A nurse is discussing with a client the potential for involuntary admission to prevent harm to themselves and their newborn. The nurse is also preparing for the administration of an IV neuroactive steroid over a 60-hour period of time. Which approach will be most effective in developing a therapeutic relationship with a client diagnosed with which of the following disorders? (Select all that apply.)

Schizotypal

Avoidant

Narcissistic

Antisocial

Paranoid

Answer and Explanation

Correct Answer : A,D,E

Choice A reason: A matter-of-fact approach is effective for clients with schizotypal personality disorder as it helps in dealing with their eccentric behaviors and distorted thinking without reinforcing their odd beliefs.

Choice B reason: Clients with avoidant personality disorder may benefit more from a supportive and encouraging approach due to their sensitivity to rejection and feelings of inadequacy.

Choice C reason: For narcissistic personality disorder, a matter-of-fact approach might not be as effective because these clients often require admiration and may not respond well to a straightforward style.

Choice D reason: An antisocial personality disorder client may respond better to a matter-of-fact approach as it sets clear boundaries and expectations without emotional engagement, which they may exploit.

Choice E reason: Paranoid personality disorder clients may find a matter-of-fact approach beneficial as it provides clear and direct communication, which can help reduce their suspicions.

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Correct Answer is B

Explanation

Choice A reason: Gastric lavage is typically not the first-line treatment for lithium toxicity due to the risk of aspiration and potential complications. It is usually reserved for cases where the ingestion was recent and massive.

Choice B reason: When a client presents with an extremely elevated lithium level, it is crucial to hold further doses to prevent exacerbation of toxicity. The nurse should monitor for early signs of toxicity, which include gastrointestinal symptoms like nausea, vomiting, diarrhea, and neurological symptoms such as tremors, confusion, and ataxia. The normal therapeutic range for lithium is 0.6 to 1.2 mmol/L, and levels above 1.5 mmol/L are considered toxic.

Choice C reason: While it is important to review the medication record, the immediate concern with an extremely elevated lithium level is addressing the toxicity. Checking the medication record can be part of the assessment process but is not the priority action.

Choice D reason: Administering the morning dose of lithium could worsen the client's condition by increasing the lithium level further, which is already extremely elevated. This could lead to severe toxicity or even fatal consequences.

A. Focusing on one issue B. Interjecting personal experiences into the interactions C. Asking leading questions to obtain the most information D. Ensuring to ask the client to restate statements for clarity

Correct Answer is B

Explanation

Choice A reason: Focusing on one issue can help in understanding the client's situation better and does not necessarily hinder empathy.

Choice B reason: Interjecting personal experiences can create a barrier to empathy by shifting the focus from the client's feelings to the nurse's own experiences.

Choice C reason: Asking leading questions may not hinder empathy but could direct the conversation away from the client's concerns.

Choice D reason: Asking the client to restate statements for clarity is a part of active listening and can actually enhance empathy by ensuring understanding.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has an extremely elevated lithium level. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

The nurse is attempting to develop empathy for a client but is not completely feeling empathetic. Which factor might be hindering the nurse from developing empathy for this client?

Correct Answer is B

Explanation

A nurse on an acute mental health unit is caring for a group of clients. For which of the following clients is seclusion contraindicated?

A client and their spouse come to talk with the nurse about their suspicion that the client may have intermittent explosive disorder after researching it on the internet. Which behaviors reported by the spouse indicate that the client may be experiencing this disorder? (Select all that apply.)

When engaging with clients, which techniques should the nurse avoid using to foster more therapeutic responses? Select all that apply.

A client is seeking counseling due to difficulty coping with being a victim of a violent attack 16 months ago. Which elements will the nurse assess for when determining the major components of posttraumatic stress disorder (PTSD)? (Select all that apply.)

The nurse maintains a therapeutic relationship with several clients on the behavioral health unit. Which characteristics will be most important for the nurse to foster to maintain these relationships? Select all that apply.

A nurse is planning discharge for a client who has borderline personality disorder. Which of the following interventions should be included for this client?