243 PrepU Ch. 24 Schizophrenia Spectrum & Other Psychotic Disorders: Management of Thought Disorders

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."

A client with schizophrenia is prescribed a second-generation antipsychotic. The client's parent asks, "About how long will it take until we see any changes in the symptoms?" Which response by the nurse would be most appropriate?

"Generally, it takes about 1 to 2 weeks to be effective in changing symptoms."

A nurse has been assigned a newly admitted client, who demonstrates grandiosity during the assessment by the nurse. Which statement by the client is most consistent with this symptom?

"I'm the world's most astute financier."

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

Which client best exhibits the characteristics that are typical of the prodromal period of schizophrenia?

A 20-year-old man who is exhibiting a gradual decrease in his ability to concentrate and function in daily activities

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.

A client diagnosed with schizophrenia has been prescribed Clozapine (Clozaril). Which of the following is a potentially fatal side effect of this medication?

Agranulocytosis

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

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

Which drug classification is the primary medication treatment for schizophrenia?

Antipsychotics

A college freshman is admitted to the hospital with a diagnosis of schizophrenia. Friends reported that the client had been in the client's room for 2 days in a trance-like state, not eating nor speaking to anyone. Which is the priority for this client?

Assessing fluid intake and output

Which would a nurse expect to administer to a client with schizophrenia who is experiencing a dystonic reaction?

Benztropine

Which increases the risk for neuroleptic malignant syndrome (NMS)?

Dehydration

The client with schizophrenia believes the student nurses are there to spy on the clients. The client is suffering from which symptom?

Delusions

A nurse is assessing a client diagnosed with delusional disorder. The nurse would expect to find what?

Delusions with a prominent theme

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

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

Which type of antipsychotic medication is most likely to produce extrapyramidal effects?

First-generation antipsychotic drugs

A client with delusional disorder tells the nurse that the client has discovered how to jump to the moon. The nurse would document this belief as what?

Grandiose delusion

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

Catatonia as seen in clients with schizophrenia is unique in the existence of which feature?

Immobility like being in a trance

When preparing a class presentation about schizophrenia, what would the nurse most likely include?

Improvement in symptoms can occur as a client with a history of schizophrenia reaches older adulthood.

Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?

Increased amount of dopamine

Which is the central focus of persecutory delusions?

Injustice that must be remedied by legal action

Which of the following would be the most accurate nursing diagnosis within the social domain for a female client with a delusional disorder who is having martial conflict?

Interrupted family processes related to delusional disorder

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

During an assessment of a client with schizophrenia, the client states, "The end of the world is coming. I just know it." The nurse interprets this as which type of delusion?

Nihilistic

Delusional disorders are primarily characterized by which of the following? Select all that apply.

Paranoia Jealousy Distrust

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?

Persecutory

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 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

A client diagnosed with delusional disorder who uses excessive health care resources most likely has which type of delusions?

Somatic

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?

Somatic

A client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. The nurse observes during a therapy session that the client's behavior includes repetitive movements of the mouth and tongue, facial grimacing, and rocking back and forth. The nurse recognizes these behaviors as indicative of what?

Tardive dyskinesia

The nurse is evaluating the plan of care for a client with schizophrenia. Which observation best suggests that the plan has been effective?

The client has resumed employment and attends social functions.

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 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 has been prescribed clozapine for treatment of schizophrenia. The client must be taught to monitor which blood concentrations weekly while taking this drug?

WBC

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 working with a client that has been diagnosed with delusional thoughts. Which is an initial short-term outcome appropriate for this client?

engage in reality oriented conversation

A psychiatric-mental health nurse is reviewing a journal article about schizophrenia and disorders related to it. The nurse demonstrates understanding of the article by identifying which information as a major factor associated with increasing a person's risk for schizophrenia?

genetics

A client diagnosed with schizoaffective disorder exhibits the symptoms of a psychosis in addition to which of the following?

mood disorder

A week after beginning therapy with thiothixene, a client demonstrates muscle rigidity, a temperature of 103°F, an elevated serum creatinine phosphokinase level, stupor, and incontinence. The nurse knows that these symptoms indicate which condition?

neuroleptic malignant syndrome

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?

persecutory