A nurse is caring for a client who has schizophrenia and is preparing for discharge. Nurses' Notes

Admission:

25-year-old client admitted with positive symptoms of schizophrenia. Client has a history of substance use, anxiety, and depression. Client demonstrates alterations in speech and persecutory delusions. Client states that they hear voices that are warning them of danger and that they should stay away from a coworker because the coworker is conspiring against them. Day 5-Discharge:

No delusions or hallucinations noted. Speech coherent. Client has a well-groomed appearance. Individual therapy attended daily.

Medication Administration Record Haloperidol 3 mg PO twice daily

The nurse is providing discharge teaching to the client. Which of the following information should the nurse include when educating the client about relapse prevention? Select all that apply.

Take a dose of the medication as soon as delusions or hallucinations begin.

Report any adverse effects of the medication to the provider immediately.

Notify your provider within 48 hr of manifestations of a relapse.

Go for a walk to decrease anxiety during times of increased stress.

Ask a trusted person to watch for manifestations of illness.

Limit alcohol consumption to no more than two drinks per week.

Answer and Explanation

Correct Answer : B,C,D,E

B is correct because reporting any adverse effects of the medication can help the provider adjust the dosage or prescribe a different medication if needed. Some common adverse effects of haloperidol are extrapyramidal symptoms, tardive dyskinesia, neuroleptic malignant syndrome, and anticholinergic effects.

C is correct because notifying the provider within 48 hr of manifestations of a relapse can help the client receive timely intervention and prevent further deterioration of their mental health. Some signs of a relapse are increased anxiety, paranoia, social withdrawal, insomnia, and mood swings.

D is correct because going for a walk or engaging in other physical activities can help the client cope with stress and reduce anxiety, which are common triggers for schizophrenia symptoms.

E is correct because asking a trusted person to watch for manifestations of illness can help the client gain insight into their condition and seek help when needed. A trusted person can be a family member, a friend, or a mental health professional.

A is incorrect because taking a dose of the medication as soon as delusions or hallucinations begin is not an effective strategy for relapse prevention. The client should take their medication as prescribed by their provider and not adjust the dosage on their own.

F is incorrect because limiting alcohol consumption to no more than two drinks per week is not sufficient for relapse prevention. Alcohol can interact with haloperidol and increase its sedative effects, impairing the client's judgment and cognition. Alcohol can also worsen schizophrenia symptoms and interfere with recovery. The client should avoid alcohol altogether or consult with their provider before consuming any alcohol.

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Correct Answer is B

Explanation

The client's statement reflects a loss of interest and pleasure in life, which is a major symptom of clinical depression. The other statements are normal expressions of grief that do not necessarily indicate depression, although they may warrant further assessment and support from the nurse.

A. Encourage the client to describe their feelings in a journal. B. Administer a dose of atomoxetine to the client. C. Encourage the client to watch television as a distraction. D. Administer a dose of alprazolam to the client.

Correct Answer is D

Explanation

Alprazolam is a benzodiazepine that can provide rapid relief of anxiety symptoms during a panic attack. Atomoxetine is a selective norepinephrine reuptake inhibitor that is used to treat attention-deficit/hyperactivity disorder, not anxiety disorders. Journaling and watching television are not appropriate interventions during an acute panic attack, as they do not address the client's physiological and psychological needs.

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Naxlex Comprehensive Predictor Exams

A nurse is leading a grief support group for bereaved clients. Which of the following client statements should the nurse report to the provider as an indication of clinical depression?

Correct Answer is B

Explanation

A nurse in an in-patient facility is caring for a client who has an anxiety disorder. Which of the following actions should the nurse take while the client is experiencing an acute panic attack?

Correct Answer is D

Explanation

A nurse is assessing a client who is restless and constantly mutters to himself. Which of the following findings should lead the nurse to suspect delirium?

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