Dps_22s

1. client with schizophrenia, disorganized type, is admitted to the inpatient unit. He frequently giggles and mumbles to himself. He hasn't taken a shower for the last 3 days, presenting a disheveled, unkempt appearance and other clients are beginning to complain. Which statement would be most appropriate for the nurse to use in persuading the client to shower? a. "Clients on this unit take showers daily." b. "It's time to shower. I will help you." c. "You'll feel better if you shower." d. "Would you like to take a shower?"

1.B Clients with schizophrenia, disorganized type, need direction and limit-setting when performing activities. Communication must be clear, simple, and directed at the client's level of functioning. Thus, telling the client that it is time to shower and that the nurse will assist is the most appropriate statement. Stating that clients on this unit take showers is demanding and not therapeutic. Additionally, the client may be unable to understand the implications of this statement as it affects him. Because of the client's current symptoms, the client will most likely be unable to comprehend the significance of feeling better if he showers. Additionally, this statement could be viewed as false reassurance. Also, in light of the client's current symptoms, he is unable to make decisions; therefore, asking him if he would like to take a shower would be inappropriate.

2. A new client is being admitted to a care facility. The client is a 22-year-old Caucasian male who has been diagnosed with paranoid schizophrenia. The nurse expects to assess which of the following in a client with the diagnosis of schizophrenia, paranoid type? a. anger, auditory hallucinations, persecutory delusions b. abnormal motor activity, frequent posturing, autism c. fl at affect, anhedonia, alogia d. silly behavior, poor personal hygiene, incoherent speech

2.A Clients with schizophrenia, paranoid type, tend to experience persecutory or grandiose delusions and auditory hallucinations in addition to behavioral changes such as anger, hostility, or violent behavior. Abnormal motor activity, posturing, autism, stupor, and echolalia are associated with schizophrenia, catatonic type. Flat affect, anhedonia, and alogia are negative symptoms associated with schizophrenia in general. Schizophrenia, disorganized type, is characterized by withdrawal, incoherent speech, and lack of attention to personal

3. The client experiences a disintegration of personality and is withdrawn. Speech may be incoherent. Behavior is uninhibited, along with a lack of attention to personal hygiene and grooming. Which type of schizophrenia best describes the above symptoms? a. catatonic type b. paranoid type c. undifferentiated type d. disorganized type

3.A The most appropriate outcome for a client with disturbed thought processes from delusions would be the client's ability to talk about concrete events without talking about delusions. This would indicate that the client is in touch with reality. Stating three symptoms of stress is unrelated to the problem involving thought processes. Identifying two personal interventions to decrease delusions would be more appropriate for a nursing diagnosis of deficient knowledge associated with controlling delusions. Using distracting techniques would be appropriate for a nursing diagnosis of ineffective coping.

4. A patient is experiencing auditory hallucinations in the form of the voice of his deceased mother. Which nursing response would be most appropriate when a client talks about hearing voices? a. "I do not hear the voices that you say you hear." b. "Those voices will disappear as soon as the medicine works." c. "Try to think about positive things instead of voices." d. "Voices are only in your imagination."

4.A When a client reports that he or she is hearing voices, it is important for the nurse to understand that the voices have meaning to the client, yet acknowledge to the client that the nurse does not hear the voices. Telling the client that the voices will disappear with medication, telling the client to think about positive things, or stating that the voices are the client's imagination ignores the importance or significance of the voices for the client.

5. During a community meeting, a client with schizophrenia begins to shout and gesture in an angry manner frightening the audience. Which nursing intervention would be the priority? a. determining reasons for the client's agitation b. encouraging appropriate behavior in a group c. facilitating group process in responding to the client d. maintaining safety of the client and others

5.D In any situation, but especially one in which a client begins to show anger and possible loss of control, the nurse is responsible for maintaining the safety of the client and others first. Once safety is addressed and the situation is stabilized, then the nurse can address other areas such as reasons, group behavior, and group process.

6. After a class on schizophrenia and its phases, the nursing students identify the following phases of schizophrenia. Place the phases in the correct sequence from fi rst to last. a. prodromal b. premorbid c. residual d. progressive e. onset

6.B, A, E, D, and C The five phases of schizophrenia, in order of occurrence, are premorbid, prodrom