The nurse's approach to a client with neurotic vs. psychotic behavior is different mainly because clients with neurotic behavior.

experience no loss of contact with reality.

never have mood or personality changes.

have conflict but only use adaptive defense mechanisms to cope.

are always aware that their behaviors are maladaptive.

Answer and Explanation

The Correct Answer is A

a. experience no loss of contact with reality. The key difference is reality testing. Clients with neurosis (anxiety disorders, OCD) generally maintain contact with reality, even though their thoughts or behaviours might be distressing. Clients with psychosis (schizophrenia) experience a break with reality, such as hallucinations or delusions.
b. Never have mood or personality changes. Not true. Mood and personality changes can occur in both neurosis and psychosis.
c. Have conflict but only use adaptive defence mechanisms to cope. Défense mechanisms are used by everyone to cope with anxiety, but in neurosis, they might be less healthy or maladaptive.
d. Are always aware that their behaviours are maladaptive. Not necessarily. Clients with neurosis might have limited insight into how their behaviours affect themselves or others.

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Correct Answer is A

Explanation

a. "I can see that you are upset. Let's talk about ways to resolve this." This is correct because it validates the client's feelings, encourages problem-solving, and maintains the therapeutic milieu's principles of respect and support.
b. "I'll fix this right away. You need to calm down." This response does not encourage the client’s participation in resolving the issue and does not foster the therapeutic milieu's goal of client empowerment.
c. "Let's find a way to avoid this conflict in the future." While this promotes future problem-solving, it does not address the immediate concern or validate the client's current feelings.
d. "You should bring this up during group therapy later this week." This delays addressing the client's immediate concerns and might make the client feel unheard.

A. question the client about choices. B. explore problem-solving alternatives. C. express approval or disapproval of the client's thoughts. D. give the client good advice.

Correct Answer is B

Explanation

a. question the client about choices: This might seem confrontational and does not directly help the client with stressors.
b. explore problem-solving alternatives. This is the most therapeutic purpose. Providing feedback helps the client to consider different ways to address and manage their stressors.
c. express approval or disapproval of the client's thoughts: Expressing approval or disapproval is not therapeutic and can inhibit open communication.
d. give the client good advice: Giving advice is not as effective as helping the client develop their own problem-solving skills.

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The nurse's approach to a client with neurotic vs. psychotic behavior is different mainly because clients with neurotic behavior.

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Naxlex Comprehensive Predictor Exams

A client diagnosed with schizophrenia, on an inpatient unit, approaches a nurse, stating, "Someone took my dinner! People need to respect others, and you need to do something about this now!" Which response by the nurse is guided by the basic assumption of the therapeutic milieu?

Correct Answer is A

Explanation

What is the mental health nurse's purpose for providing feedback to a client on a psychiatric unit who is verbalizing concerns about stressors? To:

Correct Answer is B

Explanation

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