A client with SPMI has been homeless for several months prior to ...

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A client with SPMI has been homeless for several months prior to his current admission to the hospital for the treatment of cellulitis resulting from a leg wound. How should the nurse encourage the client to attend to his hygiene needs?
 
  A) When was the last time that you got cleaned up?
  B) Do you remember how good it feels to be clean shaved and showered?
  C) I've brought you a towel and some soap because you need to take a shower.
  D) If you take a shower now, I'll get someone to take you out for a cigarette later.

Question 2

A client with SPMI is experiencing auditory hallucinations as a result of her schizophrenia. During the current discussion with the nurse, the client is referring to the hallucinations and implying that the nurse can also hear the hallucinations.
 
  Which of the nurse's following responses is most therapeutic?
 
  A) Do you think that I'm also able to hear what you're hearing?
  B) I know that you're hearing voices right now, but I'm not able to hear them.
  C) You're imagining things because of your schizophrenia.
  D) Let's move on to talking about something else.

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Answer to Question 1

Ans: C
During cognitivebehavioral therapy, the nurse encourages the client to maintain personal hygiene and uses techniques such as positive reinforcement to improve the client's efforts. Telling the client in a matter-of-fact manner that it is time to take a shower and then providing the materials needed for showering provide necessary cues.

Answer to Question 2

Ans: B
When the client experiences hallucinations or delusions, the nurse intervenes by accepting that the hallucinatory voice or delusional thought is real to the client. Explaining to the client that the nurse neither believes what the client believes nor hears what the client hears reinforces reality.

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TYSM

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Gracias!