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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:Obtaining a blood specimen is important to assess electrolyte levels, liver function, or alcohol levels, but it is not the first priority in acute alcohol withdrawal. Immediate safety concerns, such as preventing seizures, take precedence.
Choice B reason:Acute alcohol withdrawal carries a high risk of seizures, which can be life-threatening. Implementing seizure precautions, such as ensuring a safe environment and having emergency medications available, is the first priority to protect the client from harm.
Choice C reason:Performing a neurological exam is valuable to assess the client’s mental status and neurological function, but it is not the first action. Addressing immediate risks like seizures is more urgent in the acute phase of withdrawal.
Choice D reason:Inserting an IV access site is important for administering fluids or medications, such as benzodiazepines, to manage withdrawal symptoms. However, ensuring seizure precautions are in place is a higher priority to address immediate safety risks.
Correct Answer is B
Explanation
Choice A reason: Reflecting the patient’s feelings can be therapeutic in some cases, but here it could reinforce the delusion of being imprisoned rather than provide reassurance and grounding.
Choice B reason: This response provides reality orientation, reassurance, and therapeutic communication. It acknowledges the client’s concern while reinforcing the purpose of hospitalization, which is treatment and safety.
Choice C reason: Encouraging deep breathing addresses anxiety but does not respond to the client’s delusional thought. It avoids the core issue and may make the client feel dismissed.
Choice D reason: Asking “why” questions can feel confrontational and may heighten paranoia or mistrust. It does not provide therapeutic reassurance.
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