A newly hospitalized patient experiencing psychosis says. "Red chair out town board." Which term should the nurse use to document this finding?

Word salad

Echolalia

Neologism

Anhedonia

Answer and Explanation

The Correct Answer is A

A. Word salad refers to a jumble of incoherent words and phrases without logical connection, as seen in the patient’s statement.
B. Echolalia is the repetition of another person’s spoken words, not unrelated word combinations.
C. Neologism is the invention of new, made-up words, not a random string of real words.
D. Anhedonia is the inability to experience pleasure, not a speech disturbance.

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Correct Answer is A

Explanation

A. Clozapine can cause agranulocytosis, a life-threatening drop in white blood cells, leaving the client highly vulnerable to infection. Flu-like symptoms (fever, sore throat, malaise) may be early warning signs and require immediate provider notification and WBC count monitoring.

B. Olanzapine commonly causes orthostatic hypotension. Dizziness when standing is expected early in treatment and can often be managed with slow position changes, not an emergency.

C. Thioridazine, like many antipsychotics, can cause sedation. Daytime drowsiness is a common side effect and not urgent.

D. Chlorpromazine may cause GI upset such as nausea and vomiting. While bothersome, it is not immediately life-threatening unless severe or persistent.

A. "Unfortunately, delirium is a progressively disabling disorder." B. "The confusion will probably get better as we treat the infection. C. The health care provider is the best person to answer your question." D. "I will be glad to contact the chaplain to talk with you."

Correct Answer is B

Explanation

A. Delirium is usually acute and reversible, especially when caused by an underlying condition like a UTI.

B. Delirium in elderly patients is often secondary to an acute illness such as a urinary tract infection. Treatment of the underlying cause typically resolves the confusion, so this statement provides accurate and reassuring information to the family.

C. While the provider can give a formal prognosis, the nurse can provide evidence-based, general information about delirium recovery.

D. While supportive, this does not address the family’s question about recovery.

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A newly hospitalized patient experiencing psychosis says. "Red chair out town board." Which term should the nurse use to document this finding?

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