A nurse overhears a client diagnosed with schizophrenia talking to herself. The client keeps stating, "The flakalas are here. The flakalas are here." The nurse should recognize the client's use of the word "flakala" as an example of which of the following alterations in speech?
Associative looseness
Tangentiality
Neologism
Circumstantiality
Choice C reason:
The Correct Answer is C
Choice A reason:
Associative looseness refers to a disorganized thought process where connections between ideas are unclear or illogical. The use of the word "flakala" does not demonstrate a loose association between ideas but rather the creation of a new word.
Choice B reason:
Tangentiality occurs when a person goes off on a tangent and does not return to the original topic. In this case, the client is not going off on a tangent but is repeatedly using a made-up word, which is indicative of neologism.
Choice C reason:
Neologism is the creation of new words that others may not understand. The client's use of "flakala" fits this definition, as it appears to be a word created by the client that is not part of standard language¹. This can be a sign of disorganized thinking, where the client's internal thoughts do not align with conventional language patterns.
Choice D reason:
Circumstantiality involves providing unnecessary detail that makes communication less efficient but eventually returns to the original point. The client's statement does not include unnecessary details; it is the repetition of a newly created word, suggesting neologism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Providing reading material about the surgery can be informative, but it may not be the best approach for someone who is already very nervous. It could potentially increase anxiety if the information is overwhelming or if the client misinterprets the material.
Choice B reason:
Suggesting a walk could serve as a distraction and help to calm the client's nerves. However, it might not address the underlying anxiety about the surgery itself. It's a temporary measure that doesn't offer emotional support or address the client's immediate concerns.
Choice C reason:
Referring the client to the pastoral care team could be beneficial if the client is seeking spiritual support or comfort. However, this should be based on the client's personal preferences and beliefs, and it may not be the most direct way to address the client's stated nervousness.
Choice D reason:
Engaging the client in a conversation about their feelings provides an opportunity for emotional support and can help the nurse understand the client's specific fears. This approach can lead to a more personalized care plan to alleviate anxiety.
Correct Answer is D
Explanation
Choice A Reason:
Directly telling a client that their delusions are not real is not typically recommended. This approach can be confrontational and may lead to increased anxiety or agitation in the client. It's important to maintain a therapeutic relationship by validating the client's feelings and working within their current reality, rather than directly challenging their perceptions.
Choice B Reason:
Using frequent touch to provide support may not be appropriate for all clients, especially those with schizophrenia who may have altered perceptions of reality. Some individuals may find touch comforting, while others may perceive it as threatening or invasive. It's crucial to assess each client's comfort level with physical contact and proceed accordingly.
Choice C Reason:
Placing a client in seclusion can be a traumatic experience and is generally considered a last resort when other interventions have failed and the client is a danger to themselves or others. Seclusion should not be used solely because a client is experiencing visual hallucinations.
Choice D Reason:
Limiting the number of questions during assessments can help reduce the potential for overwhelming the client. Clients with schizophrenia may have difficulty processing too much information at once, and a barrage of questions can be stressful. Simplifying communication and allowing the client to focus on one question at a time can be more effective.
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