which explanation would the nurse manager give about using group therapy for a client with schizophrenia who has paranoid delusions
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Nursing Elites

NCLEX-RN

Psychosocial Integrity NCLEX Questions

1. Why might a nurse manager suggest avoiding therapeutic group work for a client with schizophrenia who has paranoid delusions?

Correct answer: B

Rationale: The nurse manager would suggest avoiding therapeutic group work for a client with schizophrenia who has paranoid delusions because individuals who are suspicious find group settings threatening. Paranoid individuals struggle in groups as they may not trust others enough to engage effectively and tolerate the necessary interactions for group therapy. Therefore, the correct answer is that therapeutic group work tends to be threatening to individuals who are suspicious. Choices A, C, and D are incorrect. While some individuals with schizophrenia may respond well to small therapeutic groups, those with paranoid delusions may find them threatening. Compliance with unit rules and medication regimens may not necessarily increase with group therapy, especially for acutely ill psychiatric clients not ready to accept reality. Involvement in small therapeutic groups is not primarily aimed at decreasing regression and dependency associated with institutionalization, making it an inappropriate option for the client's specific needs.

2. A client diagnosed with sexual dysfunction states, 'Well, I guess my sex life is over.' Which response would the nurse use as a reply?

Correct answer: C

Rationale: The response 'You are concerned about your sex life?' explores the meaning of the statement and allows further expression of concern. It shows empathy and encourages the client to elaborate on their feelings. Choice A, 'I'm sorry to hear that,' does not prompt the client to share more about their concerns and may close off communication. Choice B, 'Oh, you have a lot of good years left,' lacks empathy and understanding of the client's emotions, diverting the focus from the client's feelings. Choice D, 'Have you asked your primary health care provider about that?' shifts the responsibility away from the nurse and may not address the client's emotional needs, potentially making them feel dismissed or embarrassed to seek help.

3. A female client with frequent urinary tract infections (UTIs) asks the nurse to explain her friend's advice about drinking a glass of juice daily to prevent future UTIs. Which response is best for the nurse to provide?

Correct answer: C

Rationale: The correct answer is 'Cranberry juice stops pathogens' adherence to the bladder.' Cranberry juice maintains urinary tract health by reducing the adherence of Escherichia coli bacteria to cells within the bladder. This helps prevent UTIs. Options A, B, and D are incorrect because orange juice with vitamin C, apple juice for urine acidification, and grapefruit juice for antibiotic absorption do not have the same proven effectiveness in preventing UTIs as cranberry juice does.

4. A client who is at 28 weeks' gestation and in active labor is crying. She says, 'I just know that this baby is going to die. What's the use of doing all this to save it?' Which explanation would interpret the client's statements?

Correct answer: B

Rationale: The client's statement indicates anticipatory grief, where she is preparing for a potential loss. This grief is not necessarily about the literal death of the baby but about the loss of the anticipated healthy full-term baby. The client may not be ready to bond with the reality of a preterm baby. Providing gentle, positive support is essential to help her cope with her feelings, as firm support may come across as dismissive. Sedation is not appropriate as it could hinder the client's emotional processing. Allowing the client to express her emotions and work through anticipatory grieving is crucial. The use of the word 'it' reflects the client's emotional struggle and is not the primary issue at hand.

5. Which of the following interventions is essential when working with a client who has antisocial personality disorder?

Correct answer: B

Rationale: When working with a client diagnosed with antisocial personality disorder, it is crucial to set strict limits on their behavior. This disorder is characterized by manipulative behavior, impulsivity, and deceitfulness. By setting strict limits, the nurse can establish boundaries to prevent the client from manipulating others or engaging in disruptive behaviors. Monitoring intake and output (Choice A) is not directly related to managing antisocial personality disorder. Providing diversion (Choice C) or limiting visits from family or friends (Choice D) may not address the core issues associated with this disorder, such as manipulation and boundary violations.

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