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NEW QUESTION 46
A 28-year-old client performs a long, involved ritual in getting up and preparing for the day. He became unable to get to his job before noon. His family, in desperation, has admitted him to the hospital's psychiatric unit. On the unit, he is always late for breakfast, which is served at 8 am. The nurse identifies that the best approach to this problem is to:

A. Ask him to get all the other clients up so that he will forget about his ritualB. Allow him to eat lateC. Suggest that he do the rituals after breakfastD. Get him up early so that he can complete the ritual before breakfast

Answer: D

Explanation:
(A) Allowing him to eat late is not a solution to the problem because the ritual affects more than just this meal. (B) He is helpless to change this behavior because the rituals occur as a result of an irrational effort to control his anxiety. (C) To interfere with the ritual will increase anxiety. Until the basic problem is resolved, and in turn his need for the ritual relieved, arrange the schedule so that essential activities may be included (such as meals with the group). (D) This approach would be very disruptive to the other clients and would not serve to relieve the anxiety of the client.

 

NEW QUESTION 47
Four days after admission for cirrhosis of the liver, the nurse observes the following when assessing a male client: increased irritability, asterixis, and changes in his speech pattern. Which of the following foods would be appropriate for his bedtime snack?

A. A ham and cheese sandwichB. Fresh fruitC. A milkshakeD. Saltine crackers and peanut butter

Answer: B

Explanation:
Explanation/Reference:
Explanation:
(A) High levels of ammonia, a by-product of protein metabolism, can precipitate metabolic encephalopathy.
These clients need a diet high in carbohydrates and bulk. (B) Metabolic encephalopathy of the brain associated with liver failure is precipitated by elevated ammonia levels. Ammonia is a by-product of protein metabolism. (C, D) Metabolic encephalopathy in liver failure is precipitated by elevated ammonia levels.
Ammonia is a by-product of protein metabolism.

 

NEW QUESTION 48
A 25-year-old outpatient presents with a diagnosis of compulsive personality disorder. His coworkers become annoyed with his rigid, perfectionistic manner and preoccupation with trivial details and schedules.
A nursing intervention appropriate for this client would include:

A. Avoiding discussion of his annoying behaviorB. Encouraging the client to set a time schedule and deadlines for himselfC. Encouraging him to engage in recreational activitiesD. Contracting with him for the amount of time he will spend on the compulsive behaviors

Answer: D

Explanation:
Explanation/Reference:
Explanation:
(A) This answer is incorrect. The client will work hard at the activity instead of enjoying it. (B) This answer is incorrect. The nurse should allow the client to discuss these thoughts, within limits, not to avoid discussing them. (C) This answer is incorrect. The compulsive client tends to control time to excess. It should not be encouraged. (D) This answer is correct. A contract with the client regarding the amount of time that will be spent discussing the compulsive activities is appropriate. Time allotted should be gradually decreased.

 

NEW QUESTION 49
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