PassPoint - Psychotic Disorders
A client tells a nurse that people from Mars are going to invade the Earth. Which response by the nurse would be therapeutic? "That must be frightening to you. Can you tell me how you feel about it?" "There are no people living on Mars." "What do you mean when you say they're going to invade the Earth?" "I know you believe the Earth is going to be invaded, but I don't believe that."
"That must be frightening to you. Can you tell me how you feel about it?"
Which concept is most important for a nurse to communicate to a client preparing to sign an informed consent for electroconvulsive therapy (ECT)? "You'll be offered a strong sedative before the procedure." "This therapy will provide excellent symptom relief." "You may experience a complete loss of memory after the treatment." "You may experience a time of confusion after the treatment."
"You may experience a time of confusion after the treatment."
A nurse is teaching a client about the prescribed drugs, chlorpromazine and benztropine. What evaluation would indicate a therapeutic response to these drugs? The client displays akathisia while sitting. The client is experiencing less psychosis and a decrease in extrapyramidal symptoms. The client does not report nausea and vomiting. The client expresses a decrease in anxiety.
The client is experiencing less psychosis and a decrease in extrapyramidal symptoms.
The nurse is planning care for a client who has been experiencing a manic episode for 6 days and is unable to sit still long enough to eat meals. Which choice will best meet the client's nutritional needs at this time? a green salad topped with chicken pieces a peanut butter sandwich a bowl of vegetable soup favorite foods from home
a peanut butter sandwich Giving the client finger foods that have protein, carbohydrates, and calories supplies energy and allows the client to eat while on the move.
A client tells a nurse that the television newscaster is sending the client a secret message. The nurse suspects the client is experiencing: a delusion. flight of ideas. ideas of reference. a hallucination.
ideas of reference.
A client with schizoaffective disorder is brought to the hospital by a family member. The family member states that the client is having an increase in auditory hallucinations and is becoming significantly more withdrawn. The nurse reviewing the admission blood work expects which blood level to be subtherapeutic? phenobarbital chlordiazepoxide lithium carbonate imipramine
lithium carbonate Lithium carbonate, an antimanic drug, is used to treat clients with cyclical schizoaffective disorder, a psychotic disorder once classified under schizophrenia that causes affective symptoms, including manic and depressive activity. Lithium helps control this disorder's affective component.
A client diagnosed with paranoid personality disorder is hospitalized for physically threatening his wife because he suspects her of having an affair with a coworker. What approach should the nurse employ with this client? authoritarian parental matter-of-fact controlling
matter-of-fact
A client has been receiving chlorpromazine to treat psychosis. Which findings should alert the nurse that the client is experiencing pseudoparkinsonism? restlessness, difficulty sitting still, and pacing involuntary rolling of the eyes tremors, shuffling gait, and masklike face extremity and neck spasms, facial grimacing, and jerky movements
tremors, shuffling gait, and masklike face Pseudoparkinsonism may appear 1 to 5 days after starting an antipsychotic and may also include drooling, rigidity, and "pill rolling." Akathisia may occur several weeks after starting antipsychotic therapy and consists of restlessness, difficulty sitting still, and fidgeting. An oculogyric crisis characterized by uncontrollable rolling back of the eyes and, along with dystonia, should be considered a medical emergency. Dystonia may occur minutes to hours after receiving an antipsychotic and may include extremity and neck spasms, jerky muscle movements, and facial grimacing.
The nurse should judge client education regarding valproic acid as effective if the client states which statement? "I can stop the valproic acid because the serum level is normal." "I can take the valproic acid when I feel I need it." "Valproic acid is safe to use when I get pregnant." "I might need to take the valproic acid for a long time."
"I might need to take the valproic acid for a long time."
While pacing in the hall, a client with schizophrenia runs to a nurse and asks, "Why are you poisoning me? I know you work for Central Thought Control! You can keep my thoughts. Give me back my soul!" How should the nurse respond during the early stage of the therapeutic process? "I'm a nurse. I'm not poisoning you. That would be a violation of the nursing code of ethics." "I'm a nurse, and you're a client in the hospital. I'm not going to harm you." "I'm not poisoning you. And how could I possibly steal your soul?" "I sense anger. Are you feeling angry today?"
"I'm a nurse, and you're a client in the hospital. I'm not going to harm you."
A 23-year-old client diagnosed with schizophrenia cheerfully announces, "My mom and I are so excited that I'm pregnant. She's willing to help us take care of the baby too." Which reason should cause the nurse to be concerned about this situation? The client did not say that the father of the baby was excited about this. The mother is not likely to provide enough help for what the client needs. Symptom management will be difficult in early pregnancy without medications. The client will have difficulty financially supporting the baby.
Symptom management will be difficult in early pregnancy without medications.
A client with chronic schizophrenia has received 10 mg of fluphenazine hydrochloride PO q.i.d. Now the client has a temperature of 102° F (38.9° C), a heart rate of 120 beats/minute, a respiratory rate of 20 breaths/minute, and a blood pressure of 210/140 mm Hg. Because the client is also confused and incontinent, the nurse suspects neuroleptic malignant syndrome. What steps should the nurse take? Give the client the next dose of fluphenazine, call the physician, and monitor the client's vital signs. Withhold the client's next dose of fluphenazine, call the physician, and monitor the client's vital signs. Give the client the next dose of fluphenazine and restrict the client to an empty room to decrease stimulation. Withhold the client's next dose of fluphenazine, administer an antipyretic agent, and increase the client's fluid intake.
Withhold the client's next dose of fluphenazine, call the physician, and monitor the client's vital signs.
The nurse is facilitating a group of clients with schizophrenia when one client says, "I like to drive my car, bar, tar, far." This client is exhibiting: clang association. echolalia. echopraxia. neologisms
clang association.
A client has been admitted to the emergency department. The client's family tells the nurse that the client has suddenly become lethargic and is "not making sense." The client has not had anything to eat or drink for the last 8 hours. The nurse further assesses the client using the Confusion Assessment Method (CAM). The client's responses to questions are rambling, and the client is not able to focus clearly to answer the nurse's questions. Based on these findings, the nurse should report that the client has which problem? dementia depression delirium dehydration
delirium Based on CAM's assessment tool, the client has an acute onset of behaviors, is inattentive, has disorganized thinking, and is lethargic (decreased level of consciousness). This cluster of behaviors constitutes delirium. Dementia has a slow onset, the client's level of consciousness is usually normal, and the client can focus attention. Clients who are depressed are alert and oriented and able to focus attention, although they may be easily distracted. Further assessment is needed to determine if the client also is dehydrated.
After the nurse has taught the client who is being discharged on lithium about the drug, which client statement would indicate that the teaching has been successful? "I need to restrict eating any foods that contain salt." "If I forget a dose, I can double the dose the next time I take it." "I'll call my health care provider right away for any vomiting or muscle weakness." "I should increase my fluid intake to five to six 8-oz glasses (1,200 to 1,420 mL) of water each day."
"I'll call my health care provider right away for any vomiting or muscle weakness."
A client who is incoherent and agitated comes to the emergency department. The client reports visual and auditory hallucinations. The healthcare provider orders haloperidol, 5 mg IM. When educating the client on this medication, which statement by the nurse is correct? "This medication will prevent you from acting this way again." "This medication will make you sleep, and then you will not see or hear things that are untrue." "This medication will help decrease your tension and agitation." "This medication will prevent stiff jerky movements of your face and body that you can't control."
"This medication will help decrease your tension and agitation."
The parents of a teenager recently diagnosed with schizophrenia ask the nurse about whether their other children will be susceptible as well. The nurse explains that schizophrenia is caused by: genetic factors leading to a faulty dopamine receptor. environmental factors and childhood trauma. structural and neurobiological factors. a combination of biological, psychologic, and environmental factors.
a combination of biological, psychologic, and environmental factors. A combination of biological, psychologic, and environmental factors is thought to cause schizophrenia. Studies of twins and adopted siblings have strongly implicated a genetic predisposition for schizophrenia; however, a reliable genetic marker has not been determined. Excessive dopamine activity in the brain has also been suggested as a causal factor. Communication and the family system have been studied as contributing factors in the development of schizophrenia.
A client is brought to the hospital by the spouse, who states that the client has refused all meals for the past week and accused the spouse of trying to poison the client. During the initial interview, the client's speech, only partly comprehensible, reveals that the client's thoughts are controlled by delusions that the client is possessed by the devil. A health care provider diagnoses paranoid schizophrenia. Paranoid schizophrenia is best described as a disorder characterized by: preoccupation with persecutory delusions, anxiety, anger, and potential for violence. severe mood swings and periods of low and high activity. multiple personalities, one of which is more destructive than the others. olfactory and tactile hallucinations.
preoccupation with persecutory delusions, anxiety, anger, and potential for violence. Schizophrenia is best described as one of a group of psychotic reactions characterized by disturbed relationships with others and an inability to communicate and think clearly. Schizophrenic thoughts, feelings, and behavior are commonly evidenced by withdrawal, fluctuating moods, disordered thinking, and regressive tendencies. While some clients with schizophrenia may be at risk for violent behavior, people with schizophrenia generally are not prone to violence. Severe mood swings and periods of low and high activity are typical of bipolar disorder. Multiple personality, sometimes confused with schizophrenia, is a dissociative personality disorder, not a psychotic illness. Many schizophrenic clients have auditory hallucinations; olfactory and tactile hallucinations are much less common with schizophrenia and tend to be associated with other disorders.
