PNE 106 Ch. 11 Schizophrenia PrepU
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
Which medication is used to control the extrapyramidal effects associated with antipsychotic medications?
Benzotropine Explanation: Benzotropine is an anticholinergic drug used to relieve drug-induced extrapyramidal adverse effects, such as muscle weakness, involuntary muscle movement, pseudoparkinsonism, and tardive dyskinesia.
Which would a nurse expect to administer to a client with schizophrenia who is experiencing a dystonic reaction?
Benztropine Explanation: A client experiencing a dystonic reaction should receive immediate treatment with benztropine. Risperidone and aripiprazole are antipsychotics that may cause dystonic reactions. Trihexyphenidyl is used to treat parkinsonism due to antipsychotic drugs.
Which medication classification has been most effective in treating akathisia?
Beta-blockers Explanation: Beta-blockers, such as propranolol, have been most effective in treating akathisia.
Which group of theories is believed currently to explain the etiology of schizophrenia?
Biologic Explanation: Schizophrenia is thought to have multiple etiologies. The overwhelming body of scientific evidence suggests that schizophrenia is a brain disease. Computed tomography scanning and magnetic resonance imaging have shown frequent enlargement of the lateral cerebral ventricles in people with schizophrenia.
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?
Body complaints
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 Explanation: Ziprasidone carries a risk of dysrhythmias, extrapyramidal side effects, tardive dyskinesia, and Neuroleptic malignant syndrome. As such, cardiac and neurological assessments are a priority over the other components of a comprehensive assessment.
The client has been diagnosed with schizophrenia and is showing the following symptoms: immobility, rigidity, and stupor. These symptoms can be further classified as which characteristic symptoms of schizophrenia?
Catatonic
A client with schizoaffective disorder is engaging in an extremely long conversation about a current affairs in the world. The client goes on to provide the nurse with minute details. The nurse interprets this as suggesting what?
Circumstantiality Explanation: The client is demonstrating circumstantiality, which refers to extremely detailed and lengthy discourse about a topic.This can be commonly found in a client with euphoric or elevated mood due to the affective component of schizoaffective disorder. Clang associations are ideas that are related to one another based on sound or rhyming rather than meaning. Neologisms are words invented by the client. A verbigeration is the stereotyped repetition of words or phrases that may or may not have meaning to the listener.
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?"
Clang association
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?
Delusional thinking
A nurse is assessing a client diagnosed with schizophrenia. When documenting the findings, which would the nurse identify as a positive symptom? Select all that apply.
Delusions Hallucinations
A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, a nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer?
Diphenhydramine Explanation: For dystonic reactions, the drug of choice is benztropine mesylate or diphenhydramine. Propranolol could be used to treat akathisia. Risperidone and aripiprazole are antipsychotic agents used to treat schizophrenia.
A client with schizophrenia is exhibiting hallucinations and delusions. The mental health nurse knows that these symptoms are associated with hyperactivity of which neurotransmitter?
Dopamine
Positive symptoms of schizophrenia, specifically hallucinations and delusions, are thought to be caused by hyperactivity of which neurotransmitter?
Dopamine
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?
Dopamine Explanation: Although research is demonstrating that schizophrenia does not result from dysregulation of a single neurotransmitter or biogenic amine (such as serotonin, norepinephrine, or dopamine), positive symptoms of schizophrenia, specifically hallucinations and delusions, are thought to be caused by dopamine hyperactivity in the mesolimbic tract. Researchers are also hypothesizing a role for GABA but have yet to identify any specific information.
A client diagnosed with schizophrenia is exhibiting disorganized behavior and imitating what the nurse is saying. What term is used to identify this behavior?
Echolalia
What term is used to describe the speech pattern being used when the client imitates or repeats what the nurse is saying?
Echolalia
A client diagnosed with schizoaffective disorder and severe depression is being treated with antipsychotic medications. The client tells the nurse about difficulty with self-care activities. With which intervention should the nurse respond?
Establish a routine and set goals.
How often must clients receiving clozapine get white blood cell counts drawn?
Every week for the first 6 months Explanation: Clients taking clozapine must have weekly white blood cell counts for the first 6 months of clozapine therapy and every 2 weeks thereafter.
The nurse suspects that a client is experiencing a brief psychotic episode based on what? Select all that apply.
Evidence of hallucinations Intense changes in affect Recent life stressor Explanation: In brief psychotic disorder, the length of the episode is at least 1 day but less than 1 month. The onset is sudden and includes at least one of the positive symptoms of criteria A for schizophrenia (delusions or hallucinations). The person generally experiences overwhelming confusion and rapid, intense shifts of affect. Brief psychotic disorder can often occur in the context of a recent life stressor such as giving birth.
A client has been taking haloperidol for 5 years when the client is admitted to the inpatient unit for relapse of symptoms of schizophrenia. Upon assessment, the client demonstrates akathisia, dystonia, a stiff gait, and rigid posture. The nurse correctly identifies these symptoms are indicative of what?
Extrapyramidal side effects Explanation: Extrapyramidal side effects include severe restlessness, muscle spasms, or contractions; chronic motor problems such as tardive dyskinesia; and the pseudoparkinsonian symptoms of rigidity, masklike faces, and stiff gait.
A client broke down in tears when speaking with the nurse, stating, "You have no idea what it's like to be responsible for finding terrorist leaders. Every day I have to stay one step ahead of the operatives that have been sent after me." In light of the client's statement, which nursing diagnosis should the nurse prioritize?
Fear related to persecutory delusions
A client with schizophrenia believes that the client has discovered how to jump to the moon. The nurse would document this belief as what?
Grandiose delusion
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?
Hallucination
During an admission assessment, a client with schizoaffective disorder states that the client hears the voice of God in the client's head and the voice is telling the client that the client is worthless. What would the nurse document this symptom as?
Hallucination
Clients diagnosed with schizophrenia may experience disordered water balance that may lead to water intoxication. Which may occur as a result of water intoxication?
Hyponatremia
A client is watching the news and tells the nurse that the newscaster is sending a message to the client. What term is used to identify this symptom?
Idea of reference
A client with delusions presents with strong defensiveness, even when watching the news or listening to the radio. The nurse would document this finding in the health history as what?
Ideas of reference Explanation: Ideas of reference occur when a client has self-centered thoughts and falsely believes ideas are centered on something the client is doing, thinking, or feeling. Looseness of association is the inability to think logically. Ambivalence refers to contradictory or opposing emotions, attitudes, ideas, or desires for the same person or things or toward the environment. Echolalia is a pathological parrot-like response of a word or phrase.
Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?
Increased amount of dopamine Explanation: Positive (or productive) symptoms reflect an increased amount of dopamine affecting the cortical areas of the brain. Negative symptoms reflect an inadequate amount of dopamine, cerebral atrophy, and organic functional changes in the brain.
A client who is newly admitted to an inpatient unit is exhibiting acute delusional thoughts. The most therapeutic intervention for this client would include what?
Individual therapy
Which is the central focus of persecutory delusions?
Injustice that must be remedied by legal action Explanation: The focus of persecutory delusions is often on some injustice that must be remedied by legal action. Clients often see satisfaction by repeatedly appealing to courts and other government agencies. The central theme of somatic delusions involves bodily functioning or sensations. The central theme of the jealous subtype is the unfaithfulness or infidelity of a spouse or lover. Clients representing with grandiose delusions are convinced they have a great, unrecognized talent or have made an important discovery.
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.
Schizoaffective disorder has symptoms typical of both schizophrenia and which type of disorder?
Mood disorders Explanation: Schizoaffective disorder has symptoms typical of both schizophrenia and mood disorders, but it is a separate disorder. Symptoms of anxiety, substance use, and eating disorders are not typically part of schizoaffective disorder.
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?
Mood disturbance
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 Explanation: NMS is characterized by muscular rigidity, tremors, difficulty swallowing, fever, hypertension, and diaphoresis.
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?
Negative symptoms
Which should the nurse anticipate when providing therapy and evaluating outcomes for a client with delusional disorder? Easily attained Maintained for a short period only Achieved when delusions completely disappear within 6 months' time Often not met completely
Often not met completely Explanation: In evaluating progress, the nurse must remember that outcomes are often not met completely.
A nurse is caring for a client in the mental health unit. The client states, "They are poisoning my food by telepathy." This is an example of which type of delusion?
Paranoid
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?
Persecutory
Which type of delusion refers to a situation whereby a person or someone close to person is being malevolently treated in some way?
Persecutory type
During a client interview, a client diagnosed with delusional disorder states, "I know my spouse is being unfaithful to me with a colleague from work."The nurse interprets the client's statements as suggesting which type of delusion?
Persucatory/paranoid
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 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?
Pseudoparkinsonism
Which extrapyramidal side effect is noted by a client who has bradykinesia and a shuffling gait?
Pseudoparkinsonism
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
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?
Relapse
The nurse documents that the client is exhibiting negative symptoms of schizophrenia when observing the client doing what? Select all that apply.
Repeatedly turning down invitations to join in unit activities Inability to maintain to complete a goal-directed activity Explanation: Negative symptoms reflect a lessening or loss of normal functions, such as restriction or flattening in the range and intensity of emotion (diminished emotional expression), reduced fluency and productivity of thought and speech (alogia), withdrawal and inability to initiate and persist in goal-directed activity (avolition), and inability to experience pleasure (anhedonia).
A 24-year-old with schizophrenia and paranoid delusions is admitted to the hospital. The student nurse asks the charge nurse about what approach to take with the client, who has been exhibiting hostility and isolation. Which approach would be the most appropriate direction from the charge nurse?
Respect the client's need for personal space and avoid physical contact.
Some research has suggested that schizophreniform disorder may be an early manifestation of which other mental health condition?
Schizophrenia
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.
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.
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. Explanation: According to the DSM-V, schizophrenia lasts at least 6 months and includes at least 1 month of two or more characteristic symptoms (e.g., delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) and negative symptoms (e.g., diminished emotional expression, alogia, or avolition).
A client with schizophrenia is exhibiting positive and negative symptoms. The nurse anticipates that the client would be prescribed what?
Second generation antipsychotic Explanation: The second-generation antipsychotics are effective in treating negative and positive symptoms. These newer drugs also affect several other neurotransmitter systems, including serotonin. This is believed to contribute to their antipsychotic effectiveness. None of the other agents would be appropriate.
A client diagnosed with delusional disorder who uses excessive health care resources most likely has which type of delusions?
Somatic
A client diagnosed with schizophrenia states to the nurse, "My intestines are being eaten by snakes." This statement represents which type of delusion?
Somatic delusion
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 Explanation: Although episodes are brief, impairment can be severe. Consequently, supervision may be required to protect the person during a brief psychotic episode.
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)?
Tardive dyskinesia
Which is an appropriate intervention for a client having auditory hallucinations?
Tell the client to talk back to the voices and tell them to go away. Explanation: Interventions for managing hallucinations include dismissal intervention (i.e., telling the voices to go away), various coping strategies (e.g., jogging, telephoning, playing games, seeking out others, employing relaxation techniques), or competing stimuli (e.g., listening to music or the voice of oneself or another to overcome auditory hallucinations and using visual stimuli to overcome visual hallucinations).
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. Explanation: The presence of prominent and sustained hallucinations is suggestive of schizophrenia rather than delusional disorder. Nonbizarre delusions are associated with delusional disorder, and people with either diagnosis lack insight. Response to therapy does not differentiate between the two diagnoses.
The client's diagnosis of schizoaffective disorder is supported when the nurse documents what?
The client reports "hearing voices" for the last 3 months
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.
According to the immunovirological theory, a person is at risk for developing schizophrenia when which factors were present while the person's was in utero? Select all that apply.
The mother had the influenza virus while pregnant The mother resided in a crowded urban city while pregnant The mother had a sexually transmitted disease while pregnant
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 Explanation: Sedation with antipsychotic medication will likely happen immediately after initiating the medication. The nurse should be sure to inform the client they he or she will experience this side effect readily. The other options are examples of side effects that are possible with longer term treatment using antipsychotic medications. Weight gain is commonly associated with many antipsychotic medications. The potential for weight loss with antipsychotic medication is not typically discussed with clients.
Which data support a nursing diagnosis of impaired verbal communication?
The presence of neologism, echolalia, and clanging
A client states, "My boss keeps putting thoughts into my head. Yesterday my boss made me copy 25 reports and then told me I had wasted company time and money!" The nurse knows the client is experiencing which perceptual disturbance?
Thought insertion
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
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. Explanation: Traditional antipsychotics treat the positive symptoms of schizophrenia (i.e., hallucinations and delusions). Atypical antipsychotics relieve both the positive and negative symptoms (e.g., apathy, avolition, social withdrawal) of schizophrenia and are less likely to cause distressing extrapyramidal side effects typically seen with traditional antipsychotics.
A client diagnosed with schizophrenia states, "I want to go home, go home, go home." This is an example of which speech pattern?
Verbigeration
A client is admitted to the psychiatric hospital with a diagnosis of schizophrenia. During the physical examination, the client's arm remains outstretched after the nurse obtains the pulse and blood pressure, and the nurse must reposition the arm. The nurse interprets this as what?
Waxy flexibility
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
The nurse is caring for a client with schizoaffective disorder with depression. The nurse should instruct the client that the most effective medication therapy for this disorder is:
atypical antipsychotic medications.
A nurse is interviewing a client with schizophrenia when the client begins to say, "Kite, night, right, height, fright." The nurse documents this as:
clang association.
A nurse is caring for a client in an inpatient mental health setting. The nurse notices that when the client is conversing with other clients, the client repeats what they are saying word for word. The nurse interprets this finding and documents it as:
echolalia
When investigating biologic theories related to schizophrenia, which neuroanatomic findings would be consistent with this mental health disorder?
enlarged lateral ventricle Explanation: The lateral and third ventricles are somewhat larger and total brain volume is somewhat smaller in persons with schizophrenia compared with those without schizophrenia. The thalamus and the medial temporal lobe structures, including the hippocampus, superior temporal, and prefrontal cortices, also tend to be smaller.
When assessing a person with delusional disorder, which finding would the nurse expect to assess?
few, if any, psychological deficits Explanation: Clients with delusional disorder show few, if any, psychological deficits. In these clients, average or marginally low intelligence is characteristic. Mental status is not generally affected. Thinking, orientation, affect, attention, memory, perception, and personality are generally intact.
When describing the difference between schizoaffective disorder (SAD) and schizophrenia, the nurse would address which as associated with SAD?
increased mood responses Explanation: Clients with SAD have many similar responses to their disorder as people with schizophrenia, with one exception. These clients have many more "mood" responses and are very susceptible to suicide. Persons with SAD usually have higher functioning than those with schizophrenia, with severe negative symptoms and early onset of illness. To be diagnosed with SAD, a client must have an uninterrupted period of illness when there is a major depressive, manic, or mixed episode along with two of the following symptoms of schizophrenia: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, or negative symptoms.
A nurse is preparing to interview a client who has a delusional disorder. Which would the nurse expect?
normal behavior Explanation: The nurse plans for the interview and expects that the client will act in a normal manner. Generally, clients diagnosed with a delusional disorder have psychosocial functioning that is not markedly impaired. They show few, if any, psychological deficits, and those that do occur are generally related directly to the delusion. General behavior and emotional responses are not odd or bizarre. Cognition is not impaired, and motor symptoms are not evident.
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:
oculogyric crisis. Explanation: The nurse should contact the client's physician because the client is exhibiting a dystonic reaction termed oculogyric crisis in which the muscles that control eye movements tense and pull the eyeball so that the client is looking toward the ceiling. Akathisia is manifested by restlessness, with clients often reporting that they feel driven to keep moving. Retrocollis involves the neck muscle, causing the head to be pulled back. Tardive dyskinesia involves abnormal, involuntary movements that are constant.
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? A client with schizophrenia believes that the cook at the psychiatric hospital is trying to poison the client. The nurse would record this type of delusion as what? 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? After teaching a class of nursing students about the different types of delusions, the instructor determines that the education was successful when the class identifies which type as most common?
persecutory Explanation: A persecutory delusion is a belief that one is being watched, ridiculed, harmed, or plotted against. The belief that one has exceptional powers, wealth, skill, influence, or destiny is a grandiose delusion. A nihilistic delusion is the belief that one is dead or a calamity is impending. A somatic delusion is a belief about abnormalities in bodily functions or structures.
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?
somatic
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:
tardive dyskinesia. Explanation: Tardive dyskinesia is late-appearing, abnormal involuntary movements. Therefore, it is essential that the nurse monitor the client for tardive dyskinesia at this time. Weight gain (not weight loss) and new onset of diabetes (hyperglycemia) are possible side effects of an antipsychotic. Torticollis, a dystonic reaction, would occur early in antipsychotic drug treatment.
The nurse is working with a client with schizophrenia who has cognitive deficits. It is time for the client to get up and eat breakfast. Which statement by the nurse would be most effective in helping the client prepare for breakfast?
"First, wash your face and brush your teeth. Then put your clothes on." Explanation: The client needs clear direction, with tasks broken into small steps, to begin to participate in the client's own self-care. The client, not the nurse, should perform the steps.
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." Explanation: Assuring a client of his or her safety is a more therapeutic intervention than expressing exasperation with the client's delusions, arguing against them, or implicitly confirming them.
A client diagnosed with schizophrenia tells the nurse, "I hear the voice of Elvis." Which is the most therapeutic response by the nurse?
"I don't hear the voice, but I know you hear what sounds like a voice."
After teaching a client with schizoaffective disorder about the condition and treatment, the nurse determines that the education was successful when the client states what? "I need to eat properly so that I can control my weight." "I should go to sleep at night when I feel tired." "I can vary my routines from day to day without problems." "I can stop my medication when I start to feel better."
"I need to eat properly so that I can control my weight." Explanation: Client education should focus on nutrition and prevention of weight gain, which is a side effect of medication therapy. Establishing a regular sleep pattern by setting a routine can help to promote or reestablish normal patterns of rest. Establishing a daily routine can help address mood symptoms. Medication should not be stopped if the client feels better.
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." Explanation: Excessive amount of the neurotransmitter dopamine allows nerve impulses to bombard the mesolimbic pathway, the part of the brain normally involved in arousal and motivation. Normal cell communications are disrupted, resulting in the development of hallucinations and delusions. Abnormalities in brain shape and brain circuitry are being researched.
A client with schizoaffective disorder is prescribed clozapine to treat symptoms. Which instructions would the nurse provide?
"Keep an eye on your weight, and if you gain weight rapidly, notify your doctor."
A client tells the nurse that the client has bugs in the client's brain and asks the nurse if the nurse can see them. Which response by the nurse is most therapeutic?
"No, I don't see any bugs. That sounds scary for you."
The nurse is teaching a client with schizoaffective disorders (SAD) about the client's prescribed medication therapy. The nurse determines that additional education is needed when the client states what?
"One day, I won't have to worry about taking any medication."
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 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?
1 month Explanation: The essential features of schizophreniform disorder are identical to those of criteria A for schizophrenia, with the exception of the duration of the illness, which can be less than 6 months. Symptoms must be present for at least 1 month to be classified as a schizophreniform disorder.
A client diagnosed with schizophreniform disorder must have symptoms present for at least 1 month but with a duration of less than how long?
6 months Explanation: The essential features of schizophreniform disorder are identical to those of criteria A for schizophrenia, with the exception of the duration of the illness, which can be less than 6 months. Symptoms must be present for at least 1 month to be classified as a schizophreniform disorder.
A client diagnosed with schizophreniform disorder must have symptoms present for at least 1 month but with a duration of less than:
6 months.
A nurse teaching a client about prescribed antipsychotic medication informs the client to contact a health care provider immediately if the client notices:
A dramatic change in temperature. Explanation: Advise clients to contact their case coordinators or health care providers immediately if they experience dramatic changes in body temperature. The client may be at risk for neuroleptic malignant syndrome.
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?
Agranulocytosis Explanation: Agranulocytosis is a life-threatening adverse effect of clozapine. White blood cell counts should be monitored frequently due to extremely low levels of white blood cells. Weight gain occurs with certain antipsychotics. Palpitations and hemorrhage are not generally associated with antipsychotics.
A nurse monitoring client medication needs to recognize side effects quickly and intervene promptly for which reason?
Alleviate the side effects and help client maintain adherence Explanation: Recognizing a medication's side effects quickly and intervening promptly to alleviate them will help maintain adherence.
After assessing a client with schizophrenia, the nurse notes that the client exhibits signs and symptoms related to being unable to experience pleasure. The nurse documents this finding as what?
Anhedonia
When assuming the management of the care of a delusional client, which should be the nurse's priority intervention?
Assure the client that he or she is safe in this milieu
A client with schizoaffective disorder is prescribed long-term medication therapy. The nurse would most likely expect what to be prescribed as the mainstay of treatment?
Atypical antipsychotic Explanation: Pharmacologic intervention is needed to stabilize the symptoms, and it presents specific challenges. Long-term atypical antipsychotic agents, now the mainstay of pharmacologic treatment, are as effective as the traditional combination of a standard antipsychotic agent and an antidepressant drug. Mood stabilizers, such as lithium or valproic acid, may be used. A combination of antipsychotic and antidepressant agents is often used.
