A nurse is caring for a client in an inpatient mental health facility. The client tells the nurse that the government is reading her mail. Which of the following responses should the nurse make?
"It must be frightening to think that someone is reading your mail."
"You know that's not true, because it is against the law for others to read your mail."
"All of your letters come sealed, so that seems unlikely."
"Why do you think the government wants to read your mail?"
The Correct Answer is A
A. This response acknowledges the client's feelings and validates their experience without confirming or denying the delusion.
B. This response challenges the client's belief and may cause distress or exacerbate paranoia.
C. While factually correct, this response may not address the client's underlying concerns or feelings.
D. This response may invalidate the client's experience and may not effectively address the delusional belief.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Speaking in rhyming sentences can be a manifestation of mania but may not necessarily require immediate reporting unless it escalates to disruptive or harmful behavior.
B. Making inappropriate sexual comments can indicate impulsivity and lack of social boundaries. It does not however precede managing the risk of hypoglycemia.
C. Poor hygiene, such as not bathing, is common in mania due to increased energy and decreased need for sleep, but it may not require immediate reporting unless it poses a significant risk to the client's health.
D. Decreased appetite and irregular eating patterns are common during mania due to increased activity levels. Eating twice in teh past is not sufficient to meet energy requirements and the client might be at risk of hypoglycemia.
Correct Answer is ["B","C","D"]
Explanation
A. Blaming others for one's own mistakes is not typically associated with PTSD. Individuals with PTSD may have heightened irritability or anger, but this does not necessarily translate to blaming others.
B. Difficulty concentrating on tasks is a common symptom of PTSD as individuals may be easily distracted by intrusive thoughts related to their trauma.
C. Difficulty falling or staying asleep is another symptom often reported by individuals with PTSD, which can be attributed to hyperarousal and intrusive thoughts.
D. Holding persistent negative beliefs about oneself is indicative of the negative alterations in cognition and mood associated with PTSD.
E. Talking excessively is not a common finding in PTSD. While some individuals may speak more when anxious, it is not a diagnostic criterion for PTSD.
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