The nurse is asking a patient diagnosed with schizophrenia how they slept, and they respond, "This is a new day in May, and I can't wait to play." Which communication pattern does the nurse identify?

Neologism

Clang association

Tangentiality

Circumstantiality

Answer and Explanation

The Correct Answer is B

Choice A reason:

Neologism refers to the creation of new words or phrases that only have meaning to the individual using them. In the given scenario, the patient does not create new words but uses existing words in a rhyming pattern, which is not indicative of neologism.

Choice B reason:

Clang association is a speech pattern where words are chosen for their sound rather than their meaning, often resulting in rhyming or punning. The patient's response, "This is a new day in May, and I can't wait to play," demonstrates a focus on the rhyming sounds "-ay," which is characteristic of clang association.

Choice C reason:

Tangentiality occurs when a person goes off-topic without answering the original question, often never returning to the initial topic. While the patient's response is somewhat unrelated to the question about sleep, it does not represent a shift to a completely different topic or a failure to return to the original topic, which would be required to classify it as tangentiality.

Choice D reason:

Circumstantiality involves providing unnecessary detail that is often tedious and lengthy but eventually returns to answer the original question. The patient's response is brief and does not include excessive or irrelevant details, so it does not fit the definition of circumstantiality.

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Correct Answer is D

Explanation

Choice A reason:

Expecting a child with ASD to communicate all needs verbally by discharge may not be realistic, as communication challenges are a core feature of ASD. Some individuals with ASD may never develop verbal communication skills and may rely on alternative methods of communication.

Choice B reason:

Participation in team sports may be challenging for a child with ASD due to difficulties with social interaction and sensory processing. While some children with ASD may enjoy and excel in sports, expecting participation in a team sport by day 4 may not account for the individual needs and preferences of the child.

Choice C reason:

Establishing trust with a caregiver is an important goal, but the timeframe of 5 days may be too short. Building trust can take time, especially for children with ASD who may have difficulty with new relationships and changes in their environment.

Choice D reason:

Focusing on self-care tasks is a realistic and practical goal for a child with ASD. With appropriate support and interventions, many individuals with ASD can learn to perform self-care tasks independently, although the level of independence will vary based on the individual's abilities and needs.

A. "What are the voices telling you to do?" B. "You need to tell the voices to leave you alone." C. "You need to understand that there are no voices." D. "Why do you think you are hearing the voices?"

Correct Answer is A

Explanation

Choice A Reason:

The response "What are the voices telling you to do?" is appropriate because it allows the nurse to assess the content of the hallucinations and determine if there is an immediate risk of harm to the client or others. This approach shows empathy and concern for the client's experience while gathering crucial information to ensure safety. Understanding the nature of the voices can help the nurse provide appropriate interventions and support.

Choice B Reason:

Telling the client "You need to tell the voices to leave you alone" is not an effective response. This statement can be dismissive and may not acknowledge the client's distress. Clients with schizophrenia may not have the ability to control their hallucinations, and this response does not provide the necessary support or validation of their experience.

Choice C Reason:

The statement "You need to understand that there are no voices" is dismissive and invalidates the client's experience. Clients with schizophrenia perceive their hallucinations as real, and telling them that the voices do not exist can increase their distress and mistrust. It is important to acknowledge the client's experience while providing reassurance and support.

Choice D Reason:

Asking "Why do you think you are hearing the voices?" may not be helpful in the moment of acute distress. This question can be confusing and does not address the client's immediate fear and anxiety. The priority should be to assess the content of the hallucinations and ensure the client's safety rather than exploring the reasons behind the hallucinations.

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The nurse is asking a patient diagnosed with schizophrenia how they slept, and they respond, "This is a new day in May, and I can't wait to play." Which communication pattern does the nurse identify?

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