A nurse is contributing to the plan of care for a newly-admitted client who has schizophrenia and a history of aggressive behavior.
Which of the following interventions should the nurse include in the initial plan?

Warn the client that the staff will use seclusion as a consequence if there are repeated reports of hallucination.

Keep the facility’s security personnel constantly visible to the client throughout treatment.

Collaborate with the client to develop a daily physical exercise routine.

Agree that the hallucinations are real if the client exhibits aggressive behavior toward other clients.

Answer and Explanation

The Correct Answer is C

Collaborate with the client to develop a daily physical exercise routine. This intervention can help reduce aggression and impulsivity in schizophrenia by providing an outlet for frustration, enhancing self-esteem, and improving mood. Physical exercise can also improve physical health and reduce the risk of metabolic syndrome associated with antipsychotic medications.

Choice A is wrong because warning the client that the staff will use seclusion as a consequence if there are repeated reports of hallucination is punitive and threatening. This can increase the client’s anxiety, paranoia, and hostility, and may worsen the psychotic symptoms. Seclusion should only be used as a last resort when the client poses a serious danger to self or others, and not as a punishment or coercion.

Choice B is wrong because keeping the facility’s security personnel constantly visible to the client throughout treatment is intimidating and stigmatizing. This can also increase the client’s fear, distrust, and resentment, and may trigger aggressive behavior. Security personnel should only be involved when there is an imminent risk of violence, and not as a routine measure.

Choice D is wrong because agreeing that the hallucinations are real if the client exhibits aggressive behavior toward other clients is reinforcing the delusional belief and rewarding the aggression. This can also confuse the client and undermine the therapeutic relationship.

The nurse should acknowledge the client’s experience of hallucinations, but not endorse them as reality. The nurse should also set clear limits on aggressive behavior and use de-escalation techniques to calm the client.

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Correct Answer is ["A","C"]

Explanation

Choice A reason:

The Bradley method teaches the labor partner how to coach and support the mother during labor. This is true because the Bradley method emphasizes the role of the partner as an active participant and a skilled coach who can help the mother relax, breathe, and cope with pain during labor. The partner also serves as an advocate for the mother's preferences and needs in the hospital setting.

Choice B reason:

The Bradley method teaches the mother and partner about the variety of methods to control pain. This is false because the Bradley method does not teach a variety of methods to control pain, but rather focuses on relaxation as the main way to reduce pain during labor. The Bradley method also discourages the use of medication or medical interventions for pain relief, unless they are medically necessary.

Choice C reason:

The Bradley method prepares the woman to deliver without medical interventions and medications. This is true because the Bradley method aims to help women have an unmedicated birth with minimal medical intervention. The Bradley method teaches women how to avoid unnecessary interventions and how to cope with natural labor by using relaxation, breathing, nutrition, and exercise. The Bradley method also educates women on how to reduce their risk of having a C-section and what to do if it becomes medically necessary.

Choice D reason:

The Bradley method focuses on muscle control because muscle tension increases the pain of labor. This is false because the Bradley method does not focus on muscle control, but rather on deep and complete relaxation during labor. The Bradley method believes that muscle tension interferes with the natural process of labor and increases pain, so it teaches women how to relax their muscles and let their bodies do the work.

Choice E reason:

The Bradley method is the most widely used method in the US. This is false because the Bradley method is not the most widely used method in the US, but rather one of several options for natural childbirth. According to a 2017 survey by Listening to Mothers, only 4% of women reported using the Bradley method for their most recent birth, compared to 48% who used Lamaze, 14% who used hypnobirthing, and 9% who used other methods.

A. Report of pain as 6 on a scale of 0 to 10. B. Pulses 2+ distal to the client’s fracture. C. Petechiae over the client’s chest. D. Bruising around the fracture site.

Correct Answer is C

Explanation

This is a manifestation of a fat embolism, which is a condition where particles of fat get into the bloodstream and block blood flow. A fat embolism can occur after trauma or surgery to the legs, when fat from the bone marrow escapes into the bloodstream.

Choice A is wrong because a report of pain as 6 on a scale of 0 to 10 is not specific to a fat embolism.

Pain is a common symptom of many conditions and injuries.

Choice B is wrong because pulses 2+ distal to the client’s fracture are normal and indicate adequate blood flow to the extremity.

Choice D is wrong because bruising around the fracture site is an expected finding after a compound fracture and does not indicate a fat embolism.

Normal ranges for blood pressure are 90/60 mmHg to 120/80 mmHg and for heart rate are 60 to 100 beats per minute.

Petechiae are small red or purple spots on the skin caused by bleeding under the skin.

They can range in size from pinpoint to several millimeters. Fat embolism syndrome (FES) is a serious complication of a fat embolism that affects the lungs, skin or brain and can be fatal. FES usually occurs 12 to 72 hours after trauma.

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A nurse is contributing to the plan of care for a newly-admitted client who has schizophrenia and a history of aggressive behavior. Which of the following interventions should the nurse include in the initial plan?

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C"]

Explanation

A nurse is caring for a client who has a compound fracture of the femur. Which of the following findings should the nurse report to the provider as a manifestation of a fat embolism?

Correct Answer is C

Explanation

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A nurse is contributing to the plan of care for a newly-admitted client who has schizophrenia and a history of aggressive behavior.
Which of the following interventions should the nurse include in the initial plan?