ch 16 mh stuff
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?
white blood cells
A client diagnosed with schizophrenia has been prescribed clozapine. Which is a potentially fatal side effect of this medication?
Agranulocytosis
A client with schizophrenia is prescribed clozapine because other prescribed medications have been ineffective. After educating the client and family about the drug, the nurse determines that the education was successful when they state:
"We'll need to make sure that the client has the client's blood count checked at least weekly."
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
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
A client was admitted to the psychiatric intensive care unit with schizophrenia. Among the client's signs and symptoms, the client was experiencing nihilistic delusions. The nurse understands that these delusions involve a belief about what?
An impending calamity
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
A mental health client insists that the client's spouse is trying to poison the client. In this instance, the client is exhibiting which type of delusion?
Persecutory
Which medication is used to control the extrapyramidal effects associated with antipsychotic medications?
Benzotropine
The relationships and associations among the words used to express thoughts are markedly disturbed in clients with schizophrenia. What is this disturbance characterized by?
Disorganized speech
The nurse is assessing a client with schizophrenia who has a history of successfully managing the symptoms. The client has few social activities and speaks in a flat tone when interacting with others. Currently the client is experiencing acute psychosis with active hallucinations and social withdrawal. The nurse identifies improved social skills as an important therapeutic goal. How should the nurse implement this plan?
Enter the client in a social skills training program when acute psychosis subsides.
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
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
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
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
Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?
Increased amount of dopamine
Schizoaffective disorder has symptoms typical of both schizophrenia and which type of disorder?
Mood disorders
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
The nurse must be aware that individuals from diverse ethnic groups might describe troubling experiences in terms of physical problems or specific culture-bound syndromes. The syndrome of ghost sickness is exhibited by which culture?
Native American
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
A nurse is preparing an in-service program about schizophrenia for a group of psychiatric-mental health nurses. Which would the nurse include as a major reason for relapse?
Nonadherence to prescribed medications
The client's diagnosis of schizoaffective disorder is supported when the nurse documents what?
The client reports "hearing voices" for the last 3 months
A client with schizophrenia is prescribed clozapine. The nurse would monitor the client closely for specific signs of:
infection.
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
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.
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."
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
The nurse working with a client who is newly diagnosed with schizophrenia would include which in the client's education?
"Schizophrenia is an illness that involves neurotransmitters, more specifically dopamine."
A client diagnosed with schizophreniform disorder must have symptoms present for at least 1 month but with a duration of less than:
6 months.
Which client exhibits the characteristics that are typical of the prodromal phase of schizophrenia?
A 20-year-old is experiencing a gradual decrease in the ability to concentrate, be productive, and sleep restfully.
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.
During an admission assessment with a psychiatric-mental health nurse, a client 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. How should the nurse document this symptom?
A hallucination
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 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 would a nurse expect to administer to a client with schizophrenia who is experiencing a dystonic reaction?
Benztropine
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
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 nursing instructor is preparing a class lecture about schizophrenia and outcomes focusing on recovery. Which would the instructor include as a major goal?
Continuity of care
Assessment of a client with schizophrenia reveals that the client is hearing voices that tell the client that people are staring at the client and that the client is seeing illusions. When developing the plan of care for this client, which nursing diagnosis would be most appropriate?
Disturbed sensory perception
The nurse is developing a care plan for a client with somatic delusions. Which would be an appropriate nursing diagnosis for this client?
Disturbed thought process
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
Positive symptoms of schizophrenia, specifically hallucinations and delusions, are thought to be caused by hyperactivity of which neurotransmitter?
Dopamine
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
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?
Persecutory
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
When describing the difference between schizoaffective disorder (SAD) and schizophrenia, the nurse would address which as associated with SAD?
Increased mood responses
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
The nurse is providing teaching to a client diagnosed with schizoaffective disorder. The nurse should explain to the client that which is true about this disorder?
It is a mix of psychotic and mood symptoms.
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.
A nurse provides care to a client with schizoaffective disorder during hospitalization for acute psychosis. Nursing interventions to help the client to establish trust with the health care team is best accomplished by what?
Offering reassurance in a soft, nonthreatening voice
A client has been prescribed quetiapine for delusional disorder. In teaching the client about this medication, the nurse must be certain to include which information?
One of the common side effects is dry mouth.
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.
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
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
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 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
After teaching a class on antipsychotic agents, the instructor determines that the education was successful when the class identifies which as an example of a second-generation antipsychotic agent?
Quetiapine
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
A nurse is caring for a client diagnosed with schizophreniform disorder. The nurse demonstrates understanding of this disorder when identifying that the client is at risk for developing what?
Schizophrenia
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.
A client with schizophrenia is exhibiting positive and negative symptoms. The nurse anticipates that the client would be prescribed what?
Second generation antipsychotic
A client diagnosed with delusional disorder who uses excessive health care resources mostlikely 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
The nurse should consider which during a psychiatric assessment of a newly immigrated client who is being evaluated for possible religious delusions?
Some cultures hold religious beliefs that might be confused with delusional thought
When developing the plan of care for a client with schizophrenia who is in the acute phase of illness, the nurse understands that the client is at high risk for what?
Suicide
A 55-year-old client was admitted to the psychiatric unit after an incident in a department store in which the client accused a sales clerk of following the client around the store and stealing the client's keys. The client was subdued by the police after destroying a window display because voices had told the client that it was evil. As the nurse approached the client, the client says, "You're all out to get me, and you're one of them. They're Rostoputians and grog babies here." This demonstrates what?
Suspiciousness and neologisms
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
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.
A client with a delusional disorder has been undergoing individual psychotherapy. The therapy would be deemed ultimately successful when the client meets which outcome?
The client will differentiate between reality and fantasy.
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.
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.
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
Which is a nonneurologic side effect of antipsychotic medications?
Weight gain
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
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
A client diagnosed with delusional disorder is telling everyone that the client is the president of the United States. This client is exhibiting which type of delusion?
grandiose
