The charge nurse is talking with another nurse who states, “I feel like my clients have no interest in their care and do not care that I am trying to help.” Which response should the charge nurse make?

A lot of clients behave that way, but you cannot take it personally.

Have you tried to establish a therapeutic relationship with the clients?

Do you want me to assign another nurse?

Clients often behave that way when they are in pain.

Answer and Explanation

The Correct Answer is B

Choice A reason:
While this response acknowledges the nurse’s feelings, it does not provide a constructive solution or address the underlying issue. It may come across as dismissive rather than supportive.

Choice B reason:
Establishing a therapeutic relationship is fundamental to effective nursing care. This response encourages the nurse to build rapport and trust with the clients, which can improve their engagement and cooperation in their care. It is a proactive and supportive suggestion.

Choice C reason:
Offering to assign another nurse does not address the issue of building a therapeutic relationship and may not be feasible. It also does not help the nurse develop skills to improve client interactions.

Choice D reason:
While clients in pain may exhibit disinterest, this response does not address the broader issue of establishing a therapeutic relationship. It focuses on a specific cause rather than providing a general strategy for improving client engagement.

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Correct Answer is D

Explanation

Choice A reason:
Dystonia involves muscle contractions causing twisting and repetitive movements or abnormal postures. It typically occurs early in treatment and affects the neck, face, and back muscles. The involuntary movements described in the scenario are more characteristic of tardive dyskinesia rather than dystonia.

Choice B reason:
Parkinsonism is characterized by symptoms similar to Parkinson’s disease, such as tremors, bradykinesia, and rigidity. While it can occur with long-term use of antipsychotics, the specific involuntary movements of the tongue and face described are more indicative of tardive dyskinesia.

Choice C reason:
Akathisia involves a feeling of inner restlessness and an urgent need to move. It does not typically present with the involuntary movements of the tongue and face described in the scenario. Akathisia is more about the inability to stay still rather than specific muscle movements.

Choice D reason:
Tardive dyskinesia is a well-known adverse effect of long-term antipsychotic use, characterized by repetitive, involuntary movements, especially of the face, tongue, and limbs. The description of involuntary movements of the tongue and face fits the profile of tardive dyskinesia, making it the most likely diagnosis.

A. The document tells what treatment is to be omitted or provided if the client is unable to make the decision. B. A client is required to sign the “living will” document with an attorney present. C. An attorney draws up the papers to be given to the client and his or her family. D. The client’s physician must act as a witness when the client signs the document.

Correct Answer is A

Explanation

The correct answer is A.
Choice A reason:
An advance care directive, or “living will,” is a legal document that specifies what medical treatments the client wishes to receive or omit if they become unable to make decisions for themselves. This document guides healthcare providers and family members in making decisions that align with the client’s preferences.
Choice B reason:
A client is not required to sign the “living will” document with an attorney present. While it is advisable to consult with an attorney when creating legal documents, it is not a requirement for the validity of an advance care directive.
Choice C reason:
An attorney may assist in drafting the advance care directive, but it is not necessary for the attorney to draw up the papers. The client can create the document with the help of healthcare providers or legal advisors.
Choice D reason:
The client’s physician does not need to act as a witness when the client signs the document. Typically, witnesses are required to ensure the document is signed voluntarily and without coercion, but they do not have to be the client’s physician.

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The charge nurse is talking with another nurse who states, “I feel like my clients have no interest in their care and do not care that I am trying to help.” Which response should the charge nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?

Correct Answer is D

Explanation

A nurse is explaining advance care directives, or “living wills,” to a client and the client’s spouse. Which detail would the nurse include in the description of an advance care directive?

Correct Answer is A

Explanation

A nurse is performing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom?

A nurse is reviewing the medical record of a client who has a new prescription for chlorpromazine for the treatment of schizophrenia. Which of the following findings indicates a contraindication to chlorpromazine?

After experiencing increasing conflict in the home, a social worker calls and schedules a therapy meeting. A 24-year-old, his sister, his mother, and the mother’s live-in boyfriend are asked to attend the therapy meeting. Who is the “client” who will be treated during this session?

While working with an older client, a nurse begins to think of the client as a grandparent and responds to the client as a grandchild. The nurse is developing what type of emotional reaction?

Which client would a nurse determine to be the most likely candidate for involuntary commitment?

The nurse calls security and has physical restraints applied to a client who was admitted voluntarily when the client becomes verbally abusive, demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions?

A home health nurse drives up to the house of her client, who has schizophrenia with manic episodes. The client is sitting on his front porch with a shotgun in his arms. Which of the following actions should the nurse take?