A nurse is talking with a client who has schizophrenia.
Suddenly the client states, "I'm frightened.
Do you hear that? The voices are telling me to do terrible things.”. Which of the following responses by the nurse is appropriate?.
"What are the voices telling you to do?".
"Why do you think you are hearing the voices?".
"You need to understand that there are no voices.”.
"You need to tell the voices to leave you alone.”.
The Correct Answer is A
Choice A rationale:
Asking “What are the voices telling you to do?” shows empathy and concern without validating the hallucination.
Choice B rationale:
Asking “Why do you think you are hearing the voices?” might imply that the nurse is validating the hallucination.
Choice C rationale:
Telling the client “You need to understand that there are no voices.”. might make the client feel misunderstood.
Choice D rationale:
Telling the client “You need to tell the voices to leave you alone.”. is not recommended as it might validate the hallucination.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"C"},"C":{"answers":"C"},"D":{"answers":"A"}}
Explanation
Ventricular fibrillation: The correct electricity is Defibrillation. Ventricular fibrillation is a life-threatening condition that requires immediate medical attention. Defibrillation is the process of delivering an electric shock to the heart to stop the fibrillation and allow the heart’s normal rhythm to resume4.
PVC-run ventricular tachycardia with a pulse: The correct electricity is Synchronized Cardioversion. This is used when the patient is hemodynamically stable. It involves the delivery of a therapeutic dose of electrical current to the heart at a specific moment in the cardiac cycle5.
Atrial Flutter: The correct electricity is Synchronized Cardioversion. Atrial flutter is a type of abnormal heart rhythm, or arrhythmia. It can be treated with synchronized cardioversion, in which a controlled electric shock is delivered to the heart to restore normal rhythm5.
Bradycardia: The correct electricity is Transcutaneous Pacing. This is a temporary means of pacing a patient’s heart during a medical emergency. It should be undertaken by healthcare providers who are trained in the procedure5.
So, the correct answer is Defibrillation for Ventricular fibrillation, Synchronized Cardioversion for PVC-run ventricular tachycardia with a pulse and Atrial Flutter, and Transcutaneous Pacing for Bradycardia, after analyzing all choices.
Correct Answer is B
Explanation
Choice A rationale:
Pseudoparkinsonism is a side effect of antipsychotic medications that mimics the symptoms of Parkinson’s disease, such as tremors and rigidity. It does not typically cause hyperpyrexia or diaphoresis.
Choice B rationale:
Neuroleptic malignant syndrome is a rare but serious side effect of antipsychotic medications. It can cause severe fever (hyperpyrexia), unstable blood pressure, and heavy sweating (diaphoresis)4.
Choice C rationale:
Acute dystonia is a condition of sudden, involuntary muscle contractions. It does not typically cause hyperpyrexia or diaphoresis.
Choice D rationale:
Tardive dyskinesia is a side effect of long-term use of antipsychotic medications, causing involuntary movements, especially around the mouth. It does not typically cause hyperpyrexia or diaphoresis.
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