it is a routine, non-complex task.
B. Evaluating the effectiveness of pain medication requires assessment skills, which fall under the nurse’s scope of practice.
C. Providing client care instructions requires nursing judgment and should be done by the nurse.
D. Teaching a client how to measure their blood pressure involves client education, which is the nurse’s responsibility.

Correct Answer is C

Explanation

  • A. Incorrect. A 1-inch needle may not be long enough to reach the muscle layer in an obese client, which may result in subcutaneous injection and reduced absorption of the medication.
  • B. Incorrect. A 45° angle may not be appropriate for an IM injection, as it may cause the needle to enter at an oblique angle and miss the muscle layer or hit a bone or nerve.
  • C. Correct. The ventrogluteal site is preferred for IM injections in obese clients, as it has less subcutaneous fat and a large muscle mass that can accommodate larger volumes of medication.
  • D. Incorrect. Pinching the skin up during injection may cause the needle to enter at a shallow angle and deposit the medication in the subcutaneous tissue instead of the muscle layer.

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