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. The orientation stage focuses on establishing trust, building rapport, clarifying roles, and setting boundaries. Developing trust and rapport is essential before deeper therapeutic work can occur.
B. Self-responsibility and autonomy are outcomes seen later in the working/termination phases as the patient gains insight and coping skills.
C. A greater sense of independence is expected as the therapeutic relationship progresses, not in the orientation stage.
D. Transference (patient projecting feelings onto the nurse) may occur at any phase and is addressed in the working phase, not resolved in orientation.

A. The client is experiencing a common side effect to the medication. B. The client consumed alcohol while taking the medication. C. The client may have taken an overdose of this medication. D. The client is demonstrating an allergic response to this medication.

Correct Answer is B

Explanation

A. Disulfiram itself does not usually cause nausea and vomiting unless combined with alcohol.
B. Disulfiram is used as aversion therapy for alcohol dependence. If the client consumes alcohol while on disulfiram, it produces an acetaldehyde reaction causing severe nausea, vomiting, flushing, hypotension, and palpitations.
C. Overdose may cause neurologic or cardiac issues, but the hallmark reaction is linked to alcohol consumption.
D. Allergic reactions would typically involve rash, swelling, or respiratory distress, not severe nausea and vomiting alone.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the desirable outcome for the orientation stage of a nurse-patient relationship? The patient will demonstrate behaviors that indicate

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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