A male client with schizophrenia continues to talk to others on the mental health unit using tangential speech. What intervention should the nurse implement?

Tell the client to discuss his ideas with others when his thoughts are more clear.

Teach the client to slow down and focus on the topic by listening to his words.

Ask the client to repeat his comments.

Confront the client when he talks rapidly.

Answer and Explanation

The Correct Answer is B

A.   Telling the client to discuss his ideas when his thoughts are more clear may not be effective as it does not provide immediate guidance on improving communication.
B.   Teaching the client to slow down and focus on the topic by listening to his words is a therapeutic intervention to address tangential speech and promote effective communication.
C. Asking the client to repeat his comments may not directly address the issue of tangential speech and may not be as therapeutic as providing guidance on communication techniques.
D.   Confronting the client when he talks rapidly may be perceived as confrontational and may not be the most therapeutic approach to address tangential speech.

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Correct Answer is D

Explanation

Rationale for A: While seclusion and restraint may be necessary, this should be considered after assessing the environment for immediate safety concerns.

Rationale for B: Administering medication may help calm the client but does not address immediate safety concerns.

Rationale for C: Confirm the client’s identity and orientation to time and place is a therapeutic intervention that helps ground the client during a dissociative episode. However, in a situation where physical aggression is present, ensuring safety takes precedence over reorientation.

Rationale for D. Inspect the area for objects that can be used in a dangerous manner is the first and most critical action. When a client becomes physically aggressive, the nurse's priority is to maintain safety for the client, staff, and others in the environment. Removing or securing potentially harmful objects minimizes the risk of injury and creates a safer setting for subsequent interventions.

A. Use relaxation techniques to reduce excessive anxiety. B. Avoid alcohol and other sedatives while taking the medication. C. Move slowly from a sitting position to a standing position. D. Stop taking the medication if the intended effect is not immediate.

Correct Answer is D

Explanation

A. Using relaxation techniques is a positive and appropriate strategy for managing anxiety.
B. Avoiding alcohol and other sedatives is essential as they can potentiate the sedative effects of lorazepam.
C. Moving slowly from a sitting to a standing position is important to minimize orthostatic hypotension, a potential side effect of lorazepam.
D. Stopping the medication if the intended effect is not immediate is not appropriate guidance.
Lorazepam, like many benzodiazepines, may take some time to achieve its full therapeutic effect. Abrupt discontinuation can lead to withdrawal symptoms and should be done under the guidance of a healthcare provider.

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A male client with schizophrenia continues to talk to others on the mental health unit using tangential speech. What intervention should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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