A college student brings his roommate to the clinic because the roommate has been talking to someone who is not present. The student tells the practical nurse (PN) that his roommate is acting strange.

Which question should the PN ask the client next?

"Are you planning to obey the voices?"

"Have you taken any hallucinogens?"

"When did these voices begin?"

"Do you believe the voices are real?"

Answer and Explanation

The Correct Answer is A

This is the correct answer because it is the most relevant and respectful question to ask the client next. Asking about the onset of the voices can help the practical nurse (PN) determine the possible causes and triggers of the client's hallucinations, which are sensory perceptions that occur without external stimuli. Hallucinations can be caused by various factors, such as mental disorders, substance abuse, medication side eﬀects, physical illnesses, sleep deprivation, or stress. The PN should ask about the frequency, duration, and content of the voices, as well as the client's response to them. The PN should also assess the client's mood, behavior, cognition, and insight. The PN should use a calm, supportive, and nonjudgmental approach when communicating with the client who is experiencing hallucinations.

a) "Are you planning to obey the voices?"
This is not the correct answer because it is not a priority question to ask the client next. Asking about the client's intention to obey the voices can help the PN assess the risk of harm to self or others, which is an important aspect of safety. However, this question may also imply that the PN believes or validates the voices, which may reinforce the client's delusions or false beliefs. The PN should ask about the client's plan to obey the voices only after establishing rapport and trust with the client, and after assessing the nature and content of the voices.

b) "Have you taken any hallucinogens?"
This is not the correct answer because it is not a respectful question to ask the client next. Asking about the client's substance use can help the PN identify the possible causes of hallucinations, as some drugs such as LSD, psilocybin, or ketamine can induce hallucinogenic eﬀects. However, this question may also sound accusatory or confrontational, which may oﬀend or alienate the client. The PN should ask about the client's substance use in a sensitive and nonthreatening manner, and after obtaining informed consent and ensuring confidentiality.

d) "Do you believe the voices are real?"
This is not the correct answer because it is not a helpful question to ask the client next. Asking about the client's belief in the reality of the voices can help the PN assess the level of insight or awareness that the client has about their condition. However, this question may also challenge or invalidate the client's perception, which may cause defensiveness or resistance. The PN should avoid arguing or disagreeing with the client about their hallucinations, as this may damage the therapeutic relationship. The PN should acknowledge and accept the client's experience without endorsing or reinforcing it.

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Correct Answer is C

Explanation

When the practical nurse (PN) notices that one of the unlicensed assistive personnel (UAP) consistently records subnormal temperatures when using the thermometer, the first action the PN should take is to observe how the UAP obtains temperatures. This allows the PN to directly assess the UAP's technique and determine if any errors or inaccuracies are occurring during temperature measurement. By observing the process, the PN can identify any potential issues, such as incorrect placement of the thermometer or improper technique, and provide appropriate guidance and education.
Let's evaluate the other options:

a) Show the UAP how to chart temperatures.
While accurate charting of temperatures is important, it is not the primary concern in this situation. The PN should first focus on assessing the UAP's temperature measurement technique before addressing charting skills.

b) Return the thermometer for recalibration.
Returning the thermometer for recalibration may be necessary if there is evidence or suspicion of a malfunctioning thermometer. However, before assuming that the thermometer is the issue, it is important to first observe how the UAP obtains temperatures to rule out any human error in the measurement process.

d) Demonstrate how to use the equipment.
Demonstrating how to use the equipment may be beneficial, but it should not be the first action taken in this scenario. The PN should first observe the UAP's technique to identify any potential errors or issues in temperature measurement. Based on the observation, the PN can provide specific guidance and demonstrate the correct technique if necessary.

In summary, when a practical nurse (PN) notices that a UAP consistently records subnormal temperatures when using the thermometer, the first action the PN should take is to observe how the UAP obtains temperatures. This allows for direct assessment of the UAP's technique and identification of any potential errors or issues. Based on the observation, the PN can provide appropriate guidance, education, and intervention as needed to ensure accurate temperature measurement.

A. Leaving the client alone to give them space. B. Removing any potential means of self-harm from the client's environment. C. Encouraging the client to confront their feelings of hopelessness. D. Telling the client that they should be grateful for what they have.

Correct Answer is B

Explanation

Choice A rationale:

Leaving the client alone to give them space is not an appropriate intervention for a client with depression and a history of suicide attempts. Isolation can increase feelings of hopelessness and despair, potentially leading to self-harm or suicidal thoughts.

Choice B rationale:

Removing any potential means of self-harm from the client's environment is the most essential intervention in this scenario. It is crucial to ensure the client's safety by eliminating access to items or substances that could be used for self-harm, such as medications, sharp objects, or other dangerous items. This intervention helps reduce the immediate risk of harm.

Choice C rationale:

Encouraging the client to confront their feelings of hopelessness is important in the long term, as it can be part of therapeutic interventions. However, it should not be the immediate priority when the client is at risk of self-harm. Ensuring their safety is paramount.

Choice D rationale:

Telling the client that they should be grateful for what they have is not an appropriate intervention. It can be perceived as dismissive of their feelings and may worsen their sense of hopelessness and isolation.

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A college student brings his roommate to the clinic because the roommate has been talking to someone who is not present. The student tells the practical nurse (PN) that his roommate is acting strange. Which question should the PN ask the client next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) notices that one of the unlicensed assistive personnel (UAP) working in the long- term care facility consistently records subnormal temperatures when using the thermometer. Which action should the PN take first?

Correct Answer is C

Explanation

A client has been diagnosed with depression and has a history of suicide attempts. What intervention is essential for the nurse to implement?

Correct Answer is B

Explanation

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A college student brings his roommate to the clinic because the roommate has been talking to someone who is not present. The student tells the practical nurse (PN) that his roommate is acting strange.

Which question should the PN ask the client next?