At the first meeting of a group at a daycare center for older adults, the nurse asks one of the members what kinds of things the client would like to do with the group. The older adult shrugs and says, "You tell me. You're the leader." What would be the best response for the nurse to make?
Yes, I have been assigned to lead this group. I will be here for the next 6 weeks.
Yes, I am the leader. You seem angry about not being the leader yourself.
Yes, I am the leader today. Would you like to be the leader tomorrow?
Yes, I will be leading this group. What would you like to accomplish?
The Correct Answer is D
Choice A reason: This response is factual but does not promote engagement or address the client’s passive stance. It emphasizes the nurse’s role without encouraging participation or collaboration from the older adult.
Choice B reason: This statement makes an assumption about the client’s feelings, labeling them as “angry,” which may not be accurate. It risks creating defensiveness and does not foster open communication or trust within the group.
Choice C reason: This response inappropriately offers group leadership to a member without assessing readiness or interest. It minimizes the therapeutic structure of the group and could confuse roles, making the group less effective.
Choice D reason: This option balances the acknowledgment of the nurse’s leadership role with an invitation for the client to share personal goals. It encourages involvement, respects autonomy, and helps build a therapeutic alliance by showing interest in what the older adult wants to accomplish.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: SSRIs are antidepressants used to treat depression and anxiety disorders. They do not address extrapyramidal side effects like acute dystonia, so they would not be useful in this case.
Choice B reason: Beta-blockers are primarily used for cardiovascular conditions and akathisia (a sense of restlessness), but they are not the treatment of choice for acute dystonia.
Choice C reason: Diphenhydramine, an antihistamine with strong anticholinergic properties, is effective in treating acute dystonia by restoring the balance between dopamine and acetylcholine in the basal ganglia. This makes it the correct choice for managing the client’s symptoms.
Choice D reason: Benzodiazepines may help with agitation or anxiety, but they are not first-line treatment for acute dystonic reactions caused by antipsychotic medications.
Correct Answer is A
Explanation
Choice A reason: This presentation is consistent with neuroleptic malignant syndrome (NMS), a rare but life-threatening reaction to antipsychotics characterized by severe muscle rigidity, hyperthermia, altered mental status, and autonomic dysfunction. Immediate discontinuation of the drug and emergency treatment are required.
Choice B reason: Restlessness and inability to sit still are signs of akathisia, an extrapyramidal side effect of antipsychotics. While distressing and requiring management, it is not life-threatening compared to NMS.
Choice C reason: A flat affect and reduced speech are negative symptoms of schizophrenia and may persist despite treatment. These are concerning for quality of life but do not require urgent medical intervention.
Choice D reason: Mild weight gain is a known side effect of many antipsychotics. It should be monitored and managed with lifestyle modifications but does not represent an immediate threat.
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