Chapter 22: Schizophrenia Spectrum & Other Psychotic Disorders: Management of Thought Disorders

The client was conversing with the nurse when noticeable changes occurred with the client. Which is a term used to describe the occurrence of the eye rolling back in a locked position, which occurs with acute dystonia?

Oculogyric crisis

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 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 of the following would the nurse identify as a negative symptom associated with schizophrenia?

Anhedonia

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

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.

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

During a client interview, a client states that "God has sent me a special message. I'm the only one who can carry out his plan." The nurse interprets this statement as suggesting which type of delusion?

Grandiose

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

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 is diagnosed with schizoaffective disorder. The interdisciplinary plan of care includes key family members. The nurse understands that a major reason for doing so involves which of the following?

Strengthening the client's recovery

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 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 week after beginning therapy with thiothixene, the client demonstrates muscle rigidity, a temperature of 103°F, an elevated serum creatinine phosphokinase level, stupor, and incontinence. The nurse should notify the physician because these symptoms are indicative of:

neuroleptic malignant syndrome.

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 diagnosed with delusional disorder who uses excessive health care resources most likely has which type of delusions?

somatic

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

Pseudoparkinsonism

Which is the most common subtype of delusion?

persecutory

A client diagnosed with schizophreniform disorder must have symptoms present for at least 1 month but with a duration of less than:

6 months.

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 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

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 with schizophrenia is prescribed a second-generation antipsychotic. The client's mother asks, "About how long will it take until we see any changes in his symptoms?" Which response by the nurse would be most appropriate?

"Generally, it takes about 1 to 2 weeks to be effective in changing symptoms."

One evening, a client with schizophrenia leaves the client's room and begins marching in the hall. When approached by the nurse, the client says, "God says I'm supposed to guard the area." Which response would be best?

"I understand you hear a voice. You and I are the only ones in the hall, and I don't hear a voice."

A client with a persecutory delusion has been explaining to the nurse the specifics of the conspiracy against the client. The client pauses and says, "I get the feeling that you don't actually believe that what I'm telling you is true." How should the nurse respond?

"What you're telling me is difficult for me to believe. This may be real for you, but not me."

The nurse enters the room of a client with schizophrenia the day after the client has been admitted to an inpatient setting and says, "I would like to spend some time talking with you." The client stares straight ahead and remains silent. Which would be the best response by the nurse?

"You don't need to talk right now. I'll just sit here for a few minutes."

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.

The client with schizophrenia believes the student nurses are there to spy on the clients. The client is suffering from which symptom?

Delusions

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

After teaching a group of nursing students about neurotransmitters associated with schizophrenia, the nursing instructor determines that the education was successful when the students identify what as playing a role in the positive symptoms of schizophrenia?

Dopamine

Schizoaffective disorder is most likely to be diagnosed at which of the following stages of life?

Early adulthood

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.

The nurse suspects that a client is experiencing a brief psychotic episode based on what? Select all that apply.

Evidence of hallucinations Intense changes in affect Recent life stressor

A client is diagnosed with schizoaffective disorder. Which would the nurse identify as supporting this diagnosis?

Evidence of hallucinations and delusions accompanied by major depression

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

When preparing a class presentation about schizophrenia, what would the nurse most likely include?

Improvement in symptoms can occur as a client with a history of schizophrenia reaches older adulthood.

The student nurse correctly recognizes that which finding is best supported by genetic studies in the etiology of schizophrenia?

That schizophrenia is at least partially inherited.

A client is diagnosed with schizoaffective disorder (SAD). The nurse understands that in addition to psychosis, the client must also exhibit:

Mood disorder

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

Delusional disorders are primarily characterized by which of the following? Select all that apply.

Paranoia Jealousy Distrust

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 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

When performing discharge planning for a client who has schizophrenia, the nurse anticipates barriers to adhering to the medication regimen. The nurse assesses which as improving the likelihood that the client will follow the prescribed medication regimen? Select all that apply.

Short-term memory intact Receives monthly disability checks States location of pharmacy nearest the client's residence

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?

Somatic

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

The nurse notices the client with a shuffling gait walking in the hall. Which would not be included as a symptom of drug-induced parkinsonism?

Tachycardia

A client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. The nurse observes during a therapy session that the client's behavior includes repetitive movements of the mouth and tongue, facial grimacing, and rocking back and forth. The nurse recognizes these behaviors as indicative of what?

Tardive dyskinesia

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 nurse is caring for a client with schizoaffective disorder with depression. The nurse should instruct the client that the most effective medication therapy for this disorder is:

atypical antipsychotic medications.

A nurse is working with a client that has been diagnosed with delusional thoughts. Which is an initial short-term outcome appropriate for this client?

engage in reality oriented conversation

A client diagnosed with schizophrenia is in anticholinergic crisis. The nurse would expect which finding to be noted upon assessment?

facial flushing

The nurse is caring for a client who was diagnosed with schizoaffective disorder two years ago. Which of the following assessments should the nurse prioritize?

suicide.