Module 5 practice questions

A 56-year-old man is admitted to the inpatient unit after family members report that he seems to be experiencing auditory hallucinations. The man has a history of schizophrenia and has had several previous admissions. Which statement indicates to the nurse that the client is experiencing auditory hallucinations? "I am not the devil! Stop calling me those names!" "Get these horrible snakes out of my room!" "The food on this plate has poison in it, so take it away—I won't eat it." "I did see an alien spaceship last night outside in my yard, and I've felt worse ever since."

"I am not the devil! Stop calling me those names!" The client is responding to messages that he is hearing, which are auditory hallucinations

A client with schizophrenia, paranoid type, is readmitted to the hospital at the insistence of the family. While exploring feelings about the readmission, the client angrily shouts, "You're one of them! Leave me alone!" How should the nurse respond? "I'm not one of them—I'm here to help you." "I can see that you're upset. We can talk more later." our "I can see that you're upset. We can talk more later." family and the staff are trying to help you." "Try not to be afraid. I won't hurt you." "Your family and the staff are trying to help you."

"I can see that you're upset. We can talk more later." our "I can see that you're upset. We can talk more later." family and the staff are trying to help you."

A client with schizophrenia tells the nurse, "There are foreign agents conspiring against me; they're out to get me at every turn." How should the nurse respond? "It must be scary to believe that people are out to trick you at every opportunity." "What's happened to make you believe that these people you call foreign agents are after you?" "Those people you call foreign agents are out to do you in. What else is happening?" "I can understand how frightening your thoughts are to you, but there are not foreign agents out to get you."

"I can understand how frightening your thoughts are to you, but there are not foreign agents out to get you."

While speaking with a client with schizophrenia, the nurse notes that the client keeps interjecting sentences that have nothing to do with the main thoughts being expressed. The client asks whether the nurse understands. What is the best response by the nurse? "Why don't you take a rest? We can talk again later this afternoon." "You aren't making any sense; let's talk about something else." "I'd like to understand what you're saying, but I'm having difficulty following you." "You're so confused; I can't understand what you're saying to me."

"I'd like to understand what you're saying, but I'm having difficulty following you."

Which client statement supports the diagnosis of somatic delusions? "I wear this coat all the time to keep them from x-raying my organs." "The government has assigned a team of assassins to kill me because I know too much." "The president of France and I will be announcing our engagement soon." "My heart stopped beating three days ago, and now my lungs are rotting away."

"My heart stopped beating three days ago, and now my lungs are rotting away."

occupational therapy for the first time. The client doesn't want to go and tells the nurse so. What is the most therapeutic initial response by the nurse? "Tell me what concerns you about going to occupational therapy." "Your primary healthcare provider prescribed it as part of your treatment. You should go." "It's only for an hour, and then you'll be back." "Try it once. If you don't like it, you don't have to go back."

"Tell me what concerns you about going to occupational therapy."

A client with schizophrenia reports having ongoing auditory hallucinations and describes them as "voices telling me that I'm a bad person" to the nurse. What is the best response by the nurse? "Do you believe what the voices are saying?" "What are the voices saying to you?" "Try to ignore the voices." "They're only voices, so just try not to be afraid."

"Try to ignore the voices."

A client with schizophrenia who has auditory hallucinations is withdrawn and apathetic. What should the nurse say to involve this client in an activity? "Would you like to participate in the group walk today?" "You'll get a reward if you go to the gym." "Those voices you hear would like it if you did a little exercise." "There's a positive relationship between exercise and good mental health."

"Would you like to participate in the group walk today?"

A client with a prolonged history of chronic schizophrenia, paranoid type, shows the nurse a small plastic keychain and says that it provides protection from evil forces. The client then quickly hides the keychain, yelling, "Don't take it away from me; it's the only thing that protects me." How should the nurse respond? "You may keep it, because I know it's important to you." "You need to give it to me, because you may hurt yourself." "You're safe without the keychain, because there are no evil forces here." "You'd better put it away, because someone might take it away from you."

"You may keep it, because I know it's important to you."

One evening a nurse finds a client who has been experiencing persecutory delusions trying to get out the door. The client begs, "Please let me go. I trust you. The Mafia is going to kill me tonight." Which response is most therapeutic? "You're frightened. Come with me to your room, and we can talk about it." "Here, I will open the door for you." "Come with me to your room. I'll lock the door and no one will get in to harm you." "The Mafia is in the other room, so they cannot hurt you."

"You're frightened. Come with me to your room, and we can talk about it."

What clinical manifestation best indicates to the nurse that the mental status of a client with the diagnosis of schizophrenia, paranoid type, is improving? Development of insight into the problem Decreased need to use defense mechanisms Ability to function effectively in activities of daily living Absence of mild to moderate anxiety

Ability to function effectively in activities of daily living

The nurse discusses basic neurotransmitter theory with students during their mental health rotation. Education will be deemed successful if students identify that a decrease in gamma-aminobutyric acid (GABA) will result in which outcome? Anxiety Paranoid schizophrenia Dementia of the Alzheimer type Depression

Anxiety

A nurse is preparing a teaching plan to educate a relative of a client with schizophrenia about the early signs of relapse. What signs should the nurse plan to include? Select all that apply. Appearing disheveled Exhibiting indifference to family activities Socializing with peers Staying alone in the house Joining a local church singing group

Appearing disheveled Exhibiting indifference to family activities Staying alone in the house

A healthcare provider prescribes clozapine to a client with schizophrenia. Which parameters should be assessed before initiating the drug? Select all that apply. Potassium levels Prolactin levels Body mass index White blood cell count Absolute neutrophil count

Body mass index White blood cell count Absolute neutrophil count

A nurse is caring for several clients with major thought disorders such as schizophrenia. They are all being treated with neuroleptic drugs. How do these drugs act in the body to promote mental health? By blocking access to dopamine receptors at the postsynaptic receptor site By decreasing serotonin at the postsynaptic receptor site By inhibiting enzymes at the postsynaptic receptor site By increasing dopamine uptake at the postsynaptic receptor site

By blocking access to dopamine receptors at the postsynaptic receptor site

. Which clients with schizophrenia should not be prescribed chlorpromazine? Select all that apply. Clients with prostatic hypertrophy Clients with dynamic ileus Clients with Parkinson disease Clients with glaucoma Clients with severe hypertension

Clients with Parkinson disease Clients with severe hypertension

A client with a history of schizophrenia who responds poorly to medication is now being treated for acute depression. In light of the information elicited from the medication list and laboratory results, what does the nurse advise? Expect to be prescribed only 1 week's supply of fluoxetine at a time. Consume a high-protein diet to offset the risk of anemia while taking clozapine. Come in for weekly blood tests to monitor for drug-induced agranulocytosis. Report incidents of unusual bleeding or easy bruising while taking fluoxetine.

Come in for weekly blood tests to monitor for drug-induced agranulocytosis.

A nurse greets a client who has been experiencing delusions of persecution and auditory hallucinations by saying, "Good evening. How are you?" The client, who has been referring to himself as "the man," answers, "The man is bad." Of what is this an example? Displacement Identification Transference Dissociation

Dissociation Speaking in the third person reflects poor ego boundaries and dissociation from the real self.

A client's parents ask about the treatment of their child who has a recent diagnosis of schizophrenia. Before responding, what should the nurse consider? Family therapy has not been proved effective in the treatment of clients with schizophrenia. Drug therapy, although it does not eliminate the underlying problem, reduces the symptoms of acute schizophrenia. Insight therapy has been proved highly successful in the treatment of clients with schizophrenia. Electroconvulsive therapy is more effective in treating schizophrenia than mood disorders.

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

A client with a history of schizophrenia has recently begun reporting symptoms of depression and is now prescribed a selective serotonin reuptake inhibitor (SSRI). In light of the information in the client's chart, what is the nurse's priority? Requesting a gastrointestinal consult to identify the cause of the client's need for frequent antacids Discussing the stressors that have developed since the client moved in with the sister and brother-in-law Stressing the importance of managing the client's diet while taking the prescribed antidepressant Educating both the client and family on how to identify the early signs of extrapyramidal symptoms

Educating both the client and family on how to identify the early signs of extrapyramidal symptoms

A client with schizophrenia is admitted to an acute care psychiatric unit. Which clinical findings indicate positive signs and symptoms of schizophrenia? Flat affect, decreased spontaneity, asocial behavior Withdrawal, poverty of speech, inattentiveness Hyperactivity, auditory hallucinations, loose associations Hypomania, labile mood swings, episodes of euphoria

Hyperactivity, auditory hallucinations, loose associations

A nurse is caring for a client with a diagnosis of catatonic schizophrenia. What clinical finding does the nurse expect the client to exhibit? Crying Self-mutilation Repetitive activities Immobile posturing

Immobile posturing

A client with schizophrenia, paranoid type, is delusional, withdrawn, and negativistic. What should the nurse plan to do? Explain to the client the benefits of joining a group activity. Mention to the client that the primary healthcare provider has prescribed increased activity. Encourage the client to become involved in group activities. Invite the client to play a game of cards or board game.

Invite the client to play a game of cards or board game. Activities that require limited interpersonal contact are less threatening. Individuals with schizophrenia, paranoid type, usually do not respond to an authoritarian approach, because they do not trust others, particularly those who act in an aggressive manner. Group activities require interaction with other people, which is threatening to individuals with paranoid feelings.

A nurse is conducting a group therapy session. Why is a group setting especially conducive to therapy? It confronts individual members with their shortcomings. It decreases the focus on the individual. It fosters one-on-one personal relationships. It provides a new learning environment.

It provides a new learning environment.

An adult client with schizophrenia is involuntarily admitted to the psychiatric unit. While off the unit for needed testing, the client runs away. Legally, who should the nurse notify immediately? Probate judge Law enforcement officer Client's psychiatrist Client's family

Law enforcement officer

A client with schizophrenia is demonstrating waxy flexibility. Which intervention is the best way to manage the possible outcome of this behavior? Performing passive range-of-motion exercises three times a day for effective joint health Reinforcing appropriate social boundaries through staff role modeling Documenting intake and output each shift to monitor hydration Providing thickened liquids to minimize the risk of aspiration

Performing passive range-of-motion exercises three times a day for effective joint health

Because a severely depressed client has not responded to any of the antidepressant medications, the primary healthcare provider decides to try electroconvulsive therapy (ECT). What should the nurse do before the treatment? Provide emotional support while presenting a simple explanation of the ECT procedure. Limit the client's intake to a light breakfast on the days of the treatment. Give a detailed explanation of what to expect after the procedure. Have the client speak with other clients undergoing ECT.

Provide emotional support while presenting a simple explanation of the ECT procedure.

What should a nurse do when a client with the diagnosis of schizophrenia talks about being controlled by others? React to the feeling tone of the client's delusion. Respond to the verbal content of the client's delusion. Express disbelief about the delusion. Divert the client's attention to unit activities

React to the feeling tone of the client's delusion.

After an automobile collision involving a fatality and a subsequent arrest for speeding, a client has amnesia regarding the events surrounding the accident. Which defense mechanism is being used by the client? Rationalization- is the attempt to mask unacceptable feelings or behaviors by providing excuses and explanation Suppression- is consciously keeping unacceptable feelings and thoughts out of awareness. Projection- is attributing one's own unacceptable feelings and thoughts to others. Repression- coping with overwhelming emotions by blocking awareness or memory of the stressful event.

Repression

A client is on antipsychotic therapy for schizophrenia. During a follow-up visit, the nurse suspects acute akathisia. Which symptoms in the client support the nurse's suspicion? Select all that apply. Restless movement Anxiety Agitation Stooped posture Rigidity

Restless movement Anxiety Agitation

The nurse is facilitating group therapy for clients with the diagnosis of chronic undifferentiated schizophrenia. The nurse begins the first meeting with an introduction of all group participants. What should the nurse do next? Share with the clients the purpose of the meetings and explain the rules of behavior. Have each client express and discuss a concern. Ask the clients what they hope to gain from the meetings. Allow the clients to discuss anything they wish to bring up.

Share with the clients the purpose of the meetings and explain the rules of behavior.

A nurse on a mental health unit administers a variety of antipsychotic medications. The nurse concludes that olanzapine has a distinct advantage over other antipsychotics for what reason? Extrapyramidal symptoms do not occur. Tablets disintegrate immediately in the mouth, preventing tablet "checking." Drug effects last for weeks after administration. Dopamine is increased at receptor sites, decreasing psychotic behavior.

Tablets disintegrate immediately in the mouth, preventing tablet "checking."

A client with paranoid schizophrenia wraps the legs in toilet paper, believing that this will provide protection from deadly germs contaminating the floor. What is the best nursing intervention? Providing the client with antimicrobial soap the client with antimicrobial soap Talking with the client about anxiety that focuses on health Providing the client with antimicrobial soap Limiting the client's access to toilet paper

Talking with the client about anxiety that focuses on health

A client with a dissociative identity disorder is to be discharged after a 2-week hospitalization. What does the nurse, evaluating the effectiveness of the short-term therapy, expect the client to verbalize? The ability to deal openly with feelings The need for long-term outpatient psychotherapy That many of the personalities can be ignored That the personalities serve no protective purpose

The need for long-term outpatient psychotherapy

A nurse, understanding the possible cause of alcohol-induced amnestic disorder, should take into consideration that the client is probably experiencing which imbalance? Thiamine deficiency Riboflavin malabsorption A reduced iron intake An increase in serotonin

Thiamine deficiency

Which drugs are considered typical antipsychotics? Select all that apply. Lurasidone (2nd gen) Chlorpromazine (1st gen) Aripiprazole (2nd gen) Thioridazine (1st gen) Asenapine (2nd gen)

Thioridazine Chlorpromazine

While identifying behaviors commonly exhibited by the client who has a diagnosis of schizophrenia, what can the nurse expect to observe? Withdrawal, regressed behavior, and lack of social skills Disorientation, forgetfulness, and anxiety Slumped posture, pessimistic outlook, and flight of ideas Grandiosity, arrogance, and distractibility

Withdrawal, regressed behavior, and lack of social skills

A patient tells a nurse that the psychotropic medicines are dangerous and refuses to take them. Which intervention should the nurse use FIRST? ask the patient about any previous problems with psychotropic medications. ask the patient if an injection is preferable insist that the patient take medication as prescribed withhold the medication until patient is less suspicious

ask the patient about any previous problems with psychotropic medications.

Nurse Arya assesses for evidence of positive symptoms of schizophrenia in a newly admitted patient. Which of the following symptoms are considered positive? SATA anhedonia (positive) delusions flat affect (positive) hallucinations Loose associations Social withdrawal (positive)

delusions hallucinations Loose associations

Ramsay is diagnosed with schizophrenia. Which of the following nursing interventions would be MOST appropriate? establish a non demanding relationship. encourage involvement in group activities spending more time with Ramsay waiting until Ramsay initiates interaction

establish a non demanding relationship

Which factor is associated with increased risk for the development of schizophrenia? alcoholism adolescent pregnancy overcrowded schools poverty

poverty

A client who has been hospitalized with schizophrenia tells the nurse, "My heart has stopped and my veins have turned to glass!" What should the nurse conclude that the client is experiencing? Somatic delusion Depersonalization Hypochondriasis Echolalia

somatic delusions