A nurse is reinforcing teaching with a client who started taking haloperidol decanoate 125 mg IM 1 month ago.
Which of the following statements by the client should the nurse address?.

A client is becoming increasingly agitated, anxious, and tense.
The nurse notes a clenched jaw and a change in the pitch of the client's voice.
Which of the following interventions should the nurse implement first?.

A nurse is beginning a therapeutic relationship with a client who has paranoid personality disorder.
Which of the following strategies should the nurse plan to use?.

A nurse is speaking with the sibling of a client who refuses to see visitors.
Which of the following actions should the nurse take?.

A nurse is collecting data from a client who has bulimia nervosa.
Which of the following findings should the nurse expect?.

A nurse is caring for a client who was placed in four-point restraints by the nursing staff following an episode of violent behavior.
Which of the following actions should the nurse take?.

A nurse is contributing to the plan of care for a client who has acute delirium.
Which of the following interventions should the nurse include in the plan of care? .

A nurse is caring for a client who has depression and reports only sleeping a few hours each night.
Which of the following instructions should the nurse give the client to promote sleep? .

A nurse is reinforcing behavior management techniques with the parent of a school-age child who has conduct disorder.
Which of the following statements by the parent indicates an understanding of the redirection technique? .

A nurse is reinforcing teaching about a new prescription for haloperidol with a client who has schizophrenia.
Which of the following statements by the client indicates an understanding of the teaching?.

The nurse has reviewed the nurses' notes, provider's note, and vital signs at 0400.

Nurses' Notes 0205: Client brought to the ED by police after being found wandering on the street.

Client able to provide identity to police but not able to identify place or time.

Family notified.

0230: Client confused and agitated.

Appearance is disheveled.

Mucous membranes dry.

Lungs clear and equal, heart rhythm regular.

During data collection, the client states, "Can you ask that person to leave my room?" Client is pointing to an empty chair.

The client's adult child arrived at the ED and went to the client's room.

The client identified the family member.

The client is pacing and agitated and states, "I don't understand why I am here.”. The adult child asks the nurse to talk outside of the room and states, "I don't know why they are so confused.

They are not normally like this.”. The adult child.

Which of the following interventions should the nurse include in the client's care? Select the 3 interventions the nurse should implement.

Approach client slowly.

Alternate nursing staff daily.

Maintain a low stimulation environment.

Reorient client to person, place, and time frequently.

Provide the client with limited information about the diagnosis.