A client with borderline personality disorder says to the nurse, "I feel so comfortable talking with you. You seem to have a special way about you that really helps me." Which would be the most appropriate response by the nurse?

"I'm glad you feel comfortable with me."

"I am sorry I cannot be your friend."

"You feel other's don't understand you?"

"I'm here to help you just as all the staff members are."

Answer and Explanation

The Correct Answer is D

D. It acknowledges the client’s comfort while emphasizing the nurse’s professional role. It sets clear boundaries and reinforces that the nurse’s primary purpose is to provide care and support within the therapeutic context.

A. This response acknowledges the client’s feelings but does not set clear boundaries. It may

inadvertently encourage the client to view the nurse as a friend rather than a professional caregiver.

B. While this response establishes boundaries, it may come across as abrupt or cold. It lacks empathy and understanding.

C. This response reflects empathy and encourages further exploration of the client’s feelings. However, it does not address the professional boundaries explicitly.

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Correct Answer is D

Explanation

D. Mouthwash and other products containing alcohol should be avoided while taking disulfiram. Even small amounts of alcohol (such as those found in mouthwash) can lead to adverse reactions when combined with disulfiram.

A. Disulfiram should be taken on an empty stomach, preferably in the morning, to enhance absorption and efficacy. Taking it with food may decrease absorption and reduce its effectiveness in deterring alcohol consumption.

B. Disulfiram tablets should be swallowed whole and not crushed or broken. Crushing the tablets can alter their release mechanism and affect their intended action. However, avoidance of alcohol based substances is more important.

C. Grapefruit juice can interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, there is no specific interaction between grapefruit juice and disulfiram.

A. Symptom Positive Negative B. Disordered thinking C. Flat affect D. Trouble concentrating E. Lack of initiative F. Social withdrawal

Correct Answer is ["B"]

Explanation

A. Disordered thinking, also known as formal thought disorder, involves disturbances in the thought process, such as loosening of associations, thought blocking, or tangentiality. These disturbances result in fragmented or illogical thinking patterns.
B. Flat affect refers to a reduction or absence of emotional expression. Individuals with flat affect may appear emotionally dull or unresponsive, showing little variation in facial expressions or vocal tone.
D. Apathy refers to a lack of motivation, interest, or enthusiasm in engaging with one's environment or pursuing goals. Individuals with schizophrenia may experience extreme apathy, which can contribute to social withdrawal and functional impairment.
E. Lack of initiative, also known as avolition, refers to a reduction or absence of goal-directed behavior or motivation to engage in purposeful activities. Individuals with schizophrenia may have difficulty initiating and sustaining activities of daily living or pursuing personal interests.
F. Social withdrawal involves the avoidance or reduction of social interactions and activities. It may result from factors such as social anxiety, apathy, or disinterest in socializing due to psychotic symptoms or negative symptoms of schizophrenia.
C. Trouble concentrating is not typically considered a primary symptom of schizophrenia. While difficulties with concentration or attention may occur, they are more often associated with cognitive impairments rather than positive or negative symptoms.

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A client with borderline personality disorder says to the nurse, "I feel so comfortable talking with you. You seem to have a special way about you that really helps me." Which would be the most appropriate response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new prescription for disulfiram (Antabuse). Which of the following information should the nurse include in the teaching?

Correct Answer is D

Explanation

The nurse is doing an admission assessment on a client with schizophrenia. Which of the following are positive symptoms of schizophrenia?

Correct Answer is ["B"]

Explanation

A nurse is caring for a client who has major depressive disorder and attempted suicide. The client tells the nurse. "I should have died because I am totally worthless." Which of the following responses should the nurse make?

A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?

A nurse is caring for a client who has obsessive-compulsive disorder (OCD). Which of the following characteristics are expected findings of OCD? (Select all that apply.)

A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply)

A nurse is providing care to children on a general pediatric unit. Which of the following children should the nurse identify as a potential victim of abuse?

A nurse is admitting a client who has experienced a weight loss of 11 kg (25 lb) in the past 3 months. The client weighs 40 kg (88 lb) and believes she is fat. Which of the following aspects of care should the nurse consider the first priority for this client?

A nurse is creating a plan of care for a client who is experiencing mania. Which of the following interventions should the nurse include in the plan? (Select all that apply.)

An anxiolytic agent has been prescribed for the client. Which of the following statements by the client would indicate to the nurse that client education about this medication has been effective?