Mental Health- PrepU Chapter 24

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

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 client who has a major fear of people dressed in black tells the nurse that, for the past 2 weeks, the client has been hearing voices and at times thinks that they are being followed. The nurse interprets these findings as suggesting which condition?

paranoid type schizophrenia

The client with schizophrenia tells the nurse, "I can't go outside or answer the phone; the boss man has people watching me because I know too much. The boss is afraid I will rat out the operation to the Feds." The nurse documents the client's statement as which type of delusion?

persecutory

A client diagnosed with schizophrenia is exhibiting disorganized behavior and imitating what the nurse is saying. What term is used to identify this behavior?

Echolalia

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

Benztropine

When describing the difference between schizoaffective disorder (SAD) and schizophrenia, the nurse would address which as associated with SAD?

increased mood responses

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

Agranulocytosis

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

The nurse observes a client with schizophrenia sitting alone, laughing occasionally, and turning his head as if listening to another person. The nurse assesses this behavior to indicate that the client is experiencing auditory hallucinations and says ...

"Are you hearing something?"

A client with schizophrenia reads the advice column in the newspaper daily. The client states, "This person is my guide and tells me what I must do every day." Which is the best response by the nurse?

"Can you tell me why you are so interested in the advice column?"

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 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

Which is the most common subtype of delusion?

persecutory

A client with schizophrenia is seen sitting alone and talking out loud. Suddenly, the client stops and turns as if listening to someone. The nurse approaches and sits down beside the client. Which is the best response by the nurse?

"I don't hear or see anyone else; what are you hearing and seeing?"

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

Schizoaffective disorder has symptoms typical of both schizophrenia and which type of disorder?

Mood disorders

The nurse is teaching a client with schizoaffective disorders (SAD) about the client's prescribed medication therapy. The nurse determines that additional education is needed when the client states what?

"One day, I won't have to worry about taking any medication."

Which are key diagnostic criteria of schizophrenia? Select all that apply.

- Continuous signs for at least 6 months - One or more major areas of social or occupational functioning markedly below previously achieved levels - Delusions present for a significant portion of time during a 1-month period

A nurse is preparing a presentation for a group of mental health nurses on the staff. The nurse is planning to address the topic of the effect of psychoeducation on schizoaffective disorder. Which of the following would the nurse include as an effect? Select all that apply.

- Increased medication compliance - Decreased family tension - Increased social function

The nurse documents that the client is exhibiting negative symptoms of schizophrenia when observing the client doing what? Select all that apply.

- Repeatedly turning down invitations to join in unit activities - Inability to maintain to complete a goal-directed activity

A diagnosis of delusional disorder is based on the presence of one or more nonbizarre delusions for at least what period of time?

1 month

A client with schizophrenia is being treated with olanzapine 10 mg daily. The client asks the nurse how this medicine works. The nurse explains that the mechanism by which the olanzapine controls the client's psychotic symptoms is believed to be what?

Blocking dopamine receptors in the brain.

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 developing a plan of care for a client diagnosed with delusional disorder. Which of the following would the nurse need to keep in mind?

Clients with delusional disorder typically have problems with medication adherence.

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

First-generation antipsychotic drugs

The nurse is preparing to administer thiothixene to a client with schizophrenia and assesses muscle rigidity, a temperature of 103°F (39.4°C), an elevated serum creatinine phosphokinase level, stupor, and urinary incontinence. Which is the priority action by the nurse?

Hold the medication and notify the health care provider.

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

A client diagnosed with delusional disorder is experiencing persecutory delusions involving the belief that someone is putting poison in his food. When developing the client's plan of care, which nursing diagnosis would be most likely?

Imbalanced Nutrition, Less than Body Requirements

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 nurse assessing a client with schizoaffective disorder should obtain a detailed history with a description of the full range and duration for which of the following reasons?

Is important to predict outcomes

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

Mood disorder

A client had been withdrawn in the client's room for 3 days, not eating or sleeping, prior to his admission to the inpatient unit. Upon interview, the client demonstrates difficulty answering questions, appears to have no facial expressions, and cannot follow simple instructions. This cluster of symptoms can be described as what?

Negative symptoms

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

A client with schizoaffective disorder is prescribed an atypical antipsychotic agent. Which agent would the nurse most likely expect to be prescribed?

Olanzapine

A client is admitted with the diagnosis of possible schizophrenia and to rule out (R/O) organic pathology. Based on this information, what treatment will the nurse assist with for this client?

Prepare the client for a computed tomography (CT) of the brain.

Which extrapyramidal side effect is noted by a client who has bradykinesia and a shuffling gait?

Pseudoparkinsonism

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

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

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

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 client with schizophrenia states, "I just don't know how to count. The sky turned to fire. I have a ball in my head." Which term does the nurse use to document this statement?

associative looseness

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