Nursing Elites

1. A patient with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most appropriate?

• A. Encourage the patient to ignore the voices.
• B. Provide a structured and safe environment.
• C. Engage the patient in a debate about the reality of the voices.
• D. Ask the patient to describe the content of the hallucinations.

Correct answer: D

Rationale: The most appropriate nursing intervention when a patient with schizophrenia is experiencing auditory hallucinations is to ask the patient to describe the content of the hallucinations. This intervention helps assess the risk associated with the hallucinations and provides valuable insight into the patient's condition, aiding in developing an effective care plan. Encouraging the patient to ignore the voices (Choice A) may not address the underlying issues or risks associated with the hallucinations. Providing a structured and safe environment (Choice B) is important but does not directly address the hallucinations. Engaging the patient in a debate about the reality of the voices (Choice C) may worsen the situation by invalidating the patient's experiences.

2. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, 'Last night, demons came to my room and tried to rape me.' Which response would be most therapeutic?

• A. There are no such things as demons. What you saw were hallucinations.
• B. It is not possible for anyone to enter your room at night. You are safe here.
• C. You seem very upset. Please tell me more about what you experienced last night.
• D. That must have been very frightening, but we'll check on you at night and you'll be safe.

Correct answer: C

Rationale: Response C is the most therapeutic as it shows empathy and encourages the patient to express their feelings and share more about their experience. By actively listening and inviting the patient to talk, the nurse creates a supportive environment that can help the patient feel heard and understood, which is essential in building trust and rapport in therapeutic communication with individuals experiencing schizophrenia.

3. Which of the following is a negative symptom of schizophrenia?

• A. Hallucinations
• B. Delusions
• C. Alogia
• D. Paranoia

Correct answer: C

Rationale: Alogia, also known as poverty of speech, is a negative symptom of schizophrenia. It refers to a reduction in the amount of speech or the feeling that one has nothing to say. Hallucinations and delusions are positive symptoms, characterized by the presence of abnormal experiences and beliefs. Paranoia is a symptom involving intense anxious or fearful feelings, which is not classified as a negative symptom of schizophrenia.

4. What information should the nurse include in patient education for a patient prescribed fluoxetine for obsessive-compulsive disorder (OCD)?

• A. Take the medication in the morning to avoid insomnia.
• B. The medication may take several weeks to achieve the full effect.
• C. It is safe to consume alcohol while taking this medication.
• D. Report any side effects to the healthcare provider immediately.

Correct answer: B

Rationale: Patients prescribed fluoxetine should be educated that the medication may take several weeks to achieve its full therapeutic effect. This information helps manage patient expectations and ensures they do not discontinue the medication prematurely due to lack of immediate results. Taking the medication in the morning to avoid insomnia is not a specific requirement for fluoxetine. Consuming alcohol while taking fluoxetine is not safe and can lead to adverse effects. It is crucial to report any side effects to the healthcare provider promptly for timely management and adjustment of the treatment plan.

5. Which of the following are therapeutic communication techniques that a healthcare professional can use when interacting with clients? Select one that doesn't apply.

• A. Using silence
• B. Offering self
• C. Giving advice
• D. Providing reassurance

Correct answer: C

Rationale: Therapeutic communication techniques aim to promote understanding and trust between the professional and the client. Using silence allows the client to process thoughts, feelings, and information. Offering self involves making oneself available and showing empathy. Providing reassurance helps instill confidence. However, giving advice can sometimes be non-therapeutic as it may undermine the client's autonomy and decision-making process.

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