A nurse in a mental health unit asks a client who has schizophrenia, "How are you?" Which of the following responses should the nurse identify as the speech alteration of echolalia?
"I am lovistrated."
"Super, trooper, and duper."
"How are you?"
"Pink spots in Africa."
The Correct Answer is C
Echolalia is the repetition of words or phrases spoken by others. In this case, the client is repeating the nurse's question, "How are you?" This is an example of echolalia.
a) "I am lovistrated" is an example of neologism, which is the creation of new words.
b) "Super, trooper, and duper" is an example of clang association, which is the use of words that sound alike but have no logical connection.
d) "Pink spots in Africa" is an example of a thought disorder, which is a disruption in the organization and expression of thoughts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Answer: B. You can take a shower 1 day after your procedure.
Rationale:
A. You can resume a regular diet 3 days after your procedure:
There is typically no need to delay resuming a regular diet for three days after a cardiac catheterization. Most clients can resume their usual diet shortly after the procedure once they are fully awake and any nausea has resolved.
B. You can take a shower 1 day after your procedure:
It is generally safe to shower the day after a cardiac catheterization as long as the insertion site remains protected. Clients should avoid soaking in a bath or swimming until the site is fully healed to prevent infection.
C. You can begin exercising 2 days after your procedure:
Strenuous activities, including exercise, should generally be avoided for a few days to a week following a cardiac catheterization. This allows time for the insertion site to heal and reduces the risk of complications such as bleeding.
D. You can return to school 1 week after your procedure:
Most clients can return to school or normal activities within a few days, provided they feel well and avoid excessive physical exertion. A full week off is typically not necessary unless specified by the healthcare provider based on the individual’s recovery.
Correct Answer is D
Explanation
The subjective indication that the client needs PRN (as needed) pain medication is when the client reports pain. Pain is a subjective experience, and it is essential to address the client's self-reported pain level and provide appropriate pain management.
Explanation for the other options:
a) The client's heart rate is 110/min: An increased heart rate can be an objective indication of pain, but it is not a subjective indication. Subjective indications are based on the client's self-report or personal experiences.
b) The client is guarding their abdominal incision: Guarding the abdominal incision may suggest discomfort or pain, but it is an objective indication that can be observed by the nurse. Subjective indications focus on the client's self-report.
c) The client exhibits facial grimacing: Facial grimacing can be an objective indication of pain, but it is not a subjective indication. Again, subjective indications are based on the client's self-report or personal experiences.
In this scenario, the most reliable and appropriate indication for administering PRN pain medication is when the client reports pain, as this acknowledges the client's own perception of their pain level.
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