Extract:

Question 1 of 5

A 20-year-old client diagnosed with paranoid schizophrenia is recovering from a psychotic break. Before discharge from the hospital, the client becomes depressed and states, 'I don't want this illness. I'm about to begin my junior year in college.' Which of the following issues would be most important for the nurses to address at this time?

Correct Answer: D

Rationale: Medication non-compliance is critical to address to prevent relapse, especially given the client's distress.

Question 2 of 5

A client with dementia who prefers to stay in his room has been brought to the dayroom. After 10 minutes, the client becomes agitated and retreats to his room again. The nurse decides to assess the conditions in the dayroom. Which is the most likely occurrence that is disturbing to this client?

A. There is only one other client in the dayroom; the rest are in a group session in another room. B. There are three staff members and one physician in the nurse's station working on charting. C. A relaxation tape is playing in one corner of the room, and a television airing a special on crime is playing in the opposite corner. D. The room is brightly lit with fluorescent lights.

Correct Answer: C

Rationale: Conflicting stimuli, such as a relaxation tape and a crime show on TV, can overwhelm a client with dementia, causing agitation due to difficulty processing multiple inputs.

Question 3 of 5

The client's friend reports that the client has been taking about eight 'reds' (800 mg of secobarbital [Seconal]) daily, besides drinking more alcohol than usual. The client's friend asks anxiously, 'Do you think she will live?' Which of the following responses by the nurse is most appropriate?

A. We can only wait and see. It's too soon to tell.' B. Do you know her well? She's so young.' C. We are doing everything we can to help her pull through.' D. Her condition is serious. You sound very worried about her.'

Correct Answer: D

Rationale: Saying 'Her condition is serious. You sound very worried about her' is appropriate, as it acknowledges the gravity of the situation and validates the friend's concern therapeutically.

Question 4 of 5

A nurse observes a male client who is hyperactive and intrusive sitting very close to a female client with his arm around her shoulders. The nurse hears the male client tell a sexually explicit joke. The nurse approaches the client and asks him to walk down the hallway. Which of the following statements by the nurse should benefit the client?

A. She will not want to be around you with that kind of talk.' B. Telling sexual jokes and touching others is not permitted here.' C. You need to be careful about what you say to other people.' D. I think a time-out in your room would be appropriate now.'

Correct Answer: B

Rationale: Setting clear boundaries about inappropriate behavior promotes a safe environment.

Question 5 of 5

The nurse is with the parents of a 16-year-old boy who recently attempted suicide. The nurse cautions the parents to be especially alert for which of the following?

A. Expression of a desire to date. B. Decision to try out for an extracurricular activity. C. Giving away valued personal items. D. Desire to spend more time with friends.

Correct Answer: C

Rationale: Giving away valued items is a warning sign of suicidal intent, requiring immediate attention.