Mental Health Schizophrenia

Jen was just admitted to the inpatient psychiatric unit. She has a long history of schizophrenia and has case management services through a local community organization. Jen has been acting paranoid and doesn't want to speak to anyone. When the nurse goes to assess her, Jen yells at the nurse, "I don't belong here. There is nothing wrong with me. You guys are the ones who are crazy and you are going to get in trouble for locking me in here against my will!"What negative symptom of schizophrenia is the patient experiencing?

Anosognosia is defined as a person's lack awareness of having an illness or disorder even when symptoms are obvious to others. This symptom has been identified as a predictor of nonadherence to treatment with a high rate of involuntary treatments.

Benson is not interested in attending groups, has not showered or changed his clothes, and has problems deciding what to pick for lunch when he goes to the dining room.

Avolition Avolition is the lack of volition or the inability to initiate any goal-directed activity. This might look like lack of interest or motivation; neglect of activities of daily living, including personal hygiene and appearance; or the inability to choose a logical course of action in a situation.

The nurse asks his patient, Scott, "Did you shower this morning?" Scott states, "When did I shower? I love to take showers. I love to do a lot things, like cook breakfast. Speaking of breakfast, it was great! Oh yeah, I took a shower after breakfast this morning."What positive symptom of schizophrenia is the patient experiencing?

Circumstantiality There are many different types of speech disturbances that represent disorganized thinking. With circumstantiality, the patient is delayed in reaching the point of communication because of unnecessary and over-the-top details. The patient will eventually answer the question but with numerous interruptions by the nurse to keep the person on track.

The nurse asks Julie how she slept last night. Julie responds by saying, "I slept in a bed. My head was dead. It felt like it was full of lead. I wish I had read instead."What positive symptom of schizophrenia is the patient experiencing?

Clang Associations Clang associations are positive symptoms of disturbances in thought processes that are manifested in speech. They use rhyming sounds to speak and communicate.

Benjamin has been following the nurse around on the unit all morning and mimicking his movements.What positive symptom of schizophrenia is the patient experiencing?

Echopraxia Patients exhibiting echopraxia imitate movements made by others. Researchers are not sure why this happens, but current evidence suggests that it may involve a disturbance in mirror neuron activity in the presence of social cognition impairments and self-monitoring deficits, resulting in imitative psychomotor behavior.

A patient approaches a nurse with a look of distress and anguish on his face and shares, "Can't you hear him? It's the devil. He's telling me I'm going to hell." What symptom of schizophrenia is this patient experiencing?

Hallucinations

Ronn, who has been diagnosed with schizophrenia, was newly admitted to an inpatient unit. He becomes agitated and starts shouting to himself, "Stop talking to me! I don't want to die!"What positive symptom of schizophrenia is the patient experiencing?

Hallucinations Hallucinations are false sensory perceptions not associated with real external stimuli and can involve any of the five senses. Auditory hallucinations are false perceptions of sound, such as voices, clicks, rushing noises, music, or other noises. Command hallucinations are "voices" that issue commands to the individual and are potentially the most dangerous when the commands are for violence to self or others. Auditory hallucinations are the most common type in schizophrenia. Visual hallucinations are false visual perceptions that may consist of formed images, such as those of people, or of unformed images, such as flashes of light. These usually occur with visual hallucinations. The patient in the scenario could be experiencing a combination of visual and auditory. Other types of hallucinations include tactile, or false perceptions of the sense of touch, often of something on or under the skin; gustatory, a false perception of taste; and olfactory, false perceptions of the sense of smell.

Which of the following patients with schizophrenia is at highest risk for injury to self or others?

Has command hallucinations

Which of the following patients would be diagnosed with schizophrenia according to the diagnostic criteria? Select all that apply.

Justin has auditory and visual hallucinations and flat affect. Jenny has neologisms and echopraxia. Jeremy has auditory hallucinations and delusions of reference.

The nurse, while assessing a newly admitted client, asks, "What brought you in today, Gloria?" She responds with, "The police."What negative symptom of schizophrenia is the patient experiencing?

Lack of Abstract Thinking Abstract thinking becomes impaired in some individuals with schizophrenia and is part of the negative symptomology. Concrete thinking is defined as a literal interpretation of the environment and represents regression to earlier level of cognitive development. For example, the client with schizophrenia would have great difficulty describing the abstract meaning of sayings such as "I'm climbing the walls" or "It's raining cats and dogs." They will give very literal answers to questions that are seeking complex responses.

Terry has been on the unit for 3 days. He comes to the nurses' station and looks scared. He tells the nurse, "There's a fleedledee in my room!!"What positive symptom of schizophrenia is the patient experiencing?

Neologisms are newly invented words that have no meaning to others but only have meaning to the person using them.

Jamie pulls the nurse aside to let her know that, "The other patients are out to get me and I am worried for my safety. I know they have planned something. You have to help me!"What positive symptom of schizophrenia is the patient experiencing?

Persecutory Delusions Delusion of persecution, also known as paranoid delusions, are the most common type of delusion. People believe they are being persecuted or malevolently treated in some way. Frequent themes include being plotted against, cheated or defrauded, followed and spied on, poisoned, or drugged. Repeated complaints may be directed at legal authorities. The individual feels threatened and believes that others intend harm or persecution toward him or her in some way. This causes extreme suspiciousness of others and their actions or perceived intentions.

The RAISE approach stands for Recovery After an Initial Schizophrenia Episode. What are the approaches used in RAISE? Select all that apply.

Personalized treatment plan Vocational support Case management Family education and support

Schizophrenia has four phases. Which of the following accurately depicts a particular phase? Select all that apply.

The patient has significant deterioration with depressive symptoms. The patient's positive symptoms are improved, but negative symptoms may linger. The patient is experiencing grandiose delusions and anosognosia. The patient has signs that are hard to recognize, but include withdrawal, lack of peer relationships, and poor school performance.

A newly admitted patient, Larry, tells the nurse that he needs to be discharged because he is in the run for state senator and needs to campaign. Larry then starts handing out his "Vote for Larry 2022" card to everyone on the unit.What positive symptom of schizophrenia is the patient experiencing?

What positive symptom of schizophrenia is the patient experiencing? Grandiose Delusions People with delusions of grandeur have an exaggerated feeling of importance, power, knowledge, or identity. They also may feel like they have a special relationship with a famous person. Sometime grandiose delusions can be of a religious nature and can lead to the person thinking they are a deity or religious leader, such as the Pope.