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nurs 240 exam 6 PrepU schizophrenia Chapter 16
Terms in this set (92)
Which statements characterizes the major difference between the typical and atypical antipsychotic medications?
Typical antipsychotics most often relieve positive symptoms but do not have a significant impact on negative symptoms.
A client diagnosed with schizophrenia has been prescribed clozapine. Which is a potentially fatal side effect of this medication?
Which medication classification has been most effective in treating akathisia?
A client with schizophrenia states that the client is God's messenger and the client's mission is to become president. The nurse documents these comments as evidence of what?
A 20-year-old son of a client who was diagnosed with schizophrenia at the age of 25 is concerned that he may also develop the disorder. Which statement regarding schizophrenia and genetics is true?
Schizophrenia has shown a strong genetic contribution.
Which statement made by a client would indicate that the client has delusions of grandeur?
"I am a magician, and my magic powers are good when the moon is full."
In working with the individual and family, which is the most accurate statement the nurse can make in order to teach the client and family about schizophrenia?
"Individuals with schizophrenia do have differences in brain structure and function that cause a variety of symptoms such as lack of motivation and hearing voices."
A client with a diagnosis of schizophrenia has a history of auditory and visual hallucinations. Which intervention is most likely to minimize the client's hallucinations?
Provide frequent contact and communication with the client
A mental health client insists that the client's spouse is trying to poison the client. In this instance, the client is exhibiting which type of delusion?
A client diagnosed with delusional disorder who uses excessive health care resources most likely has which type of delusions?
A group of nursing students is reviewing the various theories related to the etiology of schizophrenia. The students demonstrate understanding of the information when they identify which neurotransmitter as being responsible for hallucinations and delusions?
A nurse provides care to a client with schizoaffective disorder during hospitalization for acute psychosis. Nursing interventions to help the client to establish trust with the health care team is best accomplished by what?
Offering reassurance in a soft, nonthreatening voice
A client with schizophrenia believes that the client has discovered how to jump to the moon. The nurse would document this belief as what?
A client with schizophrenia is prescribed an antipsychotic medication. Which immediate side effects would the nurse include in the education plan for this medication?
The potential for sedation
A client is diagnosed with schizoaffective disorder. Which would the nurse identify as supporting this diagnosis?
Evidence of hallucinations and delusions accompanied by major depression
When developing the plan of care for a client with schizophrenia who is in the acute phase of illness, the nurse understands that the client is at high risk for what?
A client with delusional disorder believes that the cook at the psychiatric hospital is trying to poison the client. The nurse would record this type of delusion as what?
The nurse expects psychiatric hospitalization for which of the clients diagnosed with schizoaffective disorder experiencing delusional thoughts? Select all that apply.
A 76-year-old person whose symptoms are acute in nature
A 25-year-old person who is having a first delusional experience
A 45-year-old person who was arrested for assaulting a policeman
A 30-year-old person who also has a diagnosis of depression
During a client interview, a client states that "God has sent me a special message. I'm the only one who can carry out his plan." The nurse interprets this statement as suggesting which type of delusion?
A client diagnosed with schizophreniform disorder must have symptoms present for at least 1 month but with a duration of less than how long?
The nurse is assigned to a client with catatonic schizophrenia. Which intervention should the nurse include in the client's care plan?
Meeting all of the client's physical needs
A client is being seen in the health clinic. The nurse observes a shuffling gait, drooling, and slowness of movement. The client is currently taking an antipsychotic for treatment of schizophrenia. The nurse knows that which side effect is occurring?
Which speech pattern is exhibited by the client stating, "I will take a pill if I go up the hill but not if my name is Jill, I don't want to kill?"
What term is used to describe the speech pattern being used when the client imitates or repeats what the nurse is saying?
A comprehensive nursing assessment for neuroleptic malignant syndrome (NMS) should include checking for which in a client taking an antipsychotic medication?
Muscular rigidity, tremors, and difficulty swallowing
A client was admitted to the psychiatric intensive care unit with schizophrenia. The client exhibits primarily disorganized behavior. In addition to hallucinations and delusions, other assessments that the nurse would expect to find include what?
Blunted inappropriate affect, withdrawal, incoherence, and confusion
A student nurse has been assigned to provide care for an inpatient psychiatric-mental health client who has a diagnosis of schizophrenia. The student nurse is apprehensive about interacting with the client. The client's detailed explanations of the client's delusions accompanied by unpredictable movements have prompted fear in the student. How should this nursing student interpret such feelings?
It is natural to feel fear when a client exhibits unpredictable behavior, and this can cause the student to be reasonably cautious.
A client with a delusional disorder has been undergoing individual psychotherapy. The therapy would be deemed ultimately successful when the client meets which outcome?
The client will differentiate between reality and fantasy.
A client diagnosed with schizophrenia is telling everyone that the client is the president of the United States. This client is exhibiting which type of delusion?
A nurse is caring for a client who has been taking clozapine for 2 weeks. The client tells the nurse, "My throat is sore, and I feel weak." The nurse assesses the client's vital signs and finds that the client has a fever. The nurse notifies the physician, expecting an order to obtain which laboratory test?
White blood cell count
A nurse is preparing an in-service program about schizophrenia for a group of psychiatric-mental health nurses. Which would the nurse include as a major reason for relapse?
Nonadherence to prescribed medications
A client with schizophrenia is receiving antipsychotic therapy. The nurse understands that which is a medical emergency should it develop in the client?
Neuroleptic malignant syndrome
A client diagnosed with delusional disorder is telling everyone that the client is the president of the United States. This client is exhibiting which type of delusion?
A nursing instructor is developing an education plan for a group of students about schizophrenia and schizoaffective disorders. The instructor identifies that in addition to psychosis, what other condition must be present at the same time for a diagnosis of schizoaffective disorder?
When reviewing the diagnostic criteria for schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), which would be most accurate?
Schizophrenia lasts at least 6 months and includes at least 1 month of two or more characteristic symptoms.
Research related to the development of schizophrenia has shown what?
The disorder is thought to arise from the interaction of a biological predisposition and environmental stressors.
A client with schizophrenia is exhibiting hallucinations and delusions. The mental health nurse knows that these symptoms are associated with hyperactivity of which neurotransmitter?
A client with schizophrenia is exhibiting positive and negative symptoms. The nurse anticipates that the client would be prescribed what?
Second generation antipsychotic
A client comes to the clinic for an evaluation. During the interview, the client states that the client feels insects crawling all over the skin on the client's arms and legs. The nurse interprets this as which type of sensorium or processing deficit?
A client had been withdrawn in the client's room for 3 days, not eating or sleeping, prior to his admission to the inpatient unit. Upon interview, the client demonstrates difficulty answering questions, appears to have no facial expressions, and cannot follow simple instructions. This cluster of symptoms can be described as what?
A client with schizophrenia is hearing voices that tell the client to kill the self. What term is used to identify this type of false sensory perception?
While conducting a mental status examination, the client accuses the nurse of recording the interview so that it can be sent to the Federal Bureau of Investigation. What type of delusion is this client experiencing?
A client with a long history of schizophrenia has managed well on fluphenazine. The client reports smacking of the lips and sticking out the tongue. Based on this report, what does the nurse suspect is occurring with the client?
Signs of tardive dyskinesia (TD) associated with neuroleptic medication
What are the signs and symptoms of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders?
Schizophrenia lasts at least 6 months and includes at least 1 month of 2 or more active-phase symptoms.
A 55-year-old client was admitted to the psychiatric unit after an incident in a department store in which the client accused a sales clerk of following the client around the store and stealing the client's keys. The client was subdued by the police after destroying a window display because voices had told the client that it was evil. As the nurse approached the client, the client says, "You're all out to get me, and you're one of them. They're Rostoputians and grog babies here." This demonstrates what?
Suspiciousness and neologisms
A client who is delusional and paranoid refuses to take antipsychotic medication as prescribed. Which is the most therapeutic response by the nurse to this refusal?
"What is it about the medicine that you don't like?"
A client with schizophrenia is exhibiting emotional withdrawal and poor eye contact. The mental health nurse knows that these symptoms are suggestive of which neurotransmitter imbalance?
Increased serotonin and dopamine
A client with a diagnosis of schizophrenia has been brought to the emergency department by a worker from the group home where the client resides. The worker states that the client has stopped taking medications and drank 2 to 3 gallons of water over the past several hours. What assessments should the nurse who is caring for this client prioritize?
Neurological assessment and monitoring of electrolyte levels
A 44-year-old client has been experiencing intense job stress. In recent weeks, the client has confided in the client's spouse that the client believes the client's firm monitors every aspect of the client's personal performance and that the firm is engaged in deception and cover-up of its "true purpose." A nurse would recognize that the primary theme of the client's delusional disorder is what?
Which client statement is suggestive of a sexual delusion?
"You've been watching me and my partner while we are together, haven't you?"
A nurse is caring for a client who has been receiving treatment for schizophrenia with chlorpromazine for the past year. It would be essential for the nurse to monitor the client for what?
A client with schizophrenia is prescribed clozapine because other prescribed medications have been ineffective. After educating the client and family about the drug, the nurse determines that the education was successful when they state what?
"We'll need to make sure that the client has the client's blood count checked at least weekly."
Which type of delusion refers to a situation whereby a person or someone close to person is being malevolently treated in some way?
A nurse is assessing a client who is complaining of the sensation of "bugs crawling under the skin" and intense itching and burning. The client states, "I know bugs have invaded my body." There is no evidence to support the client's complaint. The nurse interprets this as which type of delusion?
A client is diagnosed with a delusional disorder. While providing care to the client, the nurse assesses the client's delusions. Which would be least appropriate for the nurse to do?
Try to change the client's delusional belief
A client begins to exhibit hallucinations and delusions along with disorganized speech after forgetting to take antipsychotic medication. The nurse suspects that the client is at which point in the clinical course of the disorder?
A client is diagnosed with schizophreniform disorder. The nurse is reviewing the client's medical record and finds that the client's symptoms have been present for at least how long?
Schizoaffective disorder has symptoms typical of both schizophrenia and which type of disorder?
A nurse is assessing a client who is reporting the sensation of "bugs crawling under the skin" and intense itching and burning. The client states, "I know bugs have invaded my body." There is no evidence to support the client's report. The nurse interprets this as which type of delusion?
When preparing to educate a client regarding a newly prescribed antipsychotic medication, the nurse does what? Select all that apply.
Encourages the use of sugar-free gum to help manage dry mouth
Suggests methods to minimize the potential for weight gain
Identifies lifestyle adjustments that the resulting lethargy may require
Advises the client to discuss any concerns regarding sexual dysfunction
The nurse working with a client who is newly diagnosed with schizophrenia would include which in the client's education?
"Schizophrenia is an illness that involves neurotransmitters, more specifically dopamine."
A client diagnosed with schizophrenia is having delusions that the client is being plotted against by the government. This would be documented as which type of delusion?
Which is the central focus of persecutory delusions?
Injustice that must be remedied by legal action
When describing the difference between schizoaffective disorder (SAD) and schizophrenia, the nurse would address which as associated with SAD?
Increased mood responses
A client has been taking neuroleptic medications for many years as a treatment for schizophrenia. The client is exhibiting tongue protrusion, facial grimacing, and excessive blinking. These manifestations are characteristic of which extrapyramidal side effects (EPS)?
A client diagnosed with schizophrenia states, "I want to go home, go home, go home." This is an example of which speech pattern?
A client has been diagnosed with schizophrenia. Assessment reveals that the client lives alone. The client's clothing is disheveled, the client's hair is uncombed and matted, and the client's body has a strange odor. During an interview, the client's family members voice a desire for the client to live with them when the client is discharged. Based on the assessment findings, which nursing diagnosis would be the priority?
Bathing self-care deficit related to symptoms of schizophrenia
Assessment of genetic predisposition supports asking a client who is exhibiting symptoms of a delusional disorder what?
Whether any family members have been diagnosed with schizophrenia
Which assessment findings in a client who is suspected of having a delusional disorder would be suggestive of a diagnosis of schizophrenia?
The client experiences frequent and sustained hallucinations.
The client's diagnosis of schizoaffective disorder is supported when the nurse documents what?
The client reports "hearing voices" for the last 3 months
Which client exhibits the characteristics that are typical of the prodromal phase of schizophrenia?
A 20-year-old is experiencing a gradual decrease in the ability to concentrate, be productive, and sleep restfully.
While being interviewed, a client diagnosed with a delusional disorder states, "I have this really strange odor coming out of my mouth. I stop to brush my teeth almost every hour and then rinse with mouthwash every half hour to get rid of this smell. I've seen so many doctors, and they can't tell me what's wrong." The nurse interprets the client's statement as reflecting which type of delusion?
A client with delusional disorder is hospitalized. The most common reason for this is what?
Protect the client legally
A client has been prescribed clozapine for treatment of schizophrenia. The client must be taught to monitor which blood concentrations weekly while taking this drug?
White blood cells
A client has been prescribed clozapine for schizoaffective disorder (SCA) with depression. The nurse should explain to the client that one advantage of clozapine is that it can provide what?
Reduction of hospitalizations and risk for suicide
Although a psychotic episode can be brief, the client impact can last a long time. For this reason, the nurse is aware of what?
Supervision may be required to protect the person
A client with a persistent delusional disorder has been prescribed ziprasidone. Which assessment should the nurse prioritize when this medication regimen begins?
Cardiac and neurological assessments
Which would a nurse expect to administer to a client with schizophrenia who is experiencing a dystonic reaction?
A client with schizophrenia is prescribed clozapine. The nurse would monitor the client closely for specific signs of what?
A nurse is caring for a client diagnosed with schizophreniform disorder. The nurse demonstrates understanding of this disorder when identifying that the client is at risk for developing what?
Which medication is used to control the extrapyramidal effects associated with antipsychotic medications?
The nurse is developing a care plan for a client with somatic delusions. Which would be an appropriate nursing diagnosis for this client?
Disturbed thought process
A nurse is preparing to document information obtained from a client diagnosed with a delusional disorder who is experiencing somatic delusions. Which would the nurse most likely document?
While being assessed, a client with schizophrenia states, "Everywhere I turn, the government is watching me because I know too much. They are afraid that I might go public with the information about all those conspiracies." The nurse interprets this statement as indicating which type of delusion?
A client is receiving antipsychotic therapy. When describing dystonic reactions to the client, which should the nurse instruct the client to watch for?
Spasms of the eye muscles
A mental health client has been prescribed clozapine for the treatment of schizophrenia. The nurse should be alert to which potentially life-threatening adverse effects of this medication?
A client has been prescribed quetiapine for delusional disorder. In teaching the client about this medication, the nurse must be certain to include which information?
One of the common side effects is dry mouth.
A nurse is caring for a hospitalized client who has schizophrenia. The client has been taking antipsychotic medications for 1 week when the nurse observes that the client's eyes are fixed on the ceiling. The nurse interprets this finding as what?
The nurse should consider which during a psychiatric assessment of a newly immigrated client who is being evaluated for possible religious delusions?
Some cultures hold religious beliefs that might be confused with delusional thought
The nurse is assessing a client with schizophrenia who has a history of successfully managing the client's symptoms. The client has few social activities and speaks in a flat tone when interacting with others. Currently the client is experiencing active hallucinations and social withdrawal. The nurse identifies improved social skills as an important therapeutic goal. How should the nurse implement this plan?
Enter the client in a social skills training program when acute psychosis subsides.
The nurse must be aware that individuals from diverse ethnic groups might describe troubling experiences in terms of physical problems or specific culture-bound syndromes. The syndrome of ghost sickness is exhibited by which culture?
A client in an inpatient setting has a delusion that there are a multitude of undetectable noxious gases in circulation that have the potential to poison the client and others. Which of the nurse's responses is most therapeutic?
"I can assure you that you are actually very safe here."
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