NURSING NCLEX Module 4 Exam Questions and Answers
Submission Details
• Submission Date: 1/13/2017
• Submission Time: 9:48 PM
• Points Awarded:
... [Show More] 93
• Points Missed: 7
• Number of Attempts Allowed: 1
• Not Scored: 0
• Percentage: 93%
1. Questions
1. 1.ID: 9476884715
A schizophrenic client says, “I’m away for the day ... but don’t think we should play or do we have feet of clay?” Which alteration in the client’s speech does the nurse document?
A. Neologism
B. Word salad
C. Clang association Correct
D. Associative looseness
Awarded 1.0 points out of 1.0 possible points.
2. 2.ID: 9476884735
A client with schizophrenia and his parents are meeting with the nurse. One of the young man’s parents says to the nurse, “We were stunned when we learned that our son had schizophrenia. He was no different than from his older brother when they were growing up. Now he’s had another
relapse, and we can’t understand why he stopped his medication.” Which response by the nurse is appropriate?
A. Telling the parents, “Medication noncompliance is the most frequent
reason that people with this diagnosis relapse.”
B. Telling the parents, “Well, it’s his decision to take his medicine, but it’s
yours to have him live with you if he stops the medication.”
C. Asking the client, “How can we help you to take your medicine or to tell
us when you’re having problems so that your medication can be adjusted?” Correct
D. Saying to the parents, “Your concerns are appropriate, but I wonder
whether your son was having trouble telling someone that he had concerns about his medication.”
Rationale: The therapeutic response is the one in which the nurse models speaking directly to the client. This facilitates further assessment of the situation and helps elicit the causes of and motivations for the client’s behavior for both the nurse and the family. In the correct option, the nurse also seeks clarification of the degree of openness and mutuality felt by the client and his family toward each other. The nurse provides information to the family when stating that noncompliance is the most frequent reason for relapse in people with this diagnosis. However, the statement is nontherapeutic at this time because it does not facilitate the expression of feelings. The nurse uses a superego style of communication when stating, “Well, it’s his decision to take his medicine, but it’s yours to have him live with you if he stops the medication.” The content of this statement may be true, but it is nontherapeutic in that it carries a threatening message and may prevent the family from trusting the nurse. By stating, “Your concerns are appropriate, but I wonder whether your son was having trouble telling someone that he had concerns about his medication,” the nurse gives approval and prematurely analyzes the client’s motivation without sufficient assessment.
TestTaking Strategy: Use your knowledge of therapeutic communication techniques and remember to focus on the client’s feelings. Also note that the correct option is the only option in which the nurse directly addresses the client. Review: therapeutic communication techniques .
Reference: Stuart, G. (2009). Principles & practice of psychiatric nursing (9th ed., pp. 2731). St. Louis: Mosby.
Varcarolis, E., & Halter, M. (2009). Essentials of psychiatric mental health nursing: A communication approach to evidencebased care (p. 297). St. Louis: Saunders.
Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Adherence, Psychosis
HESI Concepts: Behaviors—Adherence, Cognition—Psychosis Awarded 1.0 points out of 1.0 possible points.
3. 3.ID: 9476898981
An acutely ill schizophrenic client says to the nurse, “He keeps saying that he likes you, and I keep telling him you’re married, but he won’t listen, and I think he’s going to get fresh with you.” Once the nurse has determined that the client is hallucinating, which response to the client would be most appropriate statement?
A. “Try not to listen to the voices right now so that I can talk with
you.” Correct
B. “I think that you can help him stop his behavior if you concentrate.”
C. “Tell him I said to mind his p’s and q’s or I’ll call the police on him.”
D. “I think that you’re trying to share your own feelings toward me, but you’re shy.”
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