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

Explanation

Proteinuria is the presence of excess protein in the urine, which is a hallmark of nephrotic syndrome. Nephrotic syndrome is a kidney disorder that causes increased permeability of the glomerular basement membrane, leading to loss of protein and other substances in the urine.

Choice B is wrong because hypolipidemia is a low level of lipids in the blood, which is not expected in nephrotic syndrome. On the contrary, nephrotic syndrome causes hyperlipidemia, which is a high level of lipids in the blood, due to increased synthesis and decreased clearance of lipoproteins.

Choice C is wrong because hyperalbuminemia is a high level of albumin in the blood, which is not expected in nephrotic syndrome. On the contrary, nephrotic syndrome causes hypoalbuminemia, which is a low level of albumin in the blood, due to loss of albumin in the urine and decreased synthesis by the liver.

Choice D is wrong because increased hemoglobin is not expected in nephrotic syndrome. On the contrary, nephrotic syndrome can cause anemia, which is a low level of hemoglobin in the blood, due to loss of iron and erythropoietin in the urine and decreased production of red blood cells by the bone marrow.

Normal ranges for proteinuria are less than 150 mg per day or less than 10 mg per deciliter on a random urine sample. Normal ranges for serum lipids are total cholesterol less than 200 mg per deciliter, LDL cholesterol less than 100 mg per deciliter, HDL cholesterol more than 40 mg per deciliter for men and more than 50 mg per deciliter for women, and triglycerides less than 150 mg per

deciliter. Normal ranges for serum albumin are 3.5 to 5.0 grams per deciliter.

A. Wheat. B. Strawberries. C. Peanuts. D. Bananas.

Correct Answer is D

Explanation

The nurse should instruct the client to avoid bananas because they are one of the foods that can cause a cross-reaction with latex allergy. This means that people who are allergic to latex may also have an allergic reaction to bananas because they contain similar proteins.

Choice A is wrong because wheat is not a latex cross-reactive food.

Choice B is wrong because strawberries are a low or undetermined cross- reactive food.

Choice C is wrong because peanuts are a low or undetermined cross-reactive food.

Some other foods that the nurse should instruct the client to avoid are avocado, kiwi, chestnut, papaya, and potato. These foods have a high or moderate association with latex cross-reactions. The client should also be careful with other fruits and vegetables that may contain similar proteins to latex.

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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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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?