Correct Answer: C

Rationale: Focusing attention on useful tasks: While the client's actions involve tasks, the primary motivation is to reduce anxiety rather than simply focusing attention on useful tasks for their own sake. Manipulating and controlling others' behavior: The client's behavior is more related to managing their own anxiety through compulsive actions rather than manipulating or controlling others. Decreasing anxiety to a tolerable level. In obsessive-compulsive disorder (OC
D), individuals often engage in repetitive and ritualistic behaviors as a way to manage anxiety. The compulsive behaviors, such as cleaning and picking up after others in this case, serve as a mechanism to reduce anxiety or prevent a feared event. These actions may provide a sense of control and temporary relief from obsessive thoughts. Limiting the amount of time available for interaction with others: While the client's compulsive behaviors may limit social interactions, the primary purpose is to manage anxiety rather than intentionally limiting interaction with others.

Correct Answer: A

Rationale: Neologism. Neologism is a language disturbance in which the individual creates new, idiosyncratic words that have meaning only to the individual. In this case, the client's use of 'mazuka' is an example of a neologism as it is a made-up word that holds significance only for the client. Clang association involves the association of words based on sound rather than meaning. Echolalia is the repetition of words or phrases spoken by others. Word salad refers to a jumble of words and phrases that lack coherent meaning or logical connection.

Correct Answer: 0.1

Rationale:
To calculate the amount of haloperidol (in mL) that the nurse should administer, use the following formula: Volume (mL) = Dose (mg) / Concentration (mg/mL). In this case: Volume (mL) = 5 mg / 50 mg/mL = 0.1 mL.
Therefore, the nurse should administer 0.1 mL of haloperidol.

Correct Answer: D

Rationale: What happened to you in the past to make you so desperate?' may be seen as judgmental and may not be as helpful in the immediate crisis. It assumes a specific cause for the desperation and might not address the current feelings or circumstances that are contributing to the suicidal thoughts. 'What will you accomplish by taking your life?' This question may be perceived as confrontational or dismissive of the client's feelings. It might not provide a clear understanding of the immediate risk or plan. 'Why do you feel depressed enough to end your life?' is a direct question that may put pressure on the client and might not be as effective in exploring their thoughts and feelings. It assumes a direct link between depression and suicidal thoughts without allowing for a more nuanced exploration. 'How will you carry out your plan?' This question is crucial because it helps assess the seriousness of the client's intent and the immediacy of the risk. Understanding the specifics of the plan can help the nurse evaluate the level of danger and take appropriate actions to ensure the client's safety.

Correct Answer: B

Rationale: Dental caries is not a specific complication commonly associated with heroin use. Dental issues may result from other substances or lifestyle factors. Perforation of the nasal septum is a complication associated with the intranasal use of heroin. Chronic snorting or sniffing of heroin can damage the nasal septum, leading to a perforation. Permanent effects on short-term memory loss are more commonly associated with the use of substances like cannabis or certain hallucinogens. Heroin use is not typically linked to permanent effects on short-term memory. Pancreatitis is not a commonly reported complication of heroin use. Pancreatitis is more commonly associated with alcohol use disorder and gallstone-related issues.