A nurse working on a psychiatric unit is providing care for a client that reports feeling irritable and distressed. The client states, “I just feel so helpless.” Which of the following statements most aligns with the client’s presentation of neurotic behavior?
The client is always aware that their behaviors are maladaptive.
The client uses adaptive defense mechanisms to cope.
The client never has mood or personality changes.
The client does not experience loss of contact with reality.
The Correct Answer is D
Choice A Reason:
The statement “The client is always aware that their behaviors are maladaptive” is incorrect. While individuals with neurotic behavior may sometimes recognize that their behaviors are maladaptive, this awareness is not consistent. Neurotic behaviors are often automatic and unconscious efforts to manage deep anxiety. Therefore, the client may not always be aware of the maladaptive nature of their actions.
Choice B Reason:
The statement “The client uses adaptive defense mechanisms to cope” is incorrect. Neurotic behavior typically involves the use of maladaptive defense mechanisms rather than adaptive ones. These mechanisms, such as denial, repression, or projection, are employed to manage anxiety and stress but do not effectively resolve the underlying issues. Adaptive defense mechanisms, on the other hand, are more constructive and promote healthier coping strategies.
Choice C Reason:
The statement “The client never has mood or personality changes” is incorrect. Neurotic behavior is often associated with mood swings and emotional instability. Clients with neurotic tendencies may experience frequent changes in mood and may struggle with regulating their emotions. Therefore, it is inaccurate to state that the client never has mood or personality changes.
Choice D Reason:
The statement “The client does not experience loss of contact with reality” is correct. Neurotic behavior, unlike psychotic behavior, does not involve a loss of contact with reality4. Clients with neurotic tendencies remain aware of their surroundings and can distinguish between reality and their internal experiences4. This characteristic differentiates neurotic behavior from more severe mental health conditions such as schizophrenia, where a loss of reality is a key feature.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choices A, C, and D: Changes to behavior and personality, Impaired judgment, Muscle stiffness and shuffling gait.
Choice A Reason:
Changes to behavior and personality are hallmark symptoms of frontotemporal dementia (FTD). This condition primarily affects the frontal and temporal lobes of the brain, which are responsible for behavior, personality, and language. Patients often exhibit socially inappropriate behaviors, apathy, and a decline in personal hygiene. These changes are among the earliest and most noticeable symptoms of FTD.
Choice B Reason:
While a past history of head trauma can be a risk factor for various types of dementia, it is not specifically associated with frontotemporal dementia. FTD is more commonly linked to genetic factors and specific protein abnormalities in the brain. Therefore, a history of head trauma is not a typical aspect of the medical history for FTD patients.
Choice C Reason:
Impaired judgment is a common symptom of frontotemporal dementia. The degeneration of the frontal lobes affects executive functions, including decision-making, problem-solving, and judgment. Patients may make poor decisions, exhibit risky behaviors, and have difficulty understanding the consequences of their actions.
Choice D Reason:
Muscle stiffness and a shuffling gait can occur in some forms of frontotemporal dementia, particularly in cases where the condition overlaps with motor neuron disease or Parkinsonism. These physical symptoms are less common than behavioral and cognitive symptoms but can still be present in some patients.
Choice E Reason:
A diagnosis of hypertension is not specifically related to frontotemporal dementia. While hypertension is a common condition that can coexist with any form of dementia, it is not a characteristic feature of FTD. The primary symptoms of FTD are related to changes in behavior, personality, and cognitive functions rather than vascular issues.
Correct Answer is C
Explanation
Choice A Reason:
Obtunded describes a state where the patient has a decreased level of consciousness and is difficult to arouse. They may respond slowly and be somewhat confused. This level of consciousness is more severe than lethargy and typically requires more vigorous stimulation to elicit a response. The client’s ability to answer questions appropriately before falling back to sleep suggests a less severe impairment than obtundation.
Choice B Reason:
Stuporous refers to a condition where the patient is almost entirely unresponsive and can only be aroused by vigorous and repeated stimuli. This state is more severe than lethargy and obtundation. The client’s ability to respond appropriately to questions indicates a higher level of consciousness than stupor. Therefore, stuporous is not the correct description of the client’s condition.
Choice C Reason:
Lethargic describes a state where the patient is very drowsy but can be aroused to respond to questions and then falls back to sleep. This matches the client’s presentation as they are able to answer questions appropriately but fall asleep immediately afterward. Lethargy is a common level of altered consciousness in various medical conditions and is less severe than obtundation or stupor.
Choice D Reason:
Alert describes a state where the patient is fully awake, aware, and responsive to stimuli. The client’s tendency to fall back to sleep immediately after responding to questions indicates that they are not fully alert. Therefore, this term does not accurately describe the client’s level of consciousness.
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