A male client is attending an after-school, adolescent group session because he frequently loses his temper, argues with his teachers, and refuses to comply with classroom rules. During the group session, the adolescent repeatedly blames others regardless of the situation. To help modify the adolescent's behavior, which action should the nurse implement?

Describe the consequences of his behavior in concrete terms.

Encourage the client to verbalize his feelings of anger.

Ignore blaming behavior and praise the client's appropriate behavior.

Explain that blaming others limits his psychological growth.

Answer and Explanation

The Correct Answer is A

A) Describing the consequences of the adolescent's behavior in concrete terms is the best action. This approach helps the client understand the direct impact of his actions on himself and others. Clear and specific explanations can facilitate accountability and encourage the adolescent to reflect on how his behavior affects his relationships and environment, which is essential for behavior modification.

B) Encouraging the client to verbalize his feelings of anger may provide an outlet for his emotions, but it does not directly address the problematic behavior of blaming others. While exploring feelings is important, it should be paired with teaching responsibility and consequences for behavior.

C) Ignoring blaming behavior and praising appropriate behavior might reinforce a lack of accountability. While positive reinforcement is beneficial, it is crucial to address negative behaviors directly to facilitate change. Ignoring the blaming behavior could lead to its continuation.

D) Explaining that blaming others limits his psychological growth could be insightful, but it may not resonate with the adolescent or lead to immediate behavior change. The focus should be on concrete consequences that he can understand and relate to, which can encourage more constructive behaviors.

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Correct Answer is A

Explanation

A) Performing the dressing change in a non-judgmental manner is crucial when caring for a client with borderline personality disorder. Clients with this diagnosis often have intense emotions and may feel vulnerable, so approaching the situation without judgment fosters a sense of safety and respect. This supportive attitude can help build trust and encourage open communication.

B) While providing thorough explanations when cleansing the wound can be beneficial, excessive detail may overwhelm the client or create anxiety. It is important to communicate effectively, but the focus should be on providing care in a compassionate manner rather than on the specifics of the procedure, especially given the client’s emotional state.

C) Asking the client in a non-threatening manner why they cut their abdomen could be perceived as intrusive or confrontational, potentially leading to defensiveness or escalation of emotions. This approach may not be appropriate during a dressing change; instead, it may be more effective to address the reasons for self-harm in a separate therapeutic context when the client is more stable.

D) Requesting another staff member to assist with the dressing change might be necessary in certain situations, but it could also convey a sense of fear or discomfort regarding the client’s behavior. In this case, it is essential for the nurse to manage the situation confidently and compassionately, rather than distancing themselves from the client’s needs. Fostering a supportive environment is more important than involving additional staff at this moment.

A. Listen to what the client is saying B. Sit in the chair next to the client. C. Escort the client to his room. D. Administer a PRN sedative.

Correct Answer is C

Explanation

A) Listening to what the client is saying can be important for understanding their perspective, but in this situation, the client's loud and wild behavior may be disruptive or alarming to others. Prioritizing safety is crucial.

B) Sitting in the chair next to the client could help establish rapport, but it does not address the immediate need to manage the disruptive behavior. The nurse must first ensure a safe environment for all clients.

C) Escorting the client to his room is the best initial action. This intervention helps to remove the client from the potentially stimulating environment of the day room, reducing the likelihood of escalation and providing a quieter space where the client can feel more secure and calm. It also minimizes disruption to other clients.

D) Administering a PRN sedative may be necessary if the behavior continues to escalate, but it should not be the first action taken. Non-pharmacological interventions, such as providing a safe space, should be prioritized before considering medication.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing care for a client diagnosed with a borderline personality disorder who has self-inflicted lacerations on the abdomen. Which approach should the nurse use when changing this client's dressings?

Correct Answer is A

Explanation

A male client with known auditory hallucinations begins talking loudly and gesturing wildly while in the unit's day room. Which action should the nurse implement first?

Correct Answer is C

Explanation

The mental health team working with a homeless client with chronic schizophrenia establishes the treatment goal of, "Improvement in avolition prior to discharge." Which behavior demonstrates achievement of this goal to the nurse?

A young adult client is brought to the emergency department with a suspected drug overdose. Which information is most important for the nurse to obtain from the family?

A middle-aged adult with major depressive disorder suffers from psychomotor retardation, hypersomnia, and amotivation. Which intervention is likely to be most effective in returning this client to a normal level of functioning?

A client with schizophrenia receives a prescription for fluphenazine. Which instruction is most important for the nurse to include when teaching the client about this drug?

The nurse is preparing a client for discharge who has been taking alprazolam long-term for generalized anxiety disorder (GAD). When evaluating the client's understanding of the discharge teaching, which statement made by the client shows awareness of the most important self-care goal?

A client is admitted to the psychiatric unit following aspiration of a caustic material related to a suicide attempt. Which nursing problem has the highest priority?