Claude is a new nurse on the psychiatric unit. He asks a senior nurse on staff for the 'best advice' when working with oppositional defiant disorder. Which statement reflects advice on solid therapeutic communication?

Correct Answer: C

Rationale: The correct answer is C: When setting limits, be specific and outline consequences. This is the most appropriate advice for working with patients with oppositional defiant disorder. By being specific and outlining consequences, the nurse establishes clear boundaries and expectations. This approach helps the patient understand the consequences of their actions and promotes accountability. Explanation of incorrect choices: A: Using a loud firm tone can escalate the situation and may trigger defensiveness in patients with oppositional defiant disorder. B: Using language beyond the patient's education level can lead to misunderstandings and hinder effective communication. D: An aggressive body language can be perceived as threatening and may worsen the patient's behavior, rather than gaining respect.

Correct Answer: C

Rationale: The correct answer is C: monitoring client treatment adherence. Nurses play a key role in ensuring patients comply with their treatment plans. This involves monitoring medication intake, therapy attendance, and following through with other recommended interventions. Nurses do not have the authority to prescribe medication (choice A) or perform surgical procedures (choice D). While some nurses may be trained in providing counseling, conducting psychotherapy sessions (choice B) is typically the role of licensed therapists or psychologists.

Correct Answer: A

Rationale: The correct answer is A: delusion. Positive symptoms of schizophrenia are behaviors or symptoms that are added to a person's personality, such as delusions. Delusions are false beliefs that are not based on reality, commonly seen in individuals with schizophrenia. Anhedonia (B) is a negative symptom characterized by the inability to experience pleasure. Apathy (C) is also a negative symptom associated with a lack of interest, motivation, or emotions. Mutism (D) is not specific to schizophrenia and refers to the inability or refusal to speak. Therefore, the correct answer is A because delusions are a classic positive symptom of schizophrenia.

Correct Answer: B

Rationale: The correct answer is B because exploring self is a crucial task in the orientation phase of the nurse-client relationship. By exploring personal misconceptions or prejudices, the nurse can identify any biases that may affect their care delivery. This self-awareness helps the nurse maintain objectivity and provide nonjudgmental care. Determining why the client sought help (A) is part of the assessment phase, assisting the patient in behavioral change (C) is typically associated with the working phase, and establishing and preparing the client for the reality of separation (D) is part of the termination phase.

Correct Answer: C

Rationale: The correct answer is C because it respects the client's right to autonomy and confidentiality. By offering to see if Mr. Hawkins wants to talk, the nurse is acknowledging his autonomy to make decisions about who he interacts with. This response also maintains confidentiality by not confirming or denying his presence without his consent. Choice A is incorrect as it does not respect Mr. Hawkins' autonomy and does not offer him the choice to speak with the caller. Choice B is incorrect because it does not protect Mr. Hawkins' confidentiality by potentially revealing his presence. Choice D is incorrect as it does not consider Mr. Hawkins' wishes and simply denies the call without involving him in the decision-making process.