A nurse is caring for a client who has schizophrenia who consistently does the opposite of what the nurse asks of him. The nurse recognizes this as which of the following alterations in behavior?

Automatic obedience.

Active negativism.

Impaired impulse control.

Waxy flexibility.

Answer and Explanation

The Correct Answer is B

Choice A reason: Automatic obedience involves unthinkingly following instructions, often seen in catatonia. The client’s oppositional behavior is the opposite, making this an incorrect choice.

Choice B reason: Active negativism, common in schizophrenia, involves deliberately doing the opposite of what is requested, reflecting resistance or opposition. The client’s behavior matches this description.

Choice C reason: Impaired impulse control involves acting on urges without restraint, such as aggression or impulsivity. The client’s deliberate opposition is not impulsive but purposeful, so this is incorrect.

Choice D reason: Waxy flexibility involves maintaining imposed postures, typically in catatonia. The client’s oppositional behavior does not involve physical posturing, making this incorrect.

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Correct Answer is D

Explanation

Choice A reason:Informing the family without addressing the client’s emotional concern misses the opportunity to explore their feelings. This response does not directly respond to the client’s expressed fear about their mother’s death.

Choice B reason:Promising to call the family in time assumes the client’s primary concern is family presence, which may not address the underlying fear of dying alone. It also risks making a promise that may not be feasible.

Choice C reason:Ensuring a staff member’s constant presence is supportive but does not directly address the client’s stated concern about their mother’s death or explore their emotional needs, making it less therapeutic.

Choice D reason:Acknowledging the client’s potential fear of dying alone directly addresses the emotional content of their statement. This therapeutic response encourages the client to express their fears, fostering emotional support and understanding.

A. "We will monitor your lithium levels closely while you are taking this medication." B. "Weight gain should be reported to your provider as an indication of lithium toxicity." C. "This medication is addictive, so you will need to discontinue it in six months." D. "Your provider may prescribe a diuretic if you have trouble urinating while taking lithium."

Correct Answer is A

Explanation

Choice A reason: Monitoring lithium levels is essential because of its narrow therapeutic index; toxicity can occur if levels rise slightly above the therapeutic range.

Choice B reason: Weight gain is not an indication of lithium toxicity; instead, toxicity signs include tremors, nausea, diarrhea, and confusion.

Choice C reason: Lithium is not addictive, and therapy is often long-term to prevent relapse of mood episodes.

Choice D reason: Diuretics are contraindicated with lithium because they increase the risk of toxicity by altering sodium and fluid balance.

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A nurse is caring for a client who has schizophrenia who consistently does the opposite of what the nurse asks of him. The nurse recognizes this as which of the following alterations in behavior?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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