Extract:

Question 1 of 5

A client diagnosed with major depression spends most of the day lying in bed with the sheet pulled over his head. Which of the following approaches by the nurse is most therapeutic?

Correct Answer: B

Rationale: Frequent initiation of contact shows care and encourages engagement without overwhelming the client.

Question 2 of 5

The client states to the nurse at the outpatient clinic, 'I don't feel ready to go back to work. It's only been a week since I left the hospital.' Assessment reveals a flat affect, disheveled appearance, poor posture, and minimal eye contact during interaction. The nurse asks the client whether he is thinking about harming himself. The client tells the nurse he has a loaded revolver at home and will probably use it. Which of the following should the nurse do next?

A. Tell the client to go and remove the gun from his home. B. Ask the client to call the nurse every hour when he gets home. C. Ask the client to promise not to harm himself. D. Initiate plans for hospitalization immediately.

Correct Answer: D

Rationale: A specific plan with access to a lethal means (loaded revolver) requires immediate hospitalization.

Question 3 of 5

A 15-year-old girl is sent to the school nurse with complaints of dizziness and nausea. While assessing the girl, who denies any health problems, the nurse smells alcohol on her breath. Which of the following responses by the nurse is most appropriate?

A. Don't tell me that you have been drinking alcohol before you came to school this morning!' B. Why don't you tell me the real reason that you are feeling sick this morning?' C. Tell me everything that you have had to eat and drink yesterday and today.' D. I know that high school is stressful, but drinking alcohol is not the best way to handle it.'

Correct Answer: C

Rationale: This response gathers information non-judgmentally, allowing the nurse to assess the situation further.

Question 4 of 5

A client with schizophrenia is prescribed olanzapine (Zyprexa). Which dietary advice should the nurse provide?

A. Limit sugar and fat intake. B. Increase protein consumption. C. Avoid all dairy products. D. Eat frequent, large meals.

Correct Answer: A

Rationale: Olanzapine can cause weight gain and metabolic issues, so limiting sugar and fat helps mitigate these risks.

Question 5 of 5

A client diagnosed with paranoid schizophrenia is still withdrawn, unkempt, and unmotivated to get out of bed. A mental health aide asks the nurse why he is this way after being on fluphenazine (Prolixin) 10 mg for 7 days. The nurse should tell the health aide:

A. Prolixin is most effective with the positive symptoms of schizophrenia.' B. He'll be less withdrawn and unmotivated when the Prolixin takes effect.' C. His Prolixin dose probably needs to be increased again.' D. His lack of motivation is a common side effect of the Prolixin.'

Correct Answer: A

Rationale: Fluphenazine, a typical antipsychotic, is more effective for positive symptoms (e.g., hallucinations, delusions) than negative symptoms (e.g., withdrawal, lack of motivation), which explains the client's persistent symptoms.