A nurse is planning a unit orientation for a newly admitted client diagnosed with severe depression. Which of the following should be the nurse's approach?

Sit with the client and offer simple, direct information.

Explain the unit policies to the client and answer any questions he might have.

Have the client attend group therapy immediately.

Take the client on a tour of the unit and introduce him to all the staff members on duty.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

The nurse's approach of sitting with the client and offering simple, direct information is appropriate for a newly admitted client diagnosed with severe depression. This approach allows the nurse to establish a therapeutic rapport and provide the client with essential information in a clear and concise manner. People with severe depression often have difficulty processing complex information, so providing simple and direct information can enhance their understanding and alleviate any feelings of overwhelm.

Choice B rationale:

Explaining the unit policies and answering the client's questions might be overwhelming for someone with severe depression during their initial orientation. People experiencing depression often have difficulties with concentration and retaining information due to cognitive impairment. Presenting them with detailed policies and procedures might increase their anxiety and hinder their ability to absorb the information effectively.

Choice C rationale:

Having the client attend group therapy immediately might not be the best approach for someone with severe depression upon admission. Group therapy could be beneficial later in the treatment process, but initially, the client might not be emotionally ready to engage in group interactions. It's essential to establish a one-on-one therapeutic relationship and provide a stable environment before introducing them to group settings.

Choice D rationale:

Taking the client on a tour of the unit and introducing them to all the staff members on duty might be overwhelming and anxiety-inducing for someone with severe depression. It's crucial to approach the client with sensitivity and respect their emotional state. Introducing them to multiple staff members might increase their social anxiety and make them feel exposed, leading to further distress.

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Correct Answer is A

Explanation

Choice A rationale:

Neuroleptic malignant syndrome (NMS) is a potentially life-threatening condition that can occur as a severe adverse effect of antipsychotic medications, such as risperidone (Risperdal). Symptoms of NMS include flu-like symptoms (fever, muscle rigidity, and sweating) along with altered mental status, and autonomic dysregulation. It's crucial for the nurse to recognize this potentially fatal condition promptly and intervene appropriately.

Choice B rationale:

Tardive dyskinesia is a movement disorder that is often a result of long-term use of antipsychotic medications, but it is characterized by repetitive, involuntary movements of the face and other body parts. It doesn't typically present with flu-like symptoms or low blood pressure.

Choice C rationale:

Acute dystonia is characterized by involuntary muscle contractions and spasms, often involving the muscles of the face, neck, and back. It usually occurs shortly after starting antipsychotic treatment. While it can cause discomfort, it doesn't present with flu-like symptoms and low blood pressure as described in the scenario.

Choice D rationale:

Pseudoparkinsonism, also known as drug-induced parkinsonism, is characterized by symptoms similar to Parkinson's disease, such as tremors, bradykinesia (slowness of movement), and rigidity. It doesn't typically cause flu-like symptoms and low blood pressure.

A. Bizarre behavior. B. Waxy flexibility. C. Somatic delusions. D. Illogicality.

Correct Answer is B

Explanation

Choice A rationale:

Bizarre behavior is not a negative symptom of schizophrenia but rather a positive symptom. Positive symptoms involve an excess or distortion of normal functioning and include hallucinations, delusions, and disorganized speech or behavior. Bizarre behavior falls under the category of disorganized behavior, which is a positive symptom.

Choice B rationale:

Waxy flexibility is a characteristic of negative symptoms in schizophrenia. Negative symptoms involve a reduction or loss of normal functioning and include behaviors like social withdrawal, reduced emotional expression, and decreased motivation. Waxy flexibility refers to the phenomenon where a person with schizophrenia can be molded into different positions and maintain those positions for an extended period. This rigidity is a manifestation of reduced spontaneous movement, which is a negative symptom.

Choice C rationale:

Somatic delusions are a type of positive symptom seen in schizophrenia. These delusions involve false beliefs about one's body, health, or bodily functions. They are not negative symptoms, which are characterized by deficits in normal functioning.

Choice D rationale:

Illogicality is related to disorganized thinking, which is a positive symptom of schizophrenia. Individuals experiencing disorganized thinking may have difficulty organizing their thoughts coherently and logically, leading to speech that is difficult to follow. Negative symptoms, on the other hand, involve a decrease in normal functioning and do not pertain to logical coherence.

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A nurse is planning a unit orientation for a newly admitted client diagnosed with severe depression. Which of the following should be the nurse's approach?

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is performing an admission assessment on a client who has been diagnosed with schizophrenia. Which of the following findings should the nurse identify as a negative symptom?

Correct Answer is B

Explanation

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