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Author Question: A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his ... (Read 9 times)

evelyn o bentley

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A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his
  sales. Today, he argued with several office mates and threatened to kill one of them.
 
  The police were
  called, and he was brought to the mental health center for evaluation. He has had previous
  admissions to the unit for stabilization of symptoms of paranoid schizophrenia. When the nurse
  meets him, he points at staff in the nursing station and states loudly They're all plotting to destroy
  me. Isn't that true? An appropriate response for the nurse would be
  a. No, that is not true. People here are trying to help you if you will let them..
  b. Everyone here is trying to help you. No one wants to harm you..
  c. Thinking that people want to destroy you must be very frightening..
  d. That is absurd. Staff are health care workers, not members of the mob..

Question 2

A depressed client who is taking a tricyclic antidepressant tells the nurse I don't think I can keep
  taking these pills. They make me very dizzy, especially when I stand up.. The nurse should
 
  a. explain how to mange hypotension and reassure that side effects go away after
  several weeks.
  b. tell the client that the side effects are a minor inconvenience compared with
  feelings of depression.
  c. withhold the drug and have the physician examine the client.
  d. perform a mental status examination on the client.



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connor417

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Answer to Question 1

C
Resist focusing on content; instead, focus on the feelings the client is expressing. This strategy
prevents arguing about the reality of delusional beliefs. Such arguments increase client anxiety and
the tenacity with which the client holds to the delusion. The other options focus on content and
provide opportunity for argument.

Answer to Question 2

A
Drowsiness, dizziness, and postural hypotension usually subside after the first few weeks of therapy
with tricyclic antidepressants. Postural hypotension can be managed by teaching the client to stay
well hydrated and rise slowly. Knowing these facts may be enough to convince the client to remain
medication compliant. Option B would not be a convincing reason to remain on the medication.
Option C is unnecessary. Independent nursing action is called for. Option D is unnecessary.





 

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