COGNITION EAQ

A client with a history of schizophrenia attends the mental health clinic for a regularly scheduled group therapy session. The client arrives agitated and exhibits behaviors that indicate that the client is hearing voices. When a nurse begins to walk toward the client, the client pulls out a large knife. What is the best approach by the nurse? A. Firm B. Passive C. Empathetic D. Confrontational

A

For which clinical indication should a nurse observe a child in whom autism is suspected? A. Lack of eye contact B. Crying for attention C. Catatonia-like rigidity D. Engaging in parallel play

A

An older adult experiencing delirium suffers from a leg fracture caused by a fall. Which interventions should the nurse follow to prevent future falls? Select all that apply. A. Minimizing medications B. Modifying the home environment C. Teaching clients about the safe use of the Internet D. Manage foot and footwear problems E. Providing information about the effects of using alcohol

A, B, D

During a home visit to an older adult, the nurse observes a change in behavior and suspects delirium. The nurse assesses the client for one of several conditions that may have precipitated the delirium. Select all that apply. A. Infection B. Dementia C. Dehydration D. Urine Retention E. Restricted mobility

A, C, D

Which clients with schizophrenia should not be prescribed chlorpromazine? Select all that apply. A. Clients with glaucoma B. Clients with dynamic ileus C. Clients with Parkinson disease D. Clients with severe hypertension E. Clients with prostatic hypertrophy

C, D

A client who is diagnosed with schizophrenia was prescribed antipsychotic drugs. During a follow-up visit, the client had developed extrapyramidal symptoms. Which drugs might be responsible for these symptoms? Select all that apply. A. Clozapine B. Olanzapine C. Perphenazine D. Fluphenazine E. Trifluoperazine

C, D, E

A client with schizophrenia tells the nurse, "There are foreign agents conspiring against me; they're out to get me at every turn." How should the nurse respond? A. "It must be scary to believe that people are out to trick you at every opportunity." B. "Those people you call foreign agents are out to do you in. What else is happening?" C. "What's happened to make you believe that these people you call foreign agents are after you?" D. "I can understand how frightening your thoughts are to you, but there are not foreign agents out to get you."

D

A client's parents ask about the treatment of their child who has a recent diagnosis of schizophrenia. Before responding, what should the nurse consider? A. Electroconvulsive therapy is more effective in treating schizophrenia than mood disorders. B. Family therapy has not been proved effective in the treatment of clients with schizophrenia. C. Insight therapy has been proved highly successful in the treatment of clients with schizophrenia. D. Drug therapy, although it does not eliminate the underlying problem, reduces the symptoms of acute schizophrenia.

D

A nurse is caring for an elderly client with dementia who has developed dehydration as a result of vomiting and diarrhea. Which assessment best reflects the fluid balance of this client? A. Skin turgor B. Intake and output results C. Client's report about fluid intake D. Blood lab results

D

A young client with schizophrenia says, "I'm starting to hear voices." What is the nurse's most therapeutic response? A. "How do you feel about the voices, and what do they mean to you?" B. "You're the only one hearing the voices. Are you sure you hear them?" C. "The health team members will observe your behavior. We won't leave you alone." D. "I understand that you're hearing voices talking to you and that the voices are very real to you. What are the voices saying to you?"

D

What is the prognosis for a normal, productive life for a child with autism? A. Dependent on an early diagnosis B. Often related to the child's overall temperament C. Ensured as long as the child attends a school tailored to meet needs D. Guarded because of interference with so many parameters of function

D

Which nursing intervention is most helpful in meeting the needs of an older adult with the diagnosis of dementia of the Alzheimer type? A. Providing nutritious foods that are high in carbohydrates and protein B. Offering opportunities for choices in the daily schedule to stimulate interest C. Developing a consistent plan with a fixed time schedule to fulfill emotional needs D. Simplifying the environment as much as possible and eliminating the need for decisions and choices

D

Which drugs may lead to a prolongation of the QT interval in a client who is on drug therapy for schizophrenia? Select all that apply. A. Loxapine B. Haloperidol C. Thiothixene D. Thioridazine E. Chlorpromazine

B, D, E

The nurse is caring for a 60-year-old client who is diagnosed with dementia. Which antipsychotic drugs would be contraindicated for the client? Select all that apply. A. Quetiapine B. Haloperidol C. Aripiprazole D. Risperidone E. Chlorpromazine

B, E

A client with schizophrenia says to the nurse, "I've been here 5 days. There are five players on a basketball team. I like to play the piano." How should the nurse document this cognitive disorder? A. Word salad B. Loose association C. Thought blocking D. Delusional thinking

B

A client with schizophrenia uses the word "worriation" when talking with the nurse. How should the nurse respond? A. By correcting the pronunciation of the word B. By asking for clarification of the word's meaning C. By ignoring its use while interacting with the client D. By telling the client to use words that everyone can understand

B

A client with dementia has been cared for by the spouse for 5 years. During the last month the client has become agitated and aggressive and is incontinent of urine and feces. What is the priority nursing care while this client is in an inpatient mental health facility? A. Managing the behavior B. Preventing further deterioration C. Focusing on the needs of the spouse D. Establishing an elimination retraining program

A

A client with schizophrenia reports having ongoing auditory hallucinations and describes them as "voices telling me that I'm a bad person" to the nurse. What is the best response by the nurse? A. "Try to ignore the voices." B. "What are the voices saying to you?" C. "Do you believe what the voices are saying?" D. "They're only voices, so just try not to be afraid."

A

The night nurse reports that a young client with paranoid schizophrenia has been awake for several nights. The day nurse reviews the client's record and finds that this client did not have an interrupted sleep pattern disorder before transfer from a private room to a four-bed room 3 days ago. What factor should the nurse identify as most likely related to the client's sleeplessness? A. Fear of the other clients B. Concern about family at home C. Watching for an opportunity to escape D. Trying to work out emotional problems

A

The primary objective of nursing intervention for clients with dementia, delirium, and other cognitive disorders is to maintain what? A. Safety within the environment B. Psychological faculties C. Participation in educational activities D. Face-to-face contact with other clients

A

A nurse is assessing a client and attempting to distinguish between dementia and delirium. Which factors are unique to delirium? Select all that apply. A. Slurred speech B. Lability of mood C. Long-term memory loss D. Visual or tactile hallucinations E. Insidious deterioration of cognition F. A fluctuating level of consciousness

A, D, F

The primary healthcare provider prescribes a neuroleptic drug to a client diagnosed with schizophrenia. On what basis would the primary healthcare provider choose the drug? A. Symptoms B. Side effects C. Therapeutic effects D. Underlying pathology

B

What is the priority when a nurse is formulating a plan of care for a client with a diagnosis of dementia of the Alzheimer type? A. Implementing remotivational therapy B. Structuring the environment for safety C. Arranging for long-term custodial care D. Stimulating thinking with new experiences

B

A healthcare provider prescribes clozapine to a client with schizophrenia. Which parameters should be assessed before initiating the drug? Select all that apply. A. Prolactin levels B. Body mass index C. White blood cell count D. Serum potassium levels E. Absolute neutrophil count

B, C, E

A nurse is caring for a community-dwelling older adult with dementia. What interventions should the nurse take to ensure the client's well-being? Select all that apply. A. Obtain the client's drug history and educate the older adult about safe medication storage B. Foster human dignity and maintain the best possible functioning, protection, and safety C. Teach the client to be cautious of false advertisements that promise a cure for the disease D. Show the caregiver techniques to dress, feed, and toilet the older adult E. Protect the client's rights and provide support to maintain the physical and mental health of family members

B, D, E

While assessing a client with schizophrenia who is receiving chlorpromazine, the nurse finds lead pipe rigidity, sudden high fever, and sweating. Which drugs would be prescribed by the healthcare provider? Select all that apply. A. Loxapine B. Dantrolene C. Thiothixene D. Haloperidol E. Bromocriptine

B, E

A client who has been hospitalized with schizophrenia tells the nurse, "My heart has stopped and my veins have turned to glass!" What should the nurse conclude that the client is experiencing? A. Echolalia B. Hypochondriasis C. Somatic delusion D. Depersonalization

C

One morning a client with the diagnosis of schizophrenia claims to be Joan of Arc about to be burned at the stake. What is the most therapeutic response by the nurse? A. "Tell me more about being Joan of Arc." B. "We both know that you're not Joan of Arc." C. "It seems like the world is a pretty scary place for you." D. "You're safe here, because we won't let you be burned."

C

When planning activities for a child with autism, what does the nurse remember that autistic children respond best to? A. Loud, cheerful music B. Large-group activities C. Individuals in small groups D. Their own self-stimulating acts

D

A nurse in the neonatal intensive care unit (NICU) is assessing parents of a baby with Down's Syndrome for behaviors that might indicate lack of bonding with the baby. The nurse determines that support may be needed when seeing the parents: A. Visiting other babies in the NICU B. Touching their baby with their fingertips C. Discussing equipment being used for their baby D. Asking numerous questions about their baby's condition

A

A young client is admitted to the hospital with a diagnosis of acute schizophrenia. The family reports that one day the client looked at a linen sheet on a clothesline and thought it was a ghost. What is the most appropriate conclusion to make about what the client was experiencing? A. Illusion B. Delusion C. Hallucination D. Confabulation

A

An older adult resident of a nursing home who has the diagnosis of dementia of the Alzheimer type frequently talks about the good old days at the ranch. What is the most appropriate action by the nurse? A. Allowing the resident to reminisce about the past and listening with interest B. Involving the resident in interesting diversional activities with a small group C. Reminding the resident that those "good old days" are past and that the client should focus on the present D. Introducing the resident to other residents with the same diagnosis so that they can share their past experiences

A

A nurse notes that a client with dementia refuses to eat. Instead of informing the primary healthcare provider, the nurse threatens to force-feed the client, and proceeds to apply restraints in order to do so. What legal charges may be brought up against the nurse? Select all that apply. A. Libel B. Assault C. Malpractice D. Invasion of privacy E. False imprisonment

B, C, E

What is the priority nursing action for a client with delirium? A. Maintaining skin integrity B. Planning for behavioral interventions C. Creating a calm and safe environment D. Maintaining personal contact through touch

C

What should a nurse do first when managing interpersonal relationships with a client who has schizophrenia? A. Allow the client to be alone when desired but provide quiet activities. B. Insist that the client join group meetings and activities with other clients. C. Establish a one-on-one relationship and then bring the client into group activities. D. Encourage dependence by the client initially but set limits on the extent of this behavior.

C

A client is undergoing treatment for schizophrenia with antipsychotic drugs. During a client assessment, the primary healthcare provider noticed an increase in body temperature and unstable blood pressure. Which adverse effect of the antipsychotic drug caused this condition in the client? A. Akathisia B. Tardive dyskinesia C. Extrapyramidal symptoms D. Neuroleptic malignant syndrome

D