A client who is taking chlorpromazine hydrochloride (Thorazine) is experiencing extrapyramidal side effects (EPS). The nurse understands that EPS is:

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Involuntary muscle movements. Extrapyramidal side effects (EPS) are known side effects of antipsychotic medications like chlorpromazine hydrochloride (Thorazine). These side effects include symptoms such as dystonia, akathisia, parkinsonism, and tardive dyskinesia, all of which involve involuntary muscle movements. Option A) Dysfunction of the cardiovascular system is incorrect because EPS does not primarily involve cardiovascular issues but rather motor disturbances. Option C) Similar to a seizure disorder is incorrect as EPS is different from seizure disorders in terms of underlying mechanisms and presentation. Option D) Toxic reaction of the liver is also incorrect as EPS is not related to liver toxicity but rather to neurological side effects of the medication. Educationally, understanding EPS is crucial for nurses caring for clients on antipsychotic medications. Recognizing and managing these side effects promptly can improve patient outcomes and quality of life. Nurses should be knowledgeable about EPS symptoms, risk factors, and interventions to provide safe and effective care for clients experiencing these side effects.

Correct Answer: A

Rationale: In the context of the Behavioral Theory of Mental Health, giving a broad opening is a technique of communication that encourages the client to talk (Option A). This technique involves using open-ended questions or statements to invite the client to freely express their thoughts, feelings, and experiences without feeling rushed or judged. By providing a broad opening, the therapist creates a safe and supportive environment for the client to explore and share their concerns. Option B, giving meaning to what the patient is saying, is incorrect in this context because it refers more to the technique of reflection or paraphrasing, where the therapist restates or summarizes the client's words to show understanding. Option C, facing the client with his behavior, is incorrect as it suggests a confrontational approach rather than the empathetic and non-judgmental stance encouraged by the Behavioral Theory. Option D, observing the client's nonverbal communication, is also incorrect as it pertains more to the skill of active listening and attending to both verbal and nonverbal cues rather than specifically initiating communication. In an educational context, understanding the importance of communication techniques like giving broad openings is crucial for mental health professionals to establish rapport, gather information, and facilitate the therapeutic process effectively. By mastering these skills, practitioners can create a foundation of trust and understanding with their clients, leading to more meaningful and productive therapeutic outcomes.

Correct Answer: C

Rationale: The patient is expressing feelings of sadness over the loss of the therapeutic group relationships that have been helpful to her. Such feelings are considered normal, just as they are considered normal when the nurse-patient relationship terminates. The feelings expressed are normal, not regressive. No hidden meaning is present; the patient openly expressed genuine feelings. Further evaluation is not needed.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Praising him for positive behavioral changes. Praising the patient for positive behavioral changes is a form of positive reinforcement that can help reinforce the desired behavior of recognizing and using more effective coping techniques. By acknowledging and praising the patient's efforts and progress, the nurse can motivate the patient to continue practicing and integrating these coping techniques into their daily life. Option A) Isolating him from more seriously ill patients is incorrect because isolation does not provide positive reinforcement for the patient's behavior change. It may also lead to feelings of stigmatization or further isolation, which can be counterproductive to the patient's mental health goals. Educationally, it is important for healthcare providers to understand the principles of behavior modification and positive reinforcement in mental health settings. By providing positive feedback and reinforcement for desired behaviors, healthcare professionals can effectively support patients in achieving their mental health goals and promoting positive coping strategies. This approach aligns with the behavioral theory of mental health, which emphasizes the importance of reinforcing positive behaviors to facilitate lasting change.

Correct Answer: C

Rationale: In this scenario, the nurse is most likely to need to schedule a pre-ECT workup and teaching for Patient C, who was unresponsive to a 6-week trial of SSRI antidepressant therapy. The correct answer is C because electroconvulsive therapy (ECT) is often considered when other treatments, such as SSRIs, have failed to produce the desired results. Pre-ECT workup is crucial to assess the patient's physical health, evaluate the need for anesthesia, and ensure the patient is well-informed about the procedure. Patient A is newly diagnosed with dysthymic disorder, which is a chronic but typically less severe form of depression, and ECT is not usually the first-line treatment for this condition. Patient B had a good response to ECT 2 years ago for melancholic depression, indicating that ECT may not be immediately necessary again. Patient D, who has depression associated with an inoperable brain tumor, may require a different treatment approach due to the underlying medical condition. Understanding the indications, contraindications, and considerations for ECT is essential for nurses working in mental health settings. Recognizing when to schedule pre-ECT workup and providing thorough patient education are key responsibilities to ensure safe and effective care for individuals undergoing this treatment.