Schizophrenia Q 57
The nurse is providing care to a client with a catatonic type of schizophrenia who exhibits extreme negativism. To help the client meet his basic needs, the nurse should:
A. Ask the client which activity he would prefer to do first.
B. Negotiate a time when the client will perform activities.
C. Tell the client specifically and concisely what needs to be done.
D. Prepare the client ahead of time for the activity.
Correct Answer: C. Tell the client specifically and concisely what needs to be done.
The client needs to be informed of the activity and when it will be done. Use clear and simple language when communicating with a client. Minimize the opportunity for miscommunication and misconstruing the meaning of the message. Set limits in a clear matter-of-fact way, using a calm tone. Giving threatening remarks to Jeremy is unacceptable. They can talk more about the proper ways of dealing with the client’s feelings. A calm and neutral approach may diffuse the escalation of anger. Offer an alternative to verbal abuse by finding appropriate ways to deal with feelings.
Option A: Giving the client choices isn’t desirable because he can be manipulative or refuse to do anything. Ensure that the goals set are realistic; whether in the hospital or community. Avoids pressure on the client and sense of failure on part of the nurse/family. This sense of failure can lead to mutual withdrawal.
Option B: Structure activities that work at the client’s pace and activity. The client can lose interest in activities that are too ambitious, which can increase a sense of failure. Structure times each day to include planned times for brief interactions and activities with the client on a one-on-one basis. Helps the client to develop a sense of safety in a non-threatening environment.
Option D: Negotiating and preparing the client ahead of time also isn’t therapeutic with this type of client because he may not want to perform the activity. If a client is unable to respond verbally or in a coherent manner, spend a frequent, short period with clients. An interested presence can provide a sense of being worthwhile. Try to incorporate the strengths and interests the client had when not as impaired into the activities planned. Increase the likelihood of client’s participation and enjoyment.