A newly admitted client diagnosed with paranoid schizophrenia is super vigilant and constantly scans the environment. The client states, "I saw doctors talking in the hall. They were plotting to kill me." Which of the following does the nurse correctly identify as this behavior?

An idea of reference

A delusion of infidelity

An auditory hallucination

Echolalia

Answer and Explanation

The Correct Answer is A

A) Correct. An idea of reference is a false belief that ordinary events, objects, or behaviors of others have a particular and unusual meaning directly pertaining to oneself. In this case, the client believes that the doctors' conversation in the hall is about them.

B)   Incorrect. A delusion of infidelity involves a false belief that one's partner is being unfaithful.
C)   Incorrect. Auditory hallucinations involve hearing things that are not present.
D)   Incorrect. Echolalia is the repetition of another person's words.

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Correct Answer is C

Explanation

A. While understanding precipitating factors is important, it is not the immediate priority when the client is actively experiencing hallucinations.
B. Distracting the client may not address the underlying cause of the hallucinations, which should be the priority.
C. Determining the content of the hallucinations can provide important information for assessment and intervention.
D. Dismissing the client's experience can be alienating and unhelpful.

A. The client will have an appropriate one-on-one interaction with a peer by day 4. B. The client will exchange personal information with peers at lunchtime. C. The client will verbalize the desire to interact with peers by day 2. D. The client will initiate an appropriate social relationship with a peer.

Correct Answer is A

Explanation

A. This outcome is specific, measurable, and timebound. It addresses the client's impaired social interactions and sets a realistic expectation for improvement within a short timeframe.
B. While this outcome is specific, it may not be achievable within a short timeframe and may not directly address the issue of egocentrism.
C. This outcome focuses on verbalization but may not necessarily lead to actual interaction or address the issue of egocentrism.
D. While this outcome is relevant, it is not as specific or timebound as option A.

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A newly admitted client diagnosed with paranoid schizophrenia is super vigilant and constantly scans the environment. The client states, "I saw doctors talking in the hall. They were plotting to kill me." Which of the following does the nurse correctly identify as this behavior?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What intervention is a priority when the client is experiencing auditory hallucinations?

Correct Answer is C

Explanation

A client diagnosed with bipolar II disorder has a problem statement of impaired social interactions related to egocentrism. Which short-term correctly written outcome is an appropriate expectation for this client problem?

Correct Answer is A

Explanation

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