Extract:

Question 1 of 5

The wife of a client diagnosed with paranoid schizophrenia visits 2 days after her husband's admission and states to the nurse, 'Why isn't he eating? He's still talking about his food being poisoned.' Which of the following appraisals by the nurse is most accurate?

Correct Answer: A

Rationale: The wife's concern about her husband's refusal to eat due to delusions is reasonable, as it reflects a common symptom of paranoid schizophrenia that persists early in treatment.

Question 2 of 5

The nurse is distinguishing between delusions experienced by a client diagnosed with major depression with psychotic features and the delusions of a client diagnosed with schizophrenia. The essential difference is:

A. Major depression delusions are more likely to be negative than schizophrenic delusions. B. Major depression delusions clear up less quickly than schizophrenic delusions. C. Major depression delusions are more likely than schizophrenic delusions to require long-acting depot antipsychotic medication given intramuscularly. D. Major depression delusions are more mood congruent than schizophrenic delusions.

Correct Answer: D

Rationale: Delusions in major depression with psychotic features are typically mood-congruent (e.g., guilt, worthlessness), unlike the often bizarre delusions in schizophrenia.

Question 3 of 5

In addition to teaching assertiveness and problem-solving skills when helping the client cope effectively with stress and anxiety, the nurse should also address the client's ability to:

A. Suppress anger. B. Balance a checkbook. C. Follow step-by-step directions. D. Use conflict resolution skills.

Correct Answer: D

Rationale: Conflict resolution skills are essential for managing stress and anxiety in interpersonal situations, complementing assertiveness and problem-solving skills. Suppressing anger is not constructive, balancing a checkbook is unrelated to stress management, and following directions is too narrow a skill for this context.

Question 4 of 5

When comparing the signs and symptoms of depression found in children with those found in adults, which of the following should the nurse expect?

A. Adults commonly display sad behaviors, while children have more somatic complaints and possible acting-out behaviors. B. Adults have more problems performing in the work setting than children have in performing in the school setting. C. Adults typically will not be able to function at record and the nurse but children continue to succeed in school activities while depressed. D. Adults usually have few major problems functioning with depression, while children usually cannot function at school or with tasks at home.

Correct Answer: A

Rationale: Children with depression often present with somatic complaints and behavioral issues, unlike adults who show more overt sadness.

Question 5 of 5

A client refuses medication, stating, 'It makes me feel worse.' Which is the nurse's best response?

A. You have to take it; it's prescribed.' B. Can you tell me more about how it makes you feel?' C. I'll inform the doctor you're refusing.' D. Let's try taking it at a different time.'

Correct Answer: B

Rationale: Asking about the client's experience encourages dialogue, identifies side effects, and informs the care plan. Forcing compliance, reporting refusal, or changing timing without understanding the issue is less therapeutic.