21 :: Client with a history of schizophrenia has been admitted for suicidal ideation. The client states "God is telling me to kill myself right now." The nurses best response is:
* A. I understand that god’s voice is real to you, but I do not hear anything. I will stay with you.* B. The voices are part of your illness; it will stop if you take medication
* C. the voices are all in your imagination, think of something else and till go away
* D. Do not think of anything right now, just go, and relax.
A. I understand that god’s voice is real to you, but I do not hear anything. I will stay with you.
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22 :: In assessing a clients suicide potential, which statement by the client would give the nurse the highest cause for concern?
* A. My thoughts of hurting my self are scary to me* B. I would like to go to sleep and not wake up
* C. I have thought about taking pills and alcohol until I pass out
* D. I would like to be free from all these worries
C. I have thought about taking pills and alcohol until I pass out
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23 :: A client with paranoid schizophrenia has persecutory delusions and auditory hallucinations and is extremely agitated. He has been given a PRN dose of Thorazine IM. Which of the following would indicate to the nurse that the medication is having the desired effect?
* A. Complains of dry mouth* B. State he feels restless in his body
* C. Stops pacing and sits with the nurse
* D. Exhibits increase activity and speech
C. Stops pacing and sits with the nurse
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24 :: A client who was wandering aimlessly around the streets acting inappropriately and appeared disheveled and admitted to a psychiatric unit and is experiencing auditory and visual hallucinations. The nurse would develop a plan of care based on:
* A. borderline personality disorder* B. anxiety disorder
* C. schizophrenia
* D. depression
C. schizophrenia
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25 :: A decision is made to discharge a client with obsessive-compulsive disorder. Of the following abilities the client has demonstrated, the one that probably most influenced the decision not to hospitalize him is his ability to:
* a. Hold a job.* b. Relate to his peers.
* c. Perform activities of daily living.
* d. Behave in an outwardly normal
c. Perform activities of daily living.
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