Quiz: Chapter 12, Schizophrenia and Schizophrenia Spectrum

Which statement by a person with paranoid schizophrenia most clearly indicates that the antipsychotic medication is effective? 1 "I used to hear scary voices but now I don't hear them anymore." 2 "My medicine is working fine. I'm not having any problems." 3 "Sometimes it's hard for me to fall asleep, but I usually sleep all night." 4 "I think some of the staff members don't like me. They're mean to me."

1. Auditory hallucinations are a common manifestation of paranoid schizophrenia, so their absence is an indicator of medication effectiveness. "My medicine is working fine. I'm not having any problems" and "Sometimes it's hard for me to fall asleep, but I usually sleep all night" are too vague. "I think some of the staff members don't like me. They're mean to me" indicates paranoid thinking.

The causation of schizophrenia currently is understood to be 1 A combination of inherited and non-genetic factors 2 Deficient amounts of the neurotransmitter dopamine 3 Excessive amounts of the neurotransmitter serotonin 4 Stress related and ineffective stress management skills

1. Causation is a complicated matter. Schizophrenia most likely occurs as a result of a combination of inherited genetic factors and extreme non-genetic factors (e.g., viral infection, birth injuries, nutritional factors) that can affect the genes governing the brain or directly injure the brain.

Which statement by a family member of a person diagnosed with schizophrenia demonstrates effective learning about the disease? 1 "The disease probably was caused by problems with several genes. These genes cause changes in how certain brain chemicals work." 2 "The disease could be cured if our politicians and laws allowed for more stem cell research. Adult stem cells hold so much promise." 3 "The disease probably resulted from the mother's smoking during pregnancy. Nicotine is actually a neurotransmitter." 4 "If our family had more money, we could afford the promising psychoneuroimmunologic treatments available in other countries."

1. The outcome statement indicates that the person understands the basic information about causative factors of schizophrenia. Rationalizing the use of stem cell research, blaming the problem on the mother's smoking behavior, and having funds to afford alternative treatments do not indicate an understanding about the mental disorder.

A patient diagnosed with schizophrenia says, "Cheese dog run fast." How should the nurse document this comment? 1 Neologism 2 Word salad 3 Circumstantiality 4 Magical thinking

2. A word salad is a jumble of words that is meaningless to the listener and results from an extreme level of disorganization. A neologism is an invented word. Circumstantiality refers to verbal expression with excessive detail. Magical thinking means believing that one's thoughts or actions can affect others.

Which statement is accurate regarding the relationship between depression and schizophrenia? 1 Suicide attempts usually occur early in the course of schizophrenia. 2 Regular assessments should occur for both depression and suicide risk in patients diagnosed with schizophrenia. 3 Antipsychotic medications alleviate symptoms of depression for patients diagnosed with schizophrenia. 4 Nicotine use in patients diagnosed with schizophrenia stimulates neurotransmitters, resulting in a decreased incidence of depression and suicide.

2. Almost half of people with schizophrenia will attempt suicide; therefore, assessments for depression and suicide should occur throughout the patient's life. Both depression and suicide attempts can occur at any point in the illness. Antipsychotic medications do not alleviate symptoms of depression for patients diagnosed with schizophrenia. Nicotine use is higher in patients diagnosed with schizophrenia; nicotine stimulates some neurotransmitters, but this does not result in a decreased incidence of depression.

A nurse plans a series of psychoeducational groups for persons with schizophrenia. Which topic would take priority? 1 How to complete an application for employment 2 The importance of taking medication correctly 3 Ways to dress and behave when attending community events 4 How to give and receive compliments

2. Although completing applications, dressing and behaving correctly, and giving and receiving compliments are important, correct self-management of pharmacotherapy takes priority. The patient cannot maintain remission without the appropriate medication. Topics

A patient with schizophrenia was prescribed antipsychotics. After daily observation, the nurse finds the patient's blood pressure has decreased. What is the most appropriate action by a nurse before administering the prescribed drug to the patient? 1 The nurse should give an adrenergic agonist to raise the blood pressure. 2 The nurse should tell the patient to rise slowly. 3 The nurse should avoid administering the drug for the day. 4 The nurse should tell the patient to avoid taking fluids

2. Antipsychotics block the α2- receptor, which may cause hypotension.The nurse can give advice to the patient to rise slowly from the bed, as the patient may feel dizzy due to reduced blood pressure. The nurse cannot administer the adrenergic agonist, but can report to the healthcare provider if the patient's blood pressure falls down below 80 mm Hg. The nurse should not stop administering the drug as it may worsen the schizophrenic symptoms. The nurse should not advise the patient to avoid fluid intake, because the patient may feel dehydrated and the total pressure exerted on the blood vessels maybe reduced.

Which of the following symptoms would alert a health care provider to a possible diagnosis of schizophrenia in a young adult male? 1 Excessive sleeping with disturbing dreams 2 Hearing voices telling him to hurt his roommate 3 Withdrawal from college because of failing grades 4 Chaotic and dysfunctional relationships with his family and peers

2. People diagnosed with schizophrenia all have at least one psychotic symptom, such as hallucinations, delusional thinking, or disorganized speech. Excessive sleeping, failing grades, and chaotic and dysfunctional relationships do not describe schizophrenia but could be caused by a number of problems.

A patient diagnosed with schizophrenia is most likely to experience which type of hallucination? 1 Visual 2 Tactile 3 Auditory 4 Olfactory

3. Patients diagnosed with schizophrenia may experience hallucinations arising out of any of the senses; however, auditory hallucinations are experienced by 60% of people with schizophrenia at some time during their lives. Visual hallucinations more commonly are associated with substance abuse and withdrawal. Tactile and olfactory hallucinations are rare.

Which symptom seen in a schizophrenic patient can be categorized as a positive symptom? 1 Loss of motivation 2 Impaired judgment 3 Delusions 4 Dysphoria

3. The behavioral traits not normally found in healthy patients are called positive symptoms of schizophrenia. They include delusions, hallucinations, bizarre behavior, and paranoia. The behaviors that the patient lacks compared to healthy people are negative symptoms, such as loss of motivation and alogia (poverty of thought or inability to speak). Impaired judgment and illogical thinking are the cognitive symptoms associated with schizophrenia. Dysphoria and suicidal intentions are affective symptoms of schizophrenia. Affective symptoms involve emotions and their expression.

A nurse assesses a patient diagnosed with schizophrenia who states, "Aliens are trying to inject me with their DNA." The nurse documents the patient's comment and applies which term? 1 Anosognosia 2 Affective blunting 3 Positive symptoms 4 Negative symptoms

3. The patient's comment indicates delusional thinking, which is a positive symptom of schizophrenia. Anosognosia refers to an inability to realize an illness exists. Affective blunting relates to the patient's outward expression of emotion. Negative symptoms include social isolation, anergia, lack of motivation, blunted affect, and inattention to personal hygiene.

A community mental health nurse plans psychoeducational sessions for a group of adults diagnosed with schizophrenia. Which topic takes priority? 1 "Interviewing for a new job" 2 "Ways to make new friends" 3 "Managing your medication" 4 "Dealing with family arguments"

3. While all the topics are important, medication management is the key. The patient will be unable to make friends or get a job if the mental illness exacerbates. Family relationships are stressed when illness is acute.