A client diagnosed with paranoid schizophrenia states, "My psychiatrist is out to get me. I'm sad that the voice is telling me to stop him." What symptom is the client exhibiting, and what is the nurse's legal responsibility related to this symptom?

Correct Answer: C

Rationale: The correct answer is C: Command hallucinations; warn the psychiatrist. The client is experiencing command hallucinations, as they are hearing voices instructing them to harm their psychiatrist. The nurse's legal responsibility is to ensure the safety of the client and others. By warning the psychiatrist, the nurse can help prevent any potential harm. Administering medication (A) may be necessary but does not directly address the safety concern. Orienting the client to reality (B) may not be effective given the severity of the hallucinations. Calling an emergency treatment team meeting (D) may be appropriate, but the immediate action should be to warn the psychiatrist to ensure safety.

Correct Answer: A

Rationale: George used exercise as a stress management technique, as swimming during his lunch hour helped reduce his anxiety. Exercise is known to release endorphins, which are natural mood lifters, and reduce stress hormones like cortisol. It also helps improve overall physical and mental health. Deep breathing, guided imagery, and progressive muscle relaxation are also effective stress management techniques, but in this scenario, exercise directly contributed to reducing George's anxiety.

Correct Answer: B

Rationale: The correct answer is B - to advocate for the patient's wishes. The nurse should ensure the physician is aware of the patient's preferences and wishes regarding end-of-life care. Advocating for the patient's autonomy and ensuring their wishes are respected is crucial in providing patient-centered care. Choices A and C involve overstepping the nurse's role by either blindly following orders or suggesting treatment without proper authority. Choice D is inappropriate as it implies the nurse should manipulate the physician's perspective. Advocating for the patient's wishes promotes ethical and compassionate care in end-of-life situations.

Correct Answer: C

Rationale: The correct answer is C: Democratic. The charge nurse's leadership style is democratic because she involves all group members in the decision-making process by eliciting their opinions and organizing a vote. This approach allows for input from everyone, promotes collaboration, and ensures that all voices are heard. A: Laissez-faire is incorrect because the charge nurse is actively involved in the decision-making process. B: Autocratic is incorrect because the charge nurse is not making decisions unilaterally without input from others. D: Scientific is incorrect as it does not accurately describe the charge nurse's leadership style in this context, which is more focused on group consensus and participation.

Correct Answer: D

Rationale: The correct answer is D, Intake & output (I&O) graphic sheet. This sheet records all fluids a patient consumes and eliminates, providing crucial information on fluid balance. It helps healthcare providers monitor hydration status and detect abnormalities. Choice A, the critical care flow sheet, focuses on critical care parameters like medications and procedures. Choice B, vital signs graphic sheet, tracks vital signs such as temperature, pulse, and blood pressure. Choice C, health assessment flow sheet, documents general health assessment findings, not specifically fluid loss. Overall, the I&O graphic sheet is the best choice for monitoring fluid loss in a patient.