ATI RN Mental Health and Psychiatric NursingTestbank with answers & Rationale(Schizophrenia)
1. A client with borderline personality disorder becomes
... [Show More] angry when he is told that today’s
psychotherapy session with the nurse will be delayed 30 minutes because of an emergency. When the session finally begins, the client expresses anger. Which response by the nurse wouldbe most helpful in dealing with the client’s anger?
A. “If it had been your emergency, I would have made the other client wait.” B. “I know it’s frustrating to wait. I’m sorry this happened.” C. “You had to wait. Can we talk about how this is making you feel right now?” D. “I really care about you and I’ll never let this happen again.” Correct Answer: C. “You had to wait. Can we talk about how this is making you feel right now?” This response may diffuse the client’s anger by helping to maintain a therapeutic relationship andaddressing the client’s feelings. Regardless of the clinical setting, the nurse must provide structureandlimit setting in the therapeutic relationship; in a clinic setting, this may mean seeing the client for
scheduled appointments of a predetermined length rather than whenever the client appears anddemands the nurse’s immediate attention. Option A: This wouldn’t address the client’s anger. Cognitive restructuring is a technique useful inchanging patterns of thinking by helping clients to recognize negative thoughts and feelings andtoreplace them with positive patterns of thinking; thought stopping is a technique to alter the processof negative or self-critical thought patterns. Option B: This is incorrect because the client with a borderline personality disorder blames others
for things that happen, so apologizing reinforces the client’s misconceptions. Establish boundaries inrelationships. The nurse must be quite clear about establishing the boundaries of the therapeuticrelationship to ensure that neither the client’s nor the nurse’s boundaries are violated. Option D: The nurse can’t promise that a delay will never occur again because such matters areoutside the nurse’s control. Help clients to cope and to control emotions. The nurse can helptheclients to identify their feelings and learn to tolerate them without exaggerated responses suchas
destruction of property or self-harm; keeping a journal often helps clients gain awareness of feelings. 2. A 26-year-old client is admitted to the psychiatric unit with acute onset of schizophrenia. His
physician prescribes the phenothiazine chlorpromazine (Thorazine), 100 mg by mouth four
times per day. Before administering the drug, the nurse reviews the client’s medication history. Concomitant use of which drug is likely to increase the risk of extrapyramidal effects?
A. guanethidine (Ismelin)
B. droperidol (Inapsine) [Show Less]