The client received aripiprazole (Abilify) on admission to the ...

[gonzo233]

The client received aripiprazole (Abilify) on admission to the inpatient unit with a diagnosis of schizophrenia, paranoid type. Which of the following would the nurse note as a sign that the aripiprazole is becoming effective?
 
  1. The client paces in the hall and engages in solitary activities most of the day.
  2. The client sleeps for shorter periods of time during the day.
  3. The client establishes eye contact and remains in conversation with the nurse for longer periods.
  4. The client eats only the food that is in its original container such as individual packages of crackers.

Question 2

The charge nurse has just given a presentation about the importance of practicing self-care. Which of the following staff behaviors will the nurse find concerning?
 
  1. Giving feedback to a fellow staff member about derogatory comments
  2. Requesting to be alone during break time
  3. Calling the unit on days off to inquire about clients' progress
  4. Verbalizing feelings about a client's situation

[amcvicar]

Answer to Question 1

3
Rationale: Because suspiciousness is a central feature of paranoid delusions, efficacy is shown by the client demonstrating behaviors that suggest increasing trust in the nurse. Sleeping less during the day is not a sign that aripiprazole is alleviating psychotic symptoms. Engaging in solitary activities and eating prepackaged food are signs of paranoia.

Answer to Question 2

3
Rationale: A nurse who feels compelled to check on clients during sanctioned time away is unable to leave concerns about the clients at work and cannot assimilate the experiences of working with troubled clients. Requesting to be alone during break time demonstrates the nurse's need for self-care after responding to the needs of clients. Providing feedback to another staff member demonstrates accountability for the quality of care and confronts demeaning language. Verbalizing one's feelings enhances self-awareness of difficult emotions and allows for constructive feedback and new perspectives.