Question

The nurse says to a schizophrenic client “Swallow your pills, John.” The client responds by saying “Swallow your pills John; swallow your pills John; swallow your pills John; swallow your pills John” Which would be a correct label for the nurse to use when documenting this communication? A. word salad B. clang association C. neologism D. echolalia

Short answer

The correct label for the nurse to use when documenting this communication is D. echolalia.

Step-by-step solution

Understand the Client's Response

First, assess the client's response. The repetition of the nurse's exact words without providing additional information or context suggests a specific communication pattern.

Identify the Communication Pattern

Based on the client repeating the exact phrase spoken to him multiple times, identify the communication pattern that is characterized by the repetition of another person's spoken words.

Match the Communication Pattern to the Correct Term

Determine which term best describes the pattern of repeating words or phrases immediately after hearing them. This is a known symptom in some individuals with psychiatric conditions.

Key concepts

Understanding Schizophrenia

Schizophrenia is a complex and chronic mental health disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which can be distressing for them and for their family and friends. Common symptoms include delusions, hallucinations, disorganized speech or behavior, and cognitive issues that affect memory and attention.

Schizophrenia does not mean split personality or multiple personalities. Instead, it indicates a fragmented perception of reality. It is a spectrum condition, meaning symptoms can range from mild to severe and vary significantly from person to person. In the context of the NCLEX-RN examination, understanding schizophrenia is crucial for nurses as they need not only to identify symptoms but also provide compassionate care tailored to the individual's experience of the disorder.

Effective nursing care for schizophrenic patients involves medication management, psychosocial interventions, and ongoing assessment of symptoms. Nurses play a vital role in the management of schizophrenia by supporting treatment adherence, monitoring for side effects, and being attuned to signs of relapse. Education and support for patients and their families are also a key part of comprehensive schizophrenia care.

Echolalia in the Clinical Context

Echolalia is the involuntary repetition or imitation of another person's spoken words. It is a characteristic behavior in certain conditions, including autism spectrum disorders, and is particularly associated with schizophrenia and other psychiatric conditions. Echolalia can be immediate, occurring directly after the original words are spoken, or delayed, occurring hours or days after.

While echolalia can sometimes serve a communicative purpose, such as affirming or calling attention to the language of another person, it often represents a disruption in normal verbal communication. In nursing practice, recognizing echolalia is essential for accurate documentation and understanding patient needs. It helps nurses differentiate between purposeful communication and behaviors related to a patient's psychiatric condition.

In the NCLEX-RN examination, identifying echolalia can help nurses to provide the appropriate interventions and adjustments in communication strategies. For instance, when faced with a patient exhibiting echolalia, nurses might need to simplify their language, slow down their speech, and offer reassurance to facilitate better understanding and patient comfort.

Nursing Communication Strategies

Nursing communication is a cornerstone of effective patient care. It involves not just the exchange of information but also the ability to understand and be understood by patients with varying needs, including those with mental health disorders, such as schizophrenia. Clear, patient-focused communication is essential to establish trust, assess patient needs, and deliver instructions effectively.

For nurses, adapting communication techniques to the patient's condition is vital. For patients demonstrating echolalia, this may involve using straightforward instructions, avoiding long and complex sentences, and being patient when awaiting responses. Additionally, non-verbal communication—such as eye contact, body language, and facial expressions—gain importance when verbal communication is challenging.

When preparing for the NCLEX-RN examination, aspiring nurses must demonstrate an understanding of how to communicate effectively with all patients, including those with psychiatric disorders. Communication skills include active listening, empathy, and the ability to use therapeutic communication techniques that promote patient engagement and support their health and wellbeing. Thus, nurse communication goes beyond the mere delivery of care—it is an empathetic engagement that recognizes the humanity and individuality of each patient.