A nurse is caring for a client who has schizophrenia. The client suddenly moves to the corner of the room and shouts, "Get it away from me!" Which of the following actions should the nurse take?

Tell the client that there is nothing there.

Ask the client to describe what is being seen.

Touch the client's arm reassuringly.

Remove the client from the room.

Answer and Explanation

The Correct Answer is B

A. Tell the client that there is nothing there. Dismissing the client's perception may increase distress and reduce trust in the nurse-client relationship. A therapeutic approach acknowledges the client’s experience without reinforcing or denying hallucinations.
B. Ask the client to describe what is being seen. Encouraging the client to describe the hallucination helps assess its nature and severity. Understanding the content allows the nurse to provide appropriate support, ensure safety, and guide interventions.
C. Touch the client's arm reassuringly. Touching the client without consent, especially during a distressing hallucination, may escalate fear or agitation. Maintaining a calm and non-threatening presence is more appropriate.
D. Remove the client from the room. Relocating the client without assessing the hallucination may not address the underlying distress. Identifying triggers and using therapeutic communication are more effective initial interventions.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

A. Being in a family with numerous siblings. While family dynamics can influence mental health, having multiple siblings does not inherently increase the risk for mental illness. Protective factors such as social support from siblings may actually be beneficial.
B. Early exposure to violence. Experiencing violence at a young age, such as abuse or witnessing traumatic events, can increase the risk for mental illness by altering stress responses, emotional regulation, and cognitive development.
C. Being raised by a single mother. While single-parent households may present challenges, they do not directly cause mental illness. Supportive parenting, economic stability, and social resources can mitigate potential stressors.
D. Living in a rural area. Although access to mental health care may be more limited in rural areas, residing in such an environment is not a direct risk factor for developing mental illness. Social support and lifestyle factors play a more significant role.

A. Cognitive behavioral therapy B. Vagal nerve stimulation C. Electroconvulsive therapy D. Deep-brain stimulation

Correct Answer is A

Explanation

A. Cognitive behavioral therapy. Cognitive behavioral therapy (CBT) is a noninvasive treatment that helps individuals with depression by identifying and modifying negative thought patterns and behaviors. It is widely used and effective in improving mood, coping skills, and overall mental well-being.
B. Vagal nerve stimulation. Vagal nerve stimulation (VNS) is an invasive procedure that involves implanting a device to stimulate the vagus nerve. It is used for treatment-resistant depression and is not considered a first-line, noninvasive option.
C. Electroconvulsive therapy. Electroconvulsive therapy (ECT) is a medical procedure that involves electrical stimulation of the brain under anesthesia. Although effective for severe depression, it is invasive and typically reserved for cases that do not respond to medication or therapy.
D. Deep-brain stimulation. Deep-brain stimulation (DBS) involves surgically implanting electrodes in specific brain regions to regulate mood-related neural activity. It is an invasive treatment used in research or for severe, treatment-resistant depression.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is caring for a client who has schizophrenia. The client suddenly moves to the corner of the room and shouts, "Get it away from me!" Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a mental health clinic is taking a medical history on a client. The nurse should recognize that which of the following factors in the client's history increases their risk for mental illness?

Correct Answer is B

Explanation

A nurse is caring for a client who has depression. Which of the following noninvasive treatments should the nurse recommend to the client?

Correct Answer is A

Explanation

A nurse is caring for a client who has depression and states, "A government agency is attempting to capture me." The nurse should identify that the client is experiencing which of the following?

A community health nurse is creating a presentation about mood disorders for a local support group. The nurse should include which of the following as a risk factor for suicide?

A nurse is assisting in teaching a client who has been newly diagnosed with schizophrenia. Which of the following information should the nurse include?

A nurse is reinforcing teaching to a client who is to undergo transcranial magnetic stimulation (TMS) for depression. Which of the following information should the nurse provide?

A nurse at a primary care clinic is collecting data on a client for manifestations of depression. Which of the following client statements should the nurse identify as being consistent with depression?

A nurse is reinforcing teaching with a client about avoiding foods with tyramine. The client states, "Thank you for all of this information, but it's just not for me. I eat what I want when I want it." Which of the following stages of change is the client demonstrating?

A nurse is caring for a client who screams, "I can read your minds!" The nurse should identify this finding as a manifestation of which of the following personality disorders?

The nurse is assisting in the care of a client who is hyperactive, pacing down the hallway, and exhibiting poor concentration during group therapy. When collecting data, the nurse should identify that which of the following is characteristic of the client's manifestations?