EAQ Ch 12, Schizophrenia and Schizophrenia Spectrum Disorders

3 (The patient's comment indicates delusional thinking, which is a positive symptom of schizophrenia. Anosognosia refers to an inability to realize an illness exists. Affective blunting relates to the patient's outward expression of emotion. Negative symptoms include social isolation, anergia, lack of motivation, blunted affect, and inattention to personal hygiene.)

A nurse assesses a patient diagnosed with schizophrenia who states, "Aliens are trying to inject me with their DNA." The nurse documents the patient's comment and applies which term? 1 Anosognosia 2 Affective blunting 3 Positive symptoms 4 Negative symptoms

d1, 4 (The nurse should advise the family of the patient to join support groups such as National Alliance on Mental Illness and other local support groups. These groups would help to provide optimal patient care as well as support to the family. Adherence to the treatment plan would result in positive outcomes for the patient. The patient's family must be educated about the possible side effects of the prescribed drugs. This would help in effective monitoring and reducing panic in the patient and family members. The patient should be encouraged to interact with others. Keeping the patient isolated can make the patient either aggressive or withdrawn. The medications should not be stopped immediately after the symptoms are relieved as it could cause relapse of the schizophrenic symptoms. Gradually decreasing the dosage of the drug would be useful to prevent a relapse.)

A nurse is educating a patient's family about schizophrenia. What is the most appropriate advice the nurse can give to the patient's family? Select all that apply. 1 The nurse should advise them to keep in touch with support groups. 2 The nurse should avoid mentioning the side effects of the drugs prescribed. 3 The nurse should advise them to keep the patient in an isolated room. 4 The nurse should advise them to adhere to the treatment plan. 5 The nurse should advise them to immediately stop the medication if the patient's symptoms are relieve

2 (Although completing applications, dressing and behaving correctly, and giving and receiving compliments are important, correct self-management of pharmacotherapy takes priority. The patient cannot maintain remission without the appropriate medication.)

A nurse plans a series of psychoeducational groups for persons with schizophrenia. Which topic would take priority? 1 How to complete an application for employment 2 The importance of taking medication correctly 3 Ways to dress and behave when attending community events 4 How to give and receive compliments

3 (The thought processes of the patient with disorganized schizophrenia are severely disordered, and severe perceptual problems are present, making it extremely difficult for the patient to understand what others are saying. All communication should be simple and concrete and may need to be repeated several times.)

A patient diagnosed with disorganized schizophrenia would have greatest difficulty when the nurse 1 Interacts with a neutral attitude 2 Uses concrete language 3 Gives multistep directions 4 Provides nutritional supplements

2 (Antipsychotics block the α2- receptor, which may cause hypotension.The nurse can give advice to the patient to rise slowly from the bed, as the patient may feel dizzy due to reduced blood pressure. The nurse cannot administer the adrenergic agonist, but can report to the healthcare provider if the patient's blood pressure falls down below 80 mm Hg. The nurse should not stop administering the drug as it may worsen the schizophrenic symptoms. The nurse should not advise the patient to avoid fluid intake, because the patient may feel dehydrated and the total pressure exerted on the blood vessels maybe reduced.)

A patient with schizophrenia was prescribed antipsychotics. After daily observation, the nurse finds the patient's blood pressure has decreased. What is the most appropriate action by a nurse before administering the prescribed drug to the patient? 1 The nurse should give an adrenergic agonist to raise the blood pressure. 2 The nurse should tell the patient to rise slowly. 3 The nurse should avoid administering the drug for the day. 4 The nurse should tell the patient to avoid taking fluids.

3 (Antipsychotic medications may cause agranulocytosis, the first manifestation of which may be a sore throat and flulike symptoms.)

A patient, who has been receiving antipsychotic medication for six weeks, tells the nurse that the hallucinations are nearly gone and that concentration has improved. When the patient reports flulike symptoms, including a fever and a very sore throat, the nurse should 1 Suggest that the patient take something for his her fever and get extra rest 2 Advise the health care provider that the patient should be admitted to the hospital 3 Arrange for the patient to have blood drawn for a white blood cell count 4 Consider recommending a change of antipsychotic medication

negative

Are these positive or negative symptoms of schizophrenia? : social isolation, anergia, lack of motivation, blunted affect, and inattention to personal hygiene

1 (Causation is a complicated matter. Schizophrenia most likely occurs as a result of a combination of inherited genetic factors and extreme non-genetic factors (e.g., viral infection, birth injuries, nutritional factors) that can affect the genes governing the brain or directly injure the brain.)

The causation of schizophrenia currently is understood to be 1 A combination of inherited and non-genetic factors 2 Deficient amounts of the neurotransmitter dopamine 3 Excessive amounts of the neurotransmitter serotonin 4 Stress related and ineffective stress management skills

3 (Patients with schizophrenia have delusions of self-importance and state false events related to them, like birds singing songs for them and spreading flowers on their path. The statement that every morning the patient enjoys the humming of birds indicates that the patient has no impaired perception and is able to connect with reality. The statement that every morning the patient's friends wait for him or her is normal. The statement that everyone feels the patient is a burden indicates that the patient feels worthless and has suicidal intentions. It does not indicate schizophrenic symptoms.)

The nurse is performing an assessment of geriatric patients in a community health care center. The nurse reports that one of the patients is schizophrenic. Which statement made by the patient while interacting with the nurse supports the nurse's assessment? 1 "Every morning I enjoy the humming of birds; it relaxes me." 2 "Every day my friends wait for me in front of my gate for our morning walk." 3 "Every day birds sing songs for me and spread flowers on the path where I walk." 4 "Everyone feels as if I am a burden to them; I would like to put an end to their problem."

4 (Hallucinations, especially auditory hallucinations, are the major example of alterations of perception in schizophrenia. They are experienced by as many as 90% of individuals with schizophrenia.)

The type of altered perception most commonly experienced by patients with schizophrenia is 1 Delusions 2 Illusions 3 Tactile hallucinations 4 Auditory hallucinations

2 (People diagnosed with schizophrenia all have at least one psychotic symptom, such as hallucinations, delusional thinking, or disorganized speech. Excessive sleeping, failing grades, and chaotic and dysfunctional relationships do not describe schizophrenia but could be caused by a number of problems.)

Which of the following symptoms would alert a health care provider to a possible diagnosis of schizophrenia in a young adult male? 1 Excessive sleeping with disturbing dreams 2 Hearing voices telling him to hurt his roommate 3 Withdrawal from college because of failing grades 4 Chaotic and dysfunctional relationships with his family and peers

4 (Tardive dyskinesia is not always reversible with discontinuation of the medication and has no proven cure. The side effects in anticholinergic effects, pseudoparkinsonism, and dystonic reaction often appear early in therapy and can be minimized with treatment.)

Which side effect of antipsychotic medication is generally nonreversible? 1 Anticholinergic effects 2 Pseudoparkinsonism 3 Dystonic reaction 4 Tardive dyskinesia

1 (Auditory hallucinations are a common manifestation of paranoid schizophrenia, so their absence is an indicator of medication effectiveness. "My medicine is working fine. I'm not having any problems" and "Sometimes it's hard for me to fall asleep, but I usually sleep all night" are too vague. "I think some of the staff members don't like me. They're mean to me" indicates paranoid thinking.)

Which statement by a person with paranoid schizophrenia most clearly indicates that the antipsychotic medication is effective? 1 "I used to hear scary voices but now I don't hear them anymore." 2 "My medicine is working fine. I'm not having any problems." 3 "Sometimes it's hard for me to fall asleep, but I usually sleep all night." 4 "I think some of the staff members don't like me. They're mean to me."

Anosognosia

___ refers to an inability to realize an illness exists.