Schizophrenia EAQ & Practice Q's

A client tells the nurse, "Brad Pitt is in love with me and often sends me flowers." Which type of delusion does the nurse document for the client based on this statement?

*Eratomanic*

A client with schizophrenia says, "Something is always crawling inside my wrist. Can you please take it out?" Which symptom does this behavior of the client indicate?

*Hallucinations* -Hallucinations are sensory perceptions for which no external stimuli exists -Illusions are misinterpretations for real experiences (Ex.: A man sees a coat hanging in a closet but misinterprets what is seen, he believes it is a bear)

The nurse is conveying the news of a family member's death to a client with schizophrenia. The nurse finds that the client is laughing after listening to the news. What does the nurse infer from the client's behavior?

*Inappropriate effect*

A client with a schizophrenia tells the nurse, "It is very cold. I am cold and bold. The gold has been sold." What intervention should the nurse implement in this situation?

*Seek clarification from the client*

Which therapeutic activity would be most important in helping a patient with residual schizophrenia remain in the workforce?

*Social skills training*

A patient has taken trifluoperazine (Stelazine) 30 mg/day orally for 3 years. The clinic nurse notes that the patient grimaces and constantly smacks both lips. The patient's neck and shoulders twist in a slow, snakelike motion. Which problem would the nurse suspect?

*Tardive dyskinesia*

Which finding in the client in the psychiatric ward enables the nurse to reach the conclusion that the client is in the premorbid phase of schizophrenia?

*The client is very shy and withdrawn*

While taking the blood pressure of a client with schizophrenia, the nurse positions the client's arm outward. After 2 hours, the nurse finds that the client is still sitting in the same position with the arm extended. What does this behavior indicate?

*Wavy flexibility*

Which of the following does the catatonia specifier stupor most likely refer to?

*absence of psychomotor activity*

Parents of a 17-year-old patient diagnosed with schizophrenia ask the nurse what the future will be like for their child. The nurse's answer should be based on knowledge that the usual course of illness is:

*characterized by alternating acute and stable phases*

Which patient would be diagnosed with schizophrenia? One who had experienced delusions, hallucinations, and social-occupational dysfunction:

*for at least 6 months*

Which brain structure abnormalities will the nurse identify as being seen on imaging among people with schizophrenia spectrum disorders?

-Reduced volume in the right anterior insula -Reduced connectivity among various brain regions -Reduce volume and changes in the shape of the hippocampus

Which findings will the nurse observe in a client who has schizophrenia?

-bizarre behavior -disorganized speech -Auditory hallucinations

Which response will the nurse make when trying to help a client with schizophrenia take a shower?

"I'll help you take a shower now. "

Which characteristics will a client with chronic schizophrenia most likely exhibit?

Apathy, flatness

Which initial action should the nurse take for a client with schizophrenia who sits rocking in a corner for long periods and responds to voices with words that the staff cannot understand?

Arrange the clients day to allow for short periods to be spent with the nurse

The nurse notifies the PHCP that a client has developed severe parkinsonian muscle rigidity, very high fever, and tachycardia 3 hours after administration of thioridazine (Mellaril). Which medication is beneficial for the client tin this situation?

Bromocriptine (Parlodel)

For a newly admitted client with schizophrenia, which rationale best supports participation in physical activity group for several days before being assigned to a life skills group?

Client will develop trust before going to a potentially anxiety producing group

Which problem is common for clients with a diagnosis of schizophrenia?

Disordered thinking

Which information will the nurse consider before responding to a clients parents who ask about the treatment of their child who has a recent diagnosis of schizophrenia?

Drug therapy, although it does not eliminate the underlying problem, reduces the symptoms of acute schizophrenia

Which condition in a client who is on antipsychotic therapy requires the administration of Cogentin (benztropine)?

Dystonia

Which action will the nurse take first when managing interpersonal relationships with a client who has schizophrenia?

Establish a one on one relationship and then bring the client into group activities

As the nurse approaches a client who has schizophrenia, he unexpectedly shouts, "get out of here before I hate you! Go away!" Which rationale best explains the clients behavior?

He feels threatened by the nurse

For a client with schizophrenia, which symptoms are classified as negative symptoms?

Lack of energy and anhedonia

Which signs and symptoms will the nurse observe in a client with schizophrenia?

Loosened associations and hallucinations

For clients who have severe psychiatric disorders, which therapeutic alchemist anticipated for the majority of prescribed antipsychotic medication?

Management of hallucinations and delusions

A hostile client with a diagnosis of schizophrenia, says, "the voices are saying that they are going to poison me because I'm bad. "Which type of schizophrenic behavior is the client displayed?

Paranoid

Which defense mechanism is most commonly used by clients who are diagnosed with schizophrenia, undifferentiated type?

Regression

The clients hallucination center on the theme of powerlessness. Which response will the charge nurse give to the primary nurse who tells the client, "you seem to be listening to some thing. Tell me what you hear"?

Remind the nurse that once the content is known, there is no need to focus on the hallucinations, because doing so reinforces them

Which action would the nurse take when a non-violent client suddenly refuses to take the prescribed antipsychotic medication?

Respect the clients decision and document the behavior and all interventions

Which guideline will the nurse consider initially when caring for a client with a diagnosis of schizophrenia who has hallucinations?

The client adamantly believes what is being experienced

A newly admitted patient diagnosed with schizophrenia is hyper vigilant and constantly scans the environment. The patient states, "I saw 2 doctors talking in the hall. They were plotting to kill me" The nurse may correctly assess this behavior as:

an idea of reference

Which intervention should the nurse perform while caring for the client with a psychiatric illness who is reluctant to be with friends and expresses a fear of rejection?

*Encourage verbalization of fears*

Which intervention should the nurse perform while caring for the client with schizophrenia who has an altered thought process and extreme suspiciousness?

*Document suspicious behavior in the client*

A highly suspicious patient tells the nurse, "When I sit in the dayroom I can see other people whispering about me and laughing. It makes me want to punch them." The direction that the nurse should give staff is:

*"Be direct. Do not whisper, laugh, or look sideways at the patient"*

A client with schizophrenia says to the nurse, "A divine voice coming from space is always telling me to go to New York." What is the best response of the nurse in this situation?

*"Even though the voices are real to you, I am unable to hear any voices speaking"*

After assessing a client with a psychiatric illness, the nurse concludes that the client is experiencing paranoia. Which client response is most consistent with paranoia?

*"I won't eat this food I know it's poisoned"*

Which findings will alert the nurse that a client with schizophrenia is experiencing positive symptoms?

Agitated behavior Delusions of Grandeur Auditory hallucinations

Which client behavior would indicate to the nurse that a client with schizophrenia is improving and that the clients plan of care can be updated?

Communicates with others in an organized manner