EXAM 3 Chapter 16: Schizophrenia

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." "Schizophrenia is being found to be related more closely to family dysfunction than to physiology, which is why family therapy is the most effective treatment for this disorder." "Medications for schizophrenia have not changed much since the early 1950s, although there are some medications that may be helpful." "It is more effective to treat the individual on a one-to-one basis than to involve the family in treatment because it is a very complicated process."

"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." NOTE: 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.

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 week 1 month 8 months 1 year

1 month

Which client exhibits the characteristics that are typical of the prodromal phase of schizophrenia? A 25-year-old does not express any of the symptoms of schizophrenia. A 20-year-old is experiencing a gradual decrease in the ability to concentrate, be productive, and sleep restfully. A 30-year-old has experienced a relapse after deciding that the client's atypical antipsychotic is unnecessary. A 28-year-old has been displaying the behaviors characteristic of schizophrenia for many months and has just been diagnosed with the disease.

A 20-year-old is experiencing a gradual decrease in the ability to concentrate, be productive, and sleep restfully. NOTE: Gradual, subtle behavioral changes appear during the prodromal phase of schizophrenia, such as tension, the inability to concentrate, insomnia, withdrawal, or cognitive deficits.

Which statement is true about delusional disorder? The disease onset is usually gradual. Psychosocial functioning is often markedly impaired. Behavior is relatively normal except when focused on the delusion. The individual's personality changes dramatically.

Behavior is relatively normal except when focused on the delusion.

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? Psychosis Tardive dyskinesia Extrapyramidal side effects Progressed schizophrenia

Extrapyramidal side effects NOTE: 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.

One of the primary goals in caring for the client with schizophrenia is to establish clear, consistent, open communication. Which nursing intervention would be most effective in accomplishing this goal? Assist the client to do at least one physical activity each day. Supervise all of the client's activities of daily living. Present reality in clear, simple language, and demonstrate patience. Arrange for the client to go home as soon as possible on a day pass.

Present reality in clear, simple language, and demonstrate patience.

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 Most cultures contain well-accepted religious beliefs Delusions are often focused on the client's cultural religious beliefs The nurse's cultural religious beliefs may differ from those of the client's

Some cultures hold religious beliefs that might be confused with delusional thought

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 no longer believes that the client has special powers. The client has resumed employment and attends social functions. The client reports that the client no longer has hallucinations. The client has been engaging in more conversation with the staff.

The client has resumed employment and attends social functions. NOTE: Major goals for the care of a client with schizophrenia are to experience improved thought processes and fewer psychotic symptoms, to not engage in violent behavior, to acquire improved social skills and engage in satisfying social interaction

The severity of a client's positive and negative symptoms of schizophrenia has not significantly improved since treatment began, despite the use of three different neuroleptic medications. The nurse should anticipate that this client may benefit from treatment with which medication? Clozapine Haloperidol Risperidone Olanzapine

clozapine

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 Nihilistic Somatic Jealous

grandiose

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 Acknowledge that there may be some truth in the delusion Encourage the client to talk about the reasoning behind his or her delusion Identify what triggers the delusion

assure the client that he or she is safe in this milieu

A nurse teaching a client about prescribed antipsychotic medication informs the client to contact a health care provider immediately if the client notices: An increase in weight of 2 lbs in 1 month. A feeling of dizziness when the client stands up. An increase in thirst. A dramatic change in temperature.

a dramatic change in temperature NOTE: 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.

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 A delusion Thought broadcasting Thought insertion

a hallucination

A client diagnosed with schizophrenia has been prescribed clozapine. Which is a potentially fatal side effect of this medication? Agranulocytosis Neuroleptic malignant syndrome Tardive dyskinesia Dystonia

agranulocytosis NOTE: Agranulocytosis is manifested by a failure of the bone marrow to produce adequate white blood cells

A nurse monitoring client medication needs to recognize side effects quickly and intervene promptly for which reason? Determine adequate dosage is maintained to control symptoms Alleviate the side effects and help client maintain adherence Provide support to the client and let the client know this is normal Provide support to the client and encourage adherence as past side effects rarely reoccur

alleviate the side effects and help client maintain adherence

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 Mood stabilizer Antidepressant Typical antipsychotic

atypical antipsychotic

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 Delusion Flight of ideas Ideas of reference

hallucinations

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? Ineffective role performance related to symptoms of schizophrenia Social isolation related to auditory hallucinations Dysfunctional family processes related to psychosis Bathing self-care deficit related to symptoms of schizophrenia

bathing self-care deficit related to symptoms of schizophrenia NOTE: The negative symptom of avolition may be so profound that simple activities of daily living, such as dressing, bathing, or combing hair, may not get done. Therefore, a priority nursing diagnosis for the client is [bathing] self-care deficit related to the symptoms of schizophrenia.

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

benztropine

Which medication is used to control the extrapyramidal effects associated with antipsychotic medications? Benztropine Chlorpromazine Haloperidol Thioridazine

benztropine NOTE: Benzotropine is an anticholinergic drug used to relieve drug-induced extrapyramidal adverse effects, such as muscle weakness, involuntary muscle movement, pseudoparkinsonism, and tardive dyskinesia.

A client was admitted to the psychiatric intensive care unit with schizophrenia. The client exhibits primarily disorganized behavior. In addition to hallucinations and delusions, other assessments that the nurse would expect to find include what? Blunted inappropriate affect, withdrawal, incoherence, and confusion Abnormal, bizarre posturing; stupor; echolalia; and negativism Hostility, aggression, persecutory hallucinations, and argumentativeness Depression, elation, hyperactivity, and pressure of speech

blunted inappropriate affect, withdrawal, incoherence, and confusion

The psychiatric nurse documents that a client is expressing nihilistic delusions when the client makes which statement? "I can't eat; I have no mouth or stomach." "I'm dying; I'm the first to have this form of cancer." "I'll just telephone the president; he always answers my calls." "I need to leave now; I'm expecting a visit from my sister, the queen."

i can not eat; i have no mouth or stomach

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? "There are actually no poison gases in the atmosphere that we don't know about." "Why do you think that you keep insisting on this belief?" "I can assure you that you are actually very safe here." "If we detect a poison gas here, I promise that you'll be the first to know."

i can assure you that you are actually safe here NOTE: Assuring a client of his or her safety is a more therapeutic intervention

A hospitalized client diagnosed 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 Propranolol Risperidone Aripiprazole

diphenhydramine

he nurse is developing a care plan for a client with somatic delusions. Which would be an appropriate nursing diagnosis for this client? Disturbed sleep pattern Risk for self-directed violence Chronic low self-esteem Disturbed thought process

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 Serotonin Norepinephrine Gamma-aminobutyric acid (GABA)

dopamine

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 Serotonin Gamma-aminobutyric acid (GABA) Norepinephrine

dopamine NOTE: Positive symptoms of schizophrenia (specifically hallucinations and delusions) are thought to be related to dopamine hyperactivity in the mesolimbic tract at the D2 receptor site of the striatal area, where memory and emotion are regulated.

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? Gain assistance from family members. Contact the physician for a change in medications. Establish a routine and set goals. Outline the side effects of the medications.

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 Every 3 months Every 6 months Every year

every week for the first 6 months

The nurse suspects that a client is experiencing a brief psychotic episode based on what? Select all that apply. Gradual onset of symptoms Evidence of hallucinations Intense changes in affect Mild confusion Recent life stressor

evidence of hallucinations intense changes in affect recent life stressor

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? "I'll expect you in the dining room in 20 minutes." "First, wash your face and brush your teeth. Then put your clothes on." "Stay right there and I'll get your clothes." "Why don't you stay here and I'll get your tray for you."

first, wash your face and brush your teeth. then put your clothes on NOTE: The client needs clear direction, with tasks broken into small steps, to begin to participate in the client's own self-care.

A nurse is preparing to administer prescribed antipsychotic medication to a client with psychosis. The nurse identifies the prescribed medication as a first-generation antipsychotic drug. Which drug would the nurse most likely be administering? Fluphenazine Aripiprazole Clozapine Olanzapine

fluphenazine

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? Ambivalence Ideas of reference Flight of ideas Echolalia

ideas of reference NOTE: 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.

Catatonia as seen in clients with schizophrenia is unique in the existence of which feature? Immobility like being in a trance Preoccupation with a delusion Presence of negative symptoms Disorganized speech patterns

immobility like being in a trance

Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction? Increased amount of dopamine An inadequate amount of dopamine Cerebral atrophy Organic functional changes in the brain

increased amount of dopamine

When describing the difference between schizoaffective disorder (SAD) and schizophrenia, the nurse would address which as associated with SAD? lower level of functioning increased mood responses decreased risk for suicide delusions but no hallucinations

increased mood disorder

A client with schizophrenia is prescribed clozapine. The nurse would monitor the client closely for specific signs of: hypotension. nausea. weight loss. infection.

infection NOTE: Agranulocytosis can develop with the use of all antipsychotic drugs, but it is most likely to develop with clozapine use. Therefore, the nurse needs to be alert for signs of infection, particularly bacterial infection.

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 more common than schizophrenia. It is usually diagnosed in late adulthood. It is most common with somatoform disorders. It is a mix of psychotic and mood symptoms.

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? Despite their unusual behavior, clients with schizophrenia do not pose a safety risk to care providers. Being afraid of a client who has schizophrenia is a result of stereotyping. It is natural to feel fear when a client exhibits unpredictable behavior, and this can cause the student to be reasonably cautious. These feelings are best disclosed to the client, and doing so can foster the openness that promotes a therapeutic relationship.

it is a natural to feel fear when a client exhibits unpredictable behavior, and this can cause the student to be reasonably cautious

A client with schizophrenia tells the nurse, "I'm being watched constantly by the Federal Bureau of Investigation because of my job." Which response by the nurse would be most appropriate? "Tell me more about how you are being watched." "It must be frightening to feel like you're always being watched." "You're not being watched; it's all in your mind." "You are experiencing a delusion because of your illness."

it must be frightening to feel like you are always being watched

A client diagnosed with schizoaffective disorder is prescribed clozapine to treat symptoms. Which instructions would the nurse provide? "Keep a record of how often and how long you experience the side effect of dry mouth." "Monitor your urinary output and notify your doctor if your urine changes color." "Keep an eye on your weight, and if you gain weight rapidly, notify your doctor." "If you experience any drowsiness, discontinue taking this medication."

keep an eye on your weight, and if you gain weight rapidly, notify your doctor

The nurse is assigned to a client with catatonic schizophrenia. Which intervention should the nurse include in the client's care plan? Meeting all of the client's physical needs Giving the client an opportunity to express concerns Administering lithium carbonate as prescribed Providing a quiet environment where the client can be alone

meeting all of the client's physical needs

A comprehensive nursing assessment for neuroleptic malignant syndrome (NMS) should include checking for which in a client taking an antipsychotic medication? Headache, muscle aches, and paresthesias Confusion, giddiness, and hyperalertness Muscular rigidity, tremors, and difficulty swallowing Dry mouth, flushing, and urinary retention

muscular rigidity, tremors, and difficulty swallowing

A client with a diagnosis of schizophrenia has been brought to the emergency department by a worker from the group home where the client resides. The worker states that the client has stopped taking medications and drank 2 to 3 gallons of water over the past several hours. What assessments should the nurse who is caring for this client prioritize? Neurological assessment and monitoring of electrolyte levels Monitoring for evidence of hallucinations or delusions Blood glucose levels and body weight Assessing for allergic reactions, dry mouth, and lethargy

neurological assessment and monitoring for electrolyte levels NOTE: Hyponatremia, electrolyte imbalances, and seizures may result from polydipsia. Consequently, close monitoring of the client's electrolytes and neurological status assessment are prioritized at this stage.

A client with schizophrenia is experiencing delusions. The client states, "My face is melting and my nose is about to fall off. Don't let it fall off!" The nurse interprets this statement as which type of delusion? grandiose nihilistic persecutory somatic

nihilistic NOTE: A nihilistic delusion involves the client belief that the client's organs aren't functioning or some body part or feature is horribly disfigured. A grandiose delusion involves the belief that one has exceptional powers, wealth, skill, influence, or destiny. A persecutory delusion involves the belief that one is being watched, ridiculed, harmed, or plotted against. A somatic delusion involves a belief about abnormalities in bodily structure or functions.

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. You seriously can't have any bugs in your brain." "No, I don't see any bugs. That sounds scary for you." "Your thinking is a little illogical. I wouldn't be able to see bugs if they were inside your brain. Would you like to talk more about this?" "You have a thought disorder and only think you have bugs in your brain. There really aren't any. You don't have to worry because we would give you medicine for any medical problems."

no, i do not see any bugs. that sounds scary for you NOTE: The person who hallucinates is preoccupied and frightened by what he or she hears or sees. The hallucination is real to the client, and the nurse cannot argue away, dismiss, or ignore it. Although the hallucination is real to the client, nurses make it clear that they do not hear the voices or see the visual images. Nurses do, however, communicate concern that the client is bothered, upset, or frightened by the hallucination.

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? Lack of family support Accessibility to community resources Non-adherence to prescribed medications Stigmatization of mental illness

non-adherence to prescribed medications

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 Reminding the client that delusions are not real Encouraging the client to participate in group therapy daily Decrease stressful situations by controlling the client's symptoms

offering reassurance in a soft, nonthreatening voice

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? Erotomanic Persecutory Grandiose Somatic

persecutory NOTE: The central theme of persecutory delusions is the client's belief that he or she is being conspired against, cheated on, spied on, followed, poisoned, drugged, maliciously maligned, harassed, or obstructed in pursuit of long-term goals

Which type of delusion refers to a situation whereby a person or someone close to person is being malevolently treated in some way? Grandiose type Persecutory type Somatic type Unspecified type

persecutory type

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? Ensuring that the client does not sleep more than 7 hours in any 24-hour period Clustering the client's medications at 0800 hours Providing a vivid, bright environment that provides distractions from hallucinations Provide frequent contact and communication with the client

provide frequent contact and communication with the client

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? Fluphenazine Thiothixene Quetiapine Chlorpromazine

quetiapine

A client with schizoaffective disorder (SAD) is prescribed clozapine. The nurse understands that in addition to the drug's antipsychotic effects, it is also effective in which area? Limiting the risk for extrapyramidal adverse effects Reducing the risk for suicide Eliminating the need for additional medications Requiring no physiological monitoring

reducing the risk for suicide NOTE: Clozapine, reported effective for SAD by several authorities, can reduce 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? Prodromal phase Acute illness Stabilization Relapse

relapse NOTE: Relapse involves a return of the symptoms, most often due to the client's failure to follow the medication regimen.

What are the signs and symptoms of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders? Schizophrenia can be diagnosed as soon as an individual states he or she is hearing voices. Schizophrenia lasts at least 6 months and includes at least 1 month of 2 or more active-phase symptoms. Schizophrenia lasts at least 1 month and must include the symptom of hallucinations. Schizophrenia can be diagnosed as soon as an individual states he or she is hallucinating and delusional.

schizophrenia last at least 6 months and includes at least 1-2 months 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? Stimulant Antidepressant Second generation antipsychotic First generation antipsychotic

second generation antipsychotic NOTE: The second-generation antipsychotics are effective in treating negative and positive symptoms.

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? Nihilistic Grandiose Somatic Persecutory

somatic NOTE: Somatic delusions involve bodily functions or sensations, such as insects having infested the skin. The client vividly describes crawling, itching, burning, swarming, and jumping on the skin surface or below the skin. The client maintains the conviction that he or she is infested with parasites in the absence of objective evidence to the contrary.

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? Depression Mania Suicide Water intoxication

suicide

Although a psychotic episode can be brief, the client impact can last a long time. For this reason, the nurse is aware of what? The best outcomes are achieved on an outpatient basis Family supports are required Supervision may be required to protect the person Cognitive therapy is indicated

supervision may be required to protect the person

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? Loose associations and flight of ideas Suspiciousness and neologisms Illusions and loss of ego boundaries Echolalia and echopraxia

suspiciousness and neologisms

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: weight loss. torticollis. hypoglycemia. tardive dyskinesia.

tardive dyskinesia

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 side effect? Tardive dyskinesia Dystonia Neuroleptic malignant syndrome Akathisia

tardive dyskinesia NOTE: Unusual movements of the tongue, neck, and arms suggest tardive dyskinesia, an adverse reaction to neuroleptic medication. Dystonia is characterized by cramps and rigidity of the tongue, face, neck, and back muscles. Neuroleptic malignant syndrome causes rigidity, fever, hypertension, and diaphoresis. Akathisia causes restlessness, anxiety, and jitteriness

The client's diagnosis of schizoaffective disorder is supported when the nurse documents what? The client reports "hearing voices" for the last 3 months The client's mother shares that "the client never missed work" even with the disorder The client's spouse reported that the client "repeated everything I said" for 48 hours Diagnosis testing confirmed a right parietal brain lesion

the client reports "hearing voices" for the last 3 months

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 identify alternatives to present coping patterns. The client will describe problems relating to others. The client will identify situations that evoke anxiety. The client will differentiate between reality and fantasy.

the client will differentiate between reality and fantasy

Research related to the development of schizophrenia has shown what? The likelihood of developing schizophrenia for a sibling of a person with the disorder is less than that of individuals in the general population. The disorder is thought to arise from the interaction of a biological predisposition and environmental stressors. Behavioral family pathology, not genetics, is the primary risk factor for the development of schizophrenia. If an identical twin develops schizophrenia, the other twin will also develop the disorder.

the disorder is thought to arise from their interaction of biological predisposition and environmental stressor

A client with schizophrenia is prescribed an antipsychotic medication. Which immediate side effects would the nurse include in the education plan for this medication? Risk for hypertension Risk for hypoprolactinemia The potential for weight loss The potential for sedation

the potential for sedation NOTE: 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.

Which data support a nursing diagnosis of impaired verbal communication? Ambivalence, delusional thinking, and avolition The presence of neologism, echolalia, and clanging The presence of neologism, delusions, and anergia Rapid pacing and running

the presence of neologism, delusions, and clanging

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 Evaluate the significance to the client Determine the impact of the delusion on the client's safety Avoid dwelling on the delusion

try to change the client's delusional belief NOTE: delusions are fixed, false beliefs that cannot be changed by reasonable arguments. The nurse should assess the client's delusion to evaluate its significance to the client, to the client's safety, and to the safety of others. The nurse should not dwell on the delusion or try to change it.

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. Atypical antipsychotics relieve only negative symptoms. Atypical antipsychotics tend to cause many more extrapyramidal side effects than do the typical antipsychotics. Typical antipsychotics cause blood dyscrasias, whereas atypical ones do not.

typical antipsychotics most often relieve positive symptoms but do not have a significant impart on negative symptoms

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 Hypervigilance Retardation Echopraxia

waxy flexibility NOTE: Waxy flexibility, the ability to assume and maintain awkward or uncomfortable positions for long periods, is characteristic of catatonic schizophrenia. Clients commonly remain in these awkward positions until someone repositions them.

The parent of a client who has a delusional disorder spends a great deal of time and energy trying to convince the client that the client is not actually the focus of a nationwide, secret plot to track the client's activities. Which of the client's responses is most typical of an individual with a delusional disorder? "I'll consider what you think, but this is something I really, really need." "I've told you before that I can't just snap my fingers and change the way I think." "You're so naïve. You just don't understand what's really happening out there." "I know I've got delusions, but you would too if you had to live my life."

you are so naïve. you dont understand what is really happening out there NOTE: Individuals with delusional disorders have no insight into their condition and typically believe that others are ignorant to the true reality.