NSG131 UNIT 2

4 Phases of Schizophrenia?

1. Premorbid 2. Prodromal 3. Active 4. Residual

How many schizophrenics are substance abusers?

50%

Somatic

A delusion that is a fixed, false belief that they have a medical condition

Erotomanic

A delusion where one believes someone is in love with them

Grandiose

A delusion with irrational ideas of one's own worth, talent, knowledge or power

Delusion

A fixed, false belief

A patient with a history of depression who experiences memory lapses and word finding difficulty is diagnosed with pseudodementia. Which of these represents a characteristic of pseudodementia? A. Cognitive impairments are reversible B. Lewy bodies form within the brain tissue C. Psychosis is a prominent feature D. Eventually evolves into Alzheimer disease

A. Cognitive impairments are reversible

The healthcare provider is teaching a patient diagnosed with schizophrenia about the medication clozapine (Clozaril). Which of the following will be included in the teaching? Select all that apply. SATA A. "Remember to make position changes slowly until you get used to the medication." B. "Remember that it's important that you avoid all citrus and citrus juices." C. "You'll need to come in periodically so your lipid profile can be monitored." D. "You should eat a healthy diet with plenty of fruits, vegetables, and fiber." E. "Let us know if you experience symptoms of infection such as fever or fatigue." F. "Call our office if you experience increased thirst and increased urination."

A. "Remember to make position changes slowly until you get used to the medication." C. "You'll need to come in periodically so your lipid profile can be monitored." D. "You should eat a healthy diet with plenty of fruits, vegetables, and fiber." E. "Let us know if you experience symptoms of infection such as fever or fatigue." F. "Call our office if you experience increased thirst and increased urination."

A client tends to be insensitive to others, engages in abusive behaviors and does not have a sense of remorse. Which personality disorder is he likely to have? A. Antisocial B. Histrionic C. Paranoid D. Narcissistic

A. Antisocial

A client is unwilling to go to his church because his ex-girlfriend goes there and he feels that she will laugh if she sees him. Because of this hypersensitivity to a reaction from her, the client remains homebound. The home care nurse develops a plan of care that addresses which personality disorder? A. Avoidant B. Borderline C. Schizotypal D. Obsessive-compulsive

A. Avoidant (The avoidant personality disorder is characterized by social withdrawal and extreme sensitivity to potential rejection. The person retreats to social isolation)

A patient diagnosed with schizophrenia states, "I am the Buddha!" Which type of psychotic symptom is the patient demonstrating? A. Delusion of grandeur B. Delusion of persecution C. Magical thinking D. Religiosity

A. Delusion of grandeur

Brandon, a client on the psychiatric unit, has been diagnosed with schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. Brandon's belief is an example of a: A. Delusion of persecution B. Delusion of reference C. Delusion of control or influence D. Delusion of grandeur

A. Delusion of persecution

How do anti-anxiety medications, such as benzodiazepines, produce a calming effect? A. Depressing the CNS B. Decreasing levels of norepinephrine and serotonin in the brain C. Decreasing levels of dopamine in the brain D. Inhibiting production of the enzyme MAO

A. Depressing the CNS

Which of the following medications have been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease? SATA A. Donepezil (Aricept) B. Rivastigmine (Exelon) C. Risperidone (Risperdal) D. Sertaline (Zoloft) E. Galantamine (Razadyne)

A. Donepezil (Aricept) B. Rivastigmine (Exelon) E. Galantamine (Razadyne)

Recent research on the RAISE approach to treatment of schizophrenia incorporates which of the following elements as important to improving outcomes? SATA A. Early intervention at the first episode of psychosis B. Support for employment and/or educational pursuits C. Rapid high-dose loading with antipsychotic medications D. Court-ordered sanctions for therapy E. Recovery-focused psychotherapy

A. Early intervention at the first episode of psychosis B. Support for employment and/or educational pursuits C. Rapid high-dose loading with antipsychotic medications

A patient diagnosed with dementia often becomes agitated and has angry outbursts. Which of the following interventions will the healthcare provider implement when caring for this patient? SATA A. Ensure the safety of the patient and staff B. Utilize distraction when agitation occurs C. Assist the patient to get involved in unit activities D. Discuss the patient's behavior in a rational manner E. Ignore the patient when agitation occurs F. Move the patient to a quiet environment

A. Ensure the safety of the patient and staff B. Utilize distraction when agitation occurs F. Move the patient to a quiet environment

The healthcare provider is caring for a patient diagnosed with a mild cognitive impairment. Which of these would be the most effective intervention for this patient? A. Frequent reorientation B. Relaxation therapy C. Behavior modification D. Application of soft restraints

A. Frequent reorientation

A patient is prescribed ziprasidone (Geodon) for the treatment of schizophrenia. Which of the following would alert the healthcare provider that the patient is experiencing an adverse effect of the medication? SATA A. Increased temperature B. Rigidity and bradykinesia C. Palpitations and syncope D. Seizure activity E. Pulmonary crackles

A. Increased temperature B. Rigidity and bradykinesia C. Palpitations and syncope E. Pulmonary crackles

Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? A. Overly self-centered and exploitative of others B. Suspicious and mistrustful of others C. Rule conscious and disapproving of change D. Anxious and socially isolated

A. Overly self-centered and exploitative of others

A newly admitted patient is experiencing hallucinations and delusions. The nurse would classify the patient in which subtype? A. Paranoid schizophrenia B. Residual schizophrenia C. Catatonic schizophrenia D. Undifferentiated schizophrenia

A. Paranoid schizophrenia

The healthcare provider is teaching a group of students about the biological basis of schizophrenia. Which of the following will be included in the teaching? SATA A. Prenatal exposure to influenza B. GABAergic interneuron dysregulation C. Increased dopamine levels D. Family history of schizophrenia E. Stimulation of the amygdala F. Decreased norepinephrine levels

A. Prenatal exposure to influenza C. Increased dopamine levels D. Family history of schizophrenia

The nurse observes that a client is pacing, agitated, and presenting aggressive gestures. The client's speech pattern is rapid, and affect is belligerent. Based on these observations, which is the nurse's immediate priority of care? A. Provide safety for the client and other clients on the unit B. Provide the clients on the unit with a sense of comfort and safety C. Assist the staff in caring for the client in a controlled environment D. Offer the client a less stimulating area in which to calm down and gain control

A. Provide safety for the client and other clients on the unit (This option is the only one that addresses the safety needs of the client as well as those of the other clients)

Substance Induced Psychotic Disorder

experiences psychosis within one month of substance intoxication or withdrawal; may be caused by medications intended for therapeutic use

The nurse is conducting a group therapy session. During the session, a client diagnosed with mania consistently disrupts the group's interactions. Which intervention should the nurse initially implement? A. Setting limits on the client's behavior B. Asking the client to leave the group session C. Asking another nurse to escort the client out of the group session D. Telling the client that they will not be able to attend any future group sessions.

A. Setting limits on the client's behavior (Manic clients may be talkative and can dominate group meetings or therapy sessions by their excessive talking. If this occurs, the nurse initially would set limits on the client's behavior. The other options are inappropriate, may agitate the client more, and are threatening)

A teenage girl is diagnosed to have an avoidant personality disorder. Which manifestations support the diagnosis? A. Social withdrawal, inadequacy, sensitivity to rejection and criticism B. Lack of self-esteem, strong dependency needs, and impulsive behavior C. Suspicious, hypervigilance and coldness D. Preoccupation with perfectionism, orderliness, and need for control

A. Social withdrawal, inadequacy, sensitivity to rejection and criticism

The healthcare provider is assessing an elderly patient who is disoriented to time and place. Which additional finding would support a diagnosis of delirium? SATA A. Sudden onset of symptoms B. Attention is impaired C. Slow and progressive course D. Rambling and incoherent speech E. Stable symptoms over time F. Often linked to an identifiable cause

A. Sudden onset of symptoms B. Attention is impaired D. Rambling and incoherent speech F. Often linked to an identifiable cause

A patient is being observed for extrapyramidal symptoms. Which of these symptoms would alert the nurse to the possible onset of this condition? SATA A. Tremors at rest B. Blurred vision C. Facial grimacing D. Inability to concentrate E. Flaccid extremities F. Restlessness

A. Tremors at rest C. Facial grimacing F. Restlessness

The nurse is aware that the following ways in vascular dementia different from Alzheimer's disease is: A. Vascular dementia has more abrupt onset. B. The duration of vascular dementia is usually brief. C. Personality change is common in vascular dementia. D. The inability to perform motor activities occurs in vascular dementia.

A. Vascular dementia has more abrupt onset.

During the administration of a Mini-Mental Status Exam (MMSE), the healthcare provider asks the patient to copy a simple geometric shape. This part of the exam tests which of the following mental functions? A. Visual comprehension and praxis B. Attention and calculation abilities C. Orientation and short-term memory D. Hearing and language skills

A. Visual comprehension and praxis

What is anosognosia?

AKA "lack of insight" a symptom of severe mental illness experienced by some that impairs a person's ability to understand and perceive his or her illness. It is the single largest reason why people with schizophrenia or bipolar disorder refuse medications or do not seek treatment

What is the definition for abnormal motor behaviors?

Abnormal motor behavior or activity displayed by a client with a mental health problem that occurs as a result of a mental health disorder.

Schizotypal Personality Disorder

Acute discomfort in relationships; cognitive or perceptual distortions; eccentric behavior - impairment of personality (self and personal) functioning but not as severe as Schizophrenia

When should schizophrenia be diagnosed?

After 7 years old to rule out ADHD with violent tendencies

Cluster C Personality Disorders

Anxious, fearful, or cautious include avoidant, dependent, obsessive-compulsive

Cluster B Personality Disorders

Appear dramatic, emotional, or erratic (antisocial, borderline, histrionic, narcissistic). Bad

Personality Disorders

Are diagnosed when personality traits become Inflexible or maladaptive and interfere with how one functions in society or cause emotional distress

82-year-old Mr. Robeson together with his daughter arrived to the medical-surgical unit for diagnostic confirmation and management of probable delirium. Which statement by the client's daughter best supports the diagnosis? A. "Maybe it's just caused by aging. This usually happens by age 82." B. "The changes in his behavior came on so quickly! I wasn't sure what was happening." C. "Dad just didn't seem to know what he was doing. He would forget what he had for breakfast." D. "Dad has always been so independent. He's lived alone for years since mom died."

B. "The changes in his behavior came on so quickly! I wasn't sure what was happening."

Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? A. Belittling themselves and their abilities B. A lifelong pattern of social withdrawal C. Suspicious and mistrustful of others D. Overreacting inappropriately to minor stimuli

B. A lifelong pattern of social withdrawal

"Splitting" by the client with BPD denotes: A. Evidence of precocious development B. A primitive defense mechanism in which the client sees objects as all good or all bad C. A brief psychotic episode in which the client loses contact with reality D. Two distinct personalities within the borderline client.

B. A primitive defense mechanism in which the client sees objects as all good or all bad

The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in mid-sentence, and listens intently. The nurse recognizes from these behaviors as a symptom of the client's illness. The most appropriate nursing intervention for this symptom is to: A. Ask the client to describe his physical symptoms B. Ask the client to describe what he is hearing C. Administer a dose of benztropine D. Call the physician for additional orders.

B. Ask the client to describe what he is hearing

The nurse is caring for a client diagnosed with paranoid personality disorder who is experiencing disturbed thought processes. In formulating a nursing plan of care, which best intervention should the nurse include? A. Increase socialization of the client with peers. B. Avoid using a whisper voice in front of the client C. Begin to educate the client about social supports in the community. D. Have the client sign a release of information to appropriate parties for assessment purposes

B. Avoid using a whisper voice in front of the client (The client is distrustful and suspicious of others. The members of the health care team needs to establish a rapport and trust with the client. Laughing or whispering in front of the client would be counterproductive)

The nurse would be correct in associating paranoid symptoms to increase in which neurotransmitter? A. Prostaglandin B. Dopamine C. Norepinephrine D. Serotonin

B. Dopamine (Delusional or paranoid symptoms are associated with increased dopamine activity. Norepinephrine is associated with positive schizophrenic symptoms.)

Milieu therapy is a good choice for clients with antisocial personality disorder because it: A. Provides a system of punishment and rewards for. behavior modification B. Emulates a social community in which the client may learn to live harmoniously with others C. Provides mostly one-to-one interaction between the client and therapist D. Provides a very structured setting in which the clients have very little input into the planning on their care.

B. Emulates a social community in which the client may learn to live harmoniously with others

Josh, age 21, has been diagnosed with schizophrenia. He has been socially isolated and hearing voices telling him to kill his parents. He has been admitted to the psychiatric unit from the emergency department. The initial nursing intervention for Josh is to: A. Give him an injection of Thorazine B. Ensure a safe environment for him and others C. Place him in restraints D. Order him a nutritious diet.

B. Ensure a safe environment for him and others

The plan of care for clients with borderline personality should include: A. Restricting her from other clients B. Ensuring she adheres to certain restrictions C. Limit setting and flexibility in schedule D. Giving medications to prevent acting out

B. Ensuring she adheres to certain restrictions

Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The primary nursing intervention in working with Mrs. G. is which of the following? A. Ensuring that she receives food she likes to prevent hunger B. Ensuring that the environment is safe to prevent injury C. Ensuring that she meets the other patients to prevent social isolation D. Ensuring that she takes care of her own ADLs to prevent dependence.

B. Ensuring that the environment is safe to prevent injury

A patient is prescribed haloperidol (Haldol) for the management of schizophrenia. Before administering the medication to the patient, the healthcare provider observes facial grimacing and tongue thrusting. Which of the following interventions should the healthcare provider perform first? A. Perform a mental status exam and document the findings B. Hold the medication and continue to assess the patient C. Administer the prescribed benztropine (Cogentin) D. Send a blood sample to the lab to measure the haloperidol level

B. Hold the medication and continue to assess the patient

A patient is admitted to the mental health unit with a diagnosis of vascular dementia. Which of the following describes the brain alteration involved in this disorder? A. Formation of beta-amyloid plaques B. Hypoxic damage to brain tissue C. Enlargement of the ventricles D. Decreased choline acetyltransferase

B. Hypoxic damage to brain tissue

Edward, a 66-year-old client with slight memory impairment and poor concentration, is diagnosed with primary degenerative dementia of the Alzheimer's type. Early signs of this dementia include subtle personality changes and withdrawal from social interactions. To assess for progression to the middle stage of Alzheimer's disease, the nurse should observe the client for: A. Occasional irritable outbursts. B. Impaired communication. C. Lack of spontaneity. D. Inability to perform self-care activities.

B. Impaired communication.

Nurse Pauline is aware that Dementia, unlike delirium, is characterized by: A. Slurred speech B. Insidious onset C. Clouding of consciousness D. Sensory perceptual change

B. Insidious onset (Dementia has a gradual onset and progressive deterioration. It causes pronounced memory and cognitive disturbances. A, C, and D: These are all characteristics of delirium.)

A teenage girl is diagnosed to have a borderline personality disorder. Which manifestations support the diagnosis? A. Social withdrawal, inadequacy, sensitivity to rejection and criticism B. Lack of self-esteem, strong dependency needs, and impulsive behavior C. Suspicious, hypervigilance and coldness D. Preoccupation with perfectionism, orderliness, and need for control

B. Lack of self-esteem, strong dependency needs, and impulsive behavior

The nurse is caring for a client just admitted to the mental health unit and diagnosed with catatonic stupor. The client is lying on the bed in the fetal position. Which is the most appropriate nursing intervention? A. Ask direct questions to encourage talking B. Leave the client alone so as to minimize external stimuli C. Sit beside the client in silence with simple open-ended questions D. Take the client into the dayroom with other clients to provide stimulation.

B. Leave the client alone so as to minimize external stimuli (Clients who are withdrawn may be immobile and mute and may require consistent, repeated approaches.)

A patient with a history of schizophrenia is brought to the emergency department. The patient is agitated and demonstrates generalized muscle rigidity. Temperature, heart rate, and respiratory rate are elevated. These assessment findings are consistent with which of the following adverse effects of antipsychotic medications? A. Tardive dyskinesia B. Neuroleptic malignant syndrome C. Parkinsonism D. Serotonin syndrome

B. Neuroleptic malignant syndrome

Which of the following, if assessed in a patient, will the healthcare provider identify as a risk factor for the development of delirium? SATA A. Decreased social interactions B. Organ failure C. Administration of opioids D. Decreased physical activity E. Sleep deprivation F. Infections

B. Organ failure C. Administration of opioids E. Sleep deprivation F. Infections

A 65 years old client is in the first stage of Alzheimer's disease. Nurse Patricia should plan to focus this client's care on: A. Offering nourishing finger foods to help maintain the client's nutritional status. B. Providing emotional support and individual counseling. C. Monitoring the client to prevent minor illnesses from turning into major problems. D. Suggesting new activities for the client and family to do together.

B. Providing emotional support and individual counseling. (Clients in the first stage of Alzheimer's disease are aware that something is happening to them and may become overwhelmed and frightened. Therefore, nursing care typically focuses on providing emotional support and individual counseling. A, C, and D: The other options are appropriate during the second stage of Alzheimer's disease when the client needs continuous monitoring to prevent minor illnesses from progressing into major problems and when maintaining adequate nutrition may become a challenge.)

Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer's type? A. Remembering the daily schedule B. Recalling past events C. Coping the anxiety D. Solving problems of daily living

B. Recalling past events

A client diagnosed with delirium becomes disoriented and confused at night. Which intervention should the nurse implement initially? A. Move the client next to the nurses' station B. Use an indirect light source and turn off the television C. Keep the television and a soft light on during the night D. Play soft music during the night and maintain a well-lit room.

B. Use an indirect light source and turn off the television (Provision of a consistent daily routine and a low stimulating environment is important when a client is disoriented. Noise including the television may add to the confusion and disorientation)

The nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be most appropriate for this client/ A. Chess B. Writing C. Board games D. Group exercise

B. Writing (Solitary activities that require a short attention span with mild physical exertion are the most appropriate for a client who is exhibiting aggressive behavior.)

Which of the following are negative symptoms of schizophrenia? A. apathy and delusion B. lack of motivation, blunted affect, and apathy C. bizarre behavior and delusions D. asociality, anhedonia, and periodic excitability

B. lack of motivation, blunted affect, and apathy

Cluster A Personality Disorders

Behavior is odd or eccentric (paranoid, schizoid, schizotypal).

Therapeutic effect for medications prescribed for schizophrenia? (TYPICAL)

Blocks dopamine receptors First generation/conventional Effective for positive symptoms

A client says to the nurse, "The federal guards were sent to kill me." Which is the best response by the nurse to the client's concern? A. "I don't believe this is true." B. "The guards are not out to kill you." C. "Do you feel afraid that people are trying to hurt you?" D. "What makes you think the guards were sent to hurt you?"

C. "Do you feel afraid that people are trying to hurt you?" (It is most therapeutic for the nurse to empathize with the client's experience.)

The nurse is preparing a client with schizophrenia a history of command hallucinations for discharge by providing instructions on interventions for managing hallucinations and anxiety. Which statement in response to these instructions suggests to the nurse that the client has a need for additional information? A. "My medications will help my anxious feelings." B. "I'll go to support group and talk about what I am feeling." C. "When I have command hallucinations, I'll call a friend for help." D. "I need to get enough sleep and eat well to prevent feeling anxious."

C. "When I have command hallucinations, I'll call a friend for help." (The risk for impulsive and aggressive behavior may increase if a client is receiving command hallucinations to harm self or others. If the client is experiencing a hallucination to harm self or others, the nurse of health care counselor, not a friend, should be contacted.)

A patient diagnosed with Alzheimer disease (AD) is admitted to a long-term care facility. Which of the following assessment findings will the healthcare provider anticipate? SATA A. Apathy B. Anhedonia C. Amnesia D. Agnosia E. Aphasia

C. Amnesia D. Agnosia E. Aphasia

A client recently admitted to the hospital reports to the nurse, "I don't understand why I was brought here. I was simply hanging out in my apartment and the police said I had to come with them." This is an example of what symptoms of schizophrenia? A. Delusions of reference B. Loose association C. Anosognosia D. Auditory hallucinations

C. Anosognosia

Characteristics of the Premorbid phase?

No clear evidence of illness yet S/s are starting to occur May have distinct personality traits or behaviors such as 1. shy and withdrawn 2. poor peer relationships 3. doing poorly in school 4. demonstrating antisocial behavior

Which of the following interventions is most appropriate in helping a client with Alzheimer's disease with her ADLs? SATA A. Perform ADLs for her while she is in the hospital B. Provide her with a written list of activities she is expected to perform C. Assist her with step-by-step instructions D. Tell her that if her morning care is not completed by 9 a.m., it will be performed fro her by the nurse's aide so that she can attend group therapy. E. Encourage her and give her plenty of time to perform independently as many of her ADLs as possible.

C. Assist her with step-by-step instructions E. Encourage her and give her plenty of time to perform independently as many of her ADLs as possible.

The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in mid-sentence, and listens intently. The nurse recognizes from these signs that the client is likely experiencing: A. Somatic delusion B. Catatonic stupor C. Auditory hallucinations D. Pseudoparkinsonism

C. Auditory hallucinations

A hospitalized client, diagnosed with a borderline personality disorder, consistently breaks the unit's rules. This behavior should be confronted because it will help the client: A. Set realistic goals B. Control anger C. Become more self-aware D. Reduce anxiety

C. Become more self-aware

A newly admitted patient can't take care of his personal needs, shows insensitivity to painful stimuli, and exhibits negativism. The nurse would classify the patient in which subtype? A. Paranoid schizophrenia B. Residual schizophrenia C. Catatonic schizophrenia D. Undifferentiated schizophrenia

C. Catatonic schizophrenia

A client is admitted to a medical nursing unit with a diagnosis of acute blindness after being involved in a hit-and-run accident. When diagnostic testing cannot identify any organic reason why this client cannot see, a mental health consult is prescribed. The nurse plans care based on which mental health condition? A. Psychosis B. Repression C. Conversion disorder D. Dissociative disorder

C. Conversion disorder (A conversion disorder is the alteration or loss of a physical function that cannot be explained by any known pathophysiological mechanism. In this situation, the client witnessed an accident that was so psychologically painful that the client became blind.)

The statement made by Steve "My co-workers envy me and are out to take me down. I swear they have hidden cameras everywhere I go!" would be documented as: A. Magical thinking B. Hallucinations C. Delusions D. Normal finding, and would warrant police investigation.

C. Delusions

A patient is diagnosed with schizoid personality disorder. When interviewing the patient, the healthcare provider would most likely observe which of the following behaviors? A. Disregard for violating the rights of others B. Distrust or suspiciousness of others' motives C. Detachment from social relationships D. Excessive attention seeking

C. Detachment from social relationships

Loretta, a newly admitted client was diagnosed with delirium and has a history of hypertension and anxiety. She had been taking digoxin, furosemide (Lasix), and diazepam (Valium) for anxiety. This client's impairment may be related to which of the following conditions? A. Infection B. Metabolic acidosis C. Drug intoxication D. Hepatic encephalopathy

C. Drug intoxication

A patient diagnosed with Alzheimer disease (AD) is demonstrating signs of impaired reasoning. The healthcare provider suspects an alteration in which area of the brain? A. Hippocampus B. Amygdala C. Frontal Lobe D. Occipital Lobe

C. Frontal Lobe

Stupor

No psychomotor activity; not actively related to the environment

In evaluating the progress of Jack, a client diagnosed with antisocial personality disorder, which of the following behaviors would be considered the most significant indication of positive change? A. Jack got angry only once in group this week B. Jack was able to wait a whole hour for a cigarette without verbally abusing the staff C. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight. D. Jack stated that he would no longer start any more fights.

C. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight.

Nurse Isabelle enters the room of a client with a cognitive impairment disorder and asks what day of the week it is; what the date, month, and year are; and where the client is. The nurse is attempting to assess: A. Confabulation B. Delirium C. Orientation D. Perseveration

C. Orientation

The following are atypical antipsychotics, except: A. Olanzapine B. Seroquel C. Prolixin D. Risperidone

C. Prolixin

Which of the following is not included in the care of plan of a client with a moderate cognitive impairment involving dementia of the Alzheimer's type? A. Daily structured schedule B. Positive reinforcement for performing activities of daily living C. Stimulating environment D. Use of validation techniques

C. Stimulating environment (Stimulating environment is a source of confusion and anxiety for a client with a moderate level of impairment and, therefore, would not be included in the POC)

In clients with a cognitive impairment disorder, the phenomenon of increased confusion in the early evening hours is called: A. Aphasia B. Agnosia C. Sundowning D. Confabulation

C. Sundowning

The children of a patient diagnosed with Alzheimer disease (AD) tell the healthcare provider, "Our mother seems better during the day, but she gets very confused and agitated in the late afternoon and evenings." How should the healthcare provider document the patient's behavior? A. Depression B. Delirium C. Sundowning D. Psychosis

C. Sundowning

A teenage girl is diagnosed to have paranoid personality disorder. Which manifestations support the diagnosis? A. Social withdrawal, inadequacy, sensitivity to rejection and criticism B. Lack of self-esteem, strong dependency needs, and impulsive behavior C. Suspicious, hypervigilance and coldness D. Preoccupation with perfectionism, orderliness, and need for control

C. Suspicious, hypervigilance and coldness

Which goal is a priority for a client with a DSM-IV TR diagnosis of delirium and the nursing diagnosis Acute confusion related to recent surgery secondary to traumatic hip fracture? A. The client will complete activities of daily living. B. The client will maintain safety. C. The client will remain oriented. D. The client will understand communication.

C. The client will remain oriented.

The nursing is caring for a client with schizophrenia. Orders from the physician include 100 mg chlorpromazine IM STAT and then 50 mg PO bid; 2 mg benztropine PO bid prn. Why is the chlorpromazine ordered? A. To reduce extrapyramidal symptoms B. To prevent neuroleptic malignant syndrome C. To decrease psychotic symptoms D. To induce sleep

C. To decrease psychotic symptoms

When reviewing the medical record of a patient diagnosed with Alzheimer disease (AD), the healthcare provider notes the patient is aphasic. Which behavior supports this finding? A. Difficultly swallowing B. Unable to recognize objects C. Unable to speak D. Difficulty with motor function

C. Unable to speak

Mrs. Jordan is an elderly client diagnosed with Alzheimer's disease. She becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to: A. tell the client firmly that it is time to get dressed. B. obtain assistance to restrain the client for safety. C. remain calm and talk quietly to the client. D. call the doctor and request an order for sedation

C. remain calm and talk quietly to the client.

Negativism

opposition or no response to instructions or external stimuli

Antisocial Personality Disorder

Characterized by a pervasive pattern of disregard for and violation of rights of others

Borderline Personality Disorder

Characterized by a pervasive pattern of unstable interpersonal relationships, self-image, and affect and marked impulsivity, high-risk for self-mutilation.

Characteristics of the Prodromal phase?

Characterized by clear decline from previous level of functioning. Lasts until onset of frank psychotic symptoms. Average length is 2 to 5 years Social withdrawn, cognitive impairment, and some adolescent clients develop sudden onset of OC behavior.

Circumstantiality

Client doesn't reach their point, constantly gets caught up in irrelevant details

Treatment options for the prodromal phase?

Cognitive therapy (to minimize functional impairment) Family interventions (to improve coping) School involvement (to reduce possibility of failure) Medication recommended at first psychotic episode

Characteristics of Active phase?

Commonly triggered by a stressful event Characterized by presence of acute psychotic symptoms (e.g. hallucinations, delusions, incoherence, and catatonic behaviors). Prognosis worsens with each acute episode. (Delusions, Hallucinations, Disorganized speech, very disorganized or catatonic behaviors)

What is the therapeutic effect of the medications prescribed for delirium?

Control agitation, aggression, hallucinations, and thought disturbances

Catalepsy

passive induction of a posture held against gravity

Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The cause of this disorder is which of the following? A) Multiple small brain infarcts B) Chronic alcohol abuse C) Cerebral abscess D) Unknown

D) Unknown

Brandon, a client on the psychiatric unit, has been diagnosed with schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. The most appropriate response by the nurse is: A. "That's ridiculous, Brandon. No one is going to hurt you." B. "The CIA isn't interested in people like you, Brandon" C. "Why do you think the CIA wants to kill you?" D. "I know you believe that, Brandon, but it's really hard for me to believe."

D. "I know you believe that, Brandon, but it's really hard for me to believe."

A patient diagnosed with schizoid personality disorder asks the healthcare provider, "Does this mean I'll eventually develop schizophrenia?" Which of the following responses is most appropriate? A. "Tell me how you would feel if you were diagnosed with schizophrenia." B. "You should not worry about the possibility of a future diagnosis of schizophrenia." C. "If you develop schizophrenia there are many medications that can help you." D. "Not everyone diagnosed with schizoid personality disorder develops schizophrenia."

D. "Not everyone diagnosed with schizoid personality disorder develops schizophrenia."

A nurse is caring for a client who is cognitively impaired. Which of the following rooms will provide a therapeutic environment for this client? A. A room adjacent to the nursing station B. A room with puzzles and games C. A room with bright sunlight D. A room containing personal belongings

D. A room containing personal belongings

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention? A. Encouraging quiet reading and writing for the first few days. B. Identification of physical activities that will provide exercise C. No socializing activities until the client asks to participate in milieu D. A structured program of activities in which the client can participate.

D. A structured program of activities in which the client can participate.

A patient diagnosed with dementia is prescribed a medication that inhibits acetylcholinesterase. Which of the following accurately explains how this medication benefits the patient? A. Acetylcholine increases norepinephrine activity and decreases depression B. Inhibition of acetylcholinesterase improves the patient's motor function C. Decreased levels of acetylcholine will help decrease the patient's anxiety D. Acetylcholine is needed for memory and problem solving

D. Acetylcholine is needed for memory and problem solving

Which of the following factors is NOT associated with increased incidence of NCD due to Alzheimer's disease? A. Multiple small strokes B. Family history of Alzheimer's disease C. Head trauma D. Advanced age

D. Advanced age

When assessing a patient diagnosed with schizophrenia, which of the following will the healthcare provider identify as a negative symptom? A. Hallucinations B. Disorganized speech C. Delusions D. Anhedonia

D. Anhedonia

When talking with a patient diagnosed with schizophrenia, the healthcare provider notes the patient continually states, "I'm the man with a plan, yes I am." The healthcare provider will document this behavior as which of the following? A. Loosening of association B. Word salad C. Tangentiality D. Clang associations

D. Clang associations

Nurse Kate would expect that a client with vascular dementia would experience: A. Loss of remote memory related to anoxia. B. Loss of abstract thinking related to emotional state. C. Inability to concentrate related to decreased stimuli. D. Disturbance in recalling recent events related to cerebral hypoxia.

D. Disturbance in recalling recent events related to cerebral hypoxia.

When planning care for a patient diagnosed with Alzheimer disease (AD), which of these interventions is most therapeutic? A. Speaking in a loud, clear voice when talking to the client B. Providing immediate feedback by correcting errors in the client's speech C. Giving the patient several directions at a time to improve memory D. Encouraging both verbal and nonverbal communication

D. Encouraging both verbal and nonverbal communication

Mrs. Mendoza is a 75-year-old client who has dementia of the Alzheimer's type and confabulates. The nurse understands that this client: A. Denies confusion by being jovial B. Pretends to be someone else C. Rationalizes various behaviors D. Fills in memory gaps with fantasy

D. Fills in memory gaps with fantasy

A patient diagnosed with delirium sees the intravenous (IV) tubing and believes it to be a snake. How should the healthcare provider document this behavior? A. Hallucination B. Delusion C. Confusion D. Illusion

D. Illusion

Nurse Josefina is caring for a client who has been diagnosed with delirium. Which statement about delirium is true? A. It's characterized by an acute onset and lasts about 1 month. B. It's characterized by a slowly evolving onset and lasts about 1 week. C. It's characterized by a slowly evolving onset and lasts about 1 month. D. It's characterized by an acute onset and lasts hours to a number of days.

D. It's characterized by an acute onset and lasts hours to a number of days.

Schizophrenia affects?

thinking, behavior, emotions, and the ability to perceive reality

A student nurse was asked which of the following best describes dementia. Which of the following best describes the condition? A. Memory loss occurring as part of the natural consequence of aging B. Difficulty coping with physical and psychological change C. Severe cognitive impairment that occurs rapidly D. Loss of cognitive abilities, impairing ability to perform activities of daily living

D. Loss of cognitive abilities, impairing ability to perform activities of daily living

Clients with personality disorders have difficulties in their social and occupational functions. Clients with a personality disorder will most likely: A. Respond to antianxiety medication B. Recover with therapeutic intervention C. Seek treatment willingly from some personally distressing symptoms D. Manifest enduring patterns of inflexible behaviors

D. Manifest enduring patterns of inflexible behaviors

A teenage girl is diagnosed to have obsessive-compulsive personality disorder. Which manifestations support the diagnosis? A. Social withdrawal, inadequacy, sensitivity to rejection and criticism B. Lack of self-esteem, strong dependency needs, and impulsive behavior C. Suspicious, hypervigilance and coldness D. Preoccupation with perfectionism, orderliness, and need for control

D. Preoccupation with perfectionism, orderliness, and need for control

A family member expresses concern to a nurse about behavioral changes in an elderly aunt. Which would cause the nurse to suspect a cognitive impairment disorder? A. Decreased interest in activities that she once enjoyed B. Fearfulness of being alone at night C. Increased complaints of physical ailments D. Problems with preparing a meal or balancing her checkbook

D. Problems with preparing a meal or balancing her checkbook (Making a meal and balancing a checkbook are higher level cognitive functions that, when unable to be performed, may signal onset of a cognitive disorder. Although the remaining behaviors may occur, they are not associated only with cognitive impairment and may indicate depression or other problems.)

Which of the following will Nurse Dory use when communicating with a client who has cognitive impairment. A. Complete explanations with multiple details B. Pictures or gestures instead of words C. Stimulating words and phrases to capture the client's attention D. Short words and simple sentences

D. Short words and simple sentences

Jessica is a nurse who was floated to the psychiatric unit to cover for a staff nurse who called out sick. She encounters a patient diagnosed with BPD, and the patient states, "Thank goodness they sent you to the unit. No one else here has taken the time to listen to my concerns." This may be an example of which symptom common in BPD? A. Impulsivity B. Self-harming behaviors C. Dissociation D. Splitting

D. Splitting

The nursing is caring for a client with schizophrenia. Orders from the physician include 100 mg chlorpromazine IM STAT and then 50 mg PO bid; 2 mg benztropine PO bid prn. Because benzotropine was ordered on a prn basis, which of the following assessments by the nurse would convey the need for this medication? A. The client's level of agitation increases B. The client complains of a sore throat C. The client's skin has a yellowish cast D. The client develops muscle spasms.

D. The client develops muscle spasms.

Nurse Ron enters a client's room, the client says, "They're crawling on my sheets! Get them off my bed!" Which of the following assessment is the most accurate? A. The client is experiencing aphasia. B. The client is experiencing dysarthria. C. The client is experiencing a flight of ideas. D. The client is experiencing visual hallucination

D. The client is experiencing visual hallucination

Which of the following descriptions of a client's experience and behavior can be assessed as an illusion? A. The client tries to hit the nurse when vital signs must be taken. B. The client says, "I keep hearing a voice telling me to run away." C. The client becomes anxious whenever the nurse leaves the bedside. D. The client looks at the shadow on a wall and tells the nurse she sees frightening faces on the wall.

D. The client looks at the shadow on a wall and tells the nurse she sees frightening faces on the wall.

Which of the following outcome criteria is appropriate for the client with dementia? A. The client will return to an adequate level of self-functioning. B. The client will learn new coping mechanisms to handle anxiety. C. The client will seek out resources in the community for support. D. The client will follow an established schedule for activities of daily living.

D. The client will follow an established schedule for activities of daily living. (Following established activity schedules is a realistic expectation for clients with dementia. All of the remaining outcome statements require a higher level of cognitive ability that can be realistically expected of clients with this disorder.)

A newly admitted patient is experiencing grossly disorganized behavior and prominent hallucinations. The nurse would classify the patient in which subtype? A. Paranoid schizophrenia B. Residual schizophrenia C. Catatonic schizophrenia D. Undifferentiated schizophrenia

D. Undifferentiated schizophrenia

During the home visit of a client with dementia, the nurse notes that an adult daughter persistently corrects her father's misperceptions of reality, even when father becomes upset and anxious. Which intervention should the nurse teach the caregiver? A. Anxiety-reducing measures B. Positive reinforcement C. Reality orientation techniques D. Validation techniques

D. Validation techniques

Alogia

Decreased verbal communication

Schizoid Personality Disorder

Detached from social relationships; restricted affect; involved more with things than people.

What are the examples of medications prescribed for dementia/AD?

Donepezil, Memantine, and Lorezapam

Types of abnormal motor behaviors in schizophrenia (3)

Echolalia Echopraxia Waxy flexibility

What is the therapeutic effect of the medications prescribed for dementia/AD?

Enhance and treat cognitive symptoms, slow progression of disease. DOES NOT CURE

Histrionic Personality Disorder

Excessive emotionality and attention-seeking

Paranoia

Extreme suspiciousness of others

Mr. Lim who is diagnosed of moderate dementia has frequent catastrophic reactions during shower time. Which of the following interventions should be implemented in the plan of care? A. Assign consistent staff members to assist the client. B. Accomplish the task quickly, with several staff members assisting. C. Schedule the client's shower at the same time of day. D. Sedate the client 30 minutes prior to showering. E. Tell the client to remain calm while showering. F. Use a calm, supportive, quiet manner when assisting the client.

F. Use a calm, supportive, quiet manner when assisting the client.

What is grandeur?

False belief that one is a powerful and important person

What is jealously?

False belief that one's partner or mate is going out with other persons

Types of delusions? (3)

Grandeur Jealously Persecution

Narcissistic Personality Disorder

Grandiose; lack of empathy; need for admiration.

What are examples of medications prescribed for delirium?

Haldol and Olanzapine

What is Waxy flexbility?

Having one's arms or legs placed in a certain position and holding that same position for hours.

Schizophreniform Disorder

Identical to schizophrenia but lasts less than 6 months

Echopraxia

Imitating movements made by others

Apathy

Indifference to or disinterest in the environment

Paranoid Personality Disorder

Mistrust and suspicion of others; guarded, restricted affect.

Auditory

Most common type of hallucination in schizophrenia

Mannerism

Odd, circumstantial caricature of normal activities

Obsessive-Compulsive Personality Disorder

Preoccupation with orderliness, perfectionism, and control

What is echopraxia?

Repeating the movements of another person

Persecutory

The most common type of delusion Being plotted against, cheated on

Psychosis

Severe; disorganization of personality; poor social functioning; impaired perception of reality

waxy flexibility

Slight, even resistance to positioning by examiner

Avoidant Personality Disorder

Social inhibitions; feelings of inadequacy; hypersensitivity to negative evaluation

Dependent Personality Disorder

Submissive and clinging behavior; excessive need to be taken care of

What is persecution?

Thought that one is being singled out for harm by others

Therapeutic effect for medications prescribed for schizophrenia? (ATYPICAL)

Weaker dopamine antagonist, strong serotonin Effective for positive and negative symptoms Often 1st line of choice

What is schizophrenia?

a group of severe disabling psychiatric disorders marked by withdrawal from reality, illogical thinking, possible delusions, hallucinations, and other emotional, behavioral, or intellectual disturbances

A home health nurse is reinforcing coping strategies with the family caregiver of a client who has Alzheimer's disease. Which of the following information should the nurse include in the teaching? SATA a. Actions to reduce stress b. Identification of a social support system c. Referral to available community recourses d. Instructions on client medication administration e. Expected physiological changes of the disease

a. Actions to reduce stress b. Identification of a social support system c. Referral to available community recourses e. Expected physiological changes of the disease (Instructions on client medication administration is important but it is not a coping mechanism)

Which of the following is a concern with children on long-term therapy with CNS stimulants for ADHD? a. Addiction b. Weight gain c. Substance abuse d. Growth suppression

a. Addiction

Jack is a new client on the psychiatric unit with a diagnosis of Antisocial Personality Disorder. Which of the following characteristics would you expect to assess in Jack? a. Lack of guilt for wrongdoing b. Insight into his own behavior c. Ability to learn from past experiences d. Compliance with authority

a. Lack of guilt for wrongdoing

A nurse is admitting an older adult who has a suspected cognitive disorder. Which of the following interventions should be included in the admission assessment? a. Mental Status Examination (MSE) b. Patient Health Questionnaire (PHQ) c. Brain Reduction Memory Scale (BRMS) d. Glasgow Coma Scale (GCS)

a. Mental Status Examination (MSE)

Part of the nurse's continual assessment of the client taking antipsychotic medications is to observe for extrapyramidal symptoms. Examples include which of the following? a. Muscular weakness, rigidity, tremors, facial spasms b. Dry mouth, blurred vision, urinary retention, orthostatic hypotension c. Amenorrhea, gynecomastia, retrograde ejaculation d. Elevated blood pressure, severe occipital headache, stiff neck

a. Muscular weakness, rigidity, tremors, facial spasms

In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? Select all that apply. a. Personality b. Vision c. Speech d. Hearing e. Mobility

a. Personality c. Speech e. Mobility

Kim, a client diagnosed with Borderline Personality Disorder, manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline client except a. refusal to stay in room alone, stating, "It's so lonely." b. asking Nurse Jones for cigarettes after 30 minutes, knowing the assigned nurse has explained she must wait 1 hour. c. stating to Nurse Jones, "I really like having you for my nurse. You're the best one around here." d. cutting arms with razor blade after discussing dismissal plans with physician.

a. refusal to stay in room alone, stating, "It's so lonely."

Clinical Description: Schizophrenia must last...

at least 6 months, at least 1 month of which includes active phase symptoms, the active phase symptoms must include at least 2 of the followingdelusions, hallucinations, disorganized speech, disorganized or catatonic behavior, negative symptoms

Mrs. G, who has NCD due to Alzheimer's disease, says to a nurse, "I have a date tonight. I always have a date on Christmas." Which of these are the most appropriate response? a. "Don't be silly, It's not Christmas, Mrs. G" b. "Today is Tuesday, Oct. 21, Mrs. G. We will have supper soon, and then your daughter will come to visit." c. "Who do you have a date with, Mrs. G?" d. "I think you need some more medication, Mrs. G. I'll bring it to you now."

b. "Today is Tuesday, Oct. 21, Mrs. G. We will have supper soon, and then your daughter will come to visit."

Mr. Stone is a client in the hospital with a diagnosis of Vascular NCD. In explaining this disorder to Mr. Stone's family, which of the following statements by the nurse is correct? a. "He will probably live longer than if his disorder was of the Alzheimer's type." b. "Vascular NCD shows step-wise progression. This is why he sometimes seems okay." c. "Vascular NCD is caused by plaques and tangles that form in the brain." d. "The cause of vascular NCD is unknown."

b. "Vascular NCD shows step-wise progression. This is why he sometimes seems okay."

There is a very narrow margin between the therapeutic and toxic levels of lithium carbonate. Symptoms of toxicity are most likely to appear if the serum levels exceed which of the following levels? a. 0.15 mEq/L b. 1.5 mEq/L c. 15.0 mEq/L d. 150 mEq/L

b. 1.5 mEq/L

If the foregoing extrapyramidal symptoms should occur, which of the following would be a priority nursing intervention? a. Notify the physician immediately. b. Administer prn trihexyphenidyl (Artane). c. Withhold the next dose of antipsychotic medication. d. Explain to the client that these symptoms are only temporary and will disappear shortly.

b. Administer prn trihexyphenidyl (Artane).

Antipsychotic medications are thought to decrease psychotic symptoms by which of the following actions? a. Blocking reuptake of norepinephrine and serotonin b. Blocking the action of dopamine in the brain c. Inhibiting production of the enzyme MAO d. Depressing the CNS

b. Blocking the action of dopamine in the brain

Doses of bupropion should be administered at least 4 to 6 hours apart and never doubled when a dose is missed in order to prevent: a. To prevent orthostatic hypotension b. To prevent seizures c. To prevent hypertensive crisis d. To prevent extrapyramidal symptoms

b. To prevent seizures

The primary goal in working with an actively psychotic, suspicious client would be to a. promote interaction with others b. decrease his anxiety and increase trust c. improve his relationship with his parents d. encourage participation in therapy activities

b. decrease his anxiety and increase trust

An example of a treatable (reversible) form of NCD is one caused by which of the following? Select all that apply. a. Multiple sclerosis b. Huntington's disease c. Electrolyte imbalances d. HIV disease e. Folate deficiency

c. Electrolyte imbalances e. Folate deficiency

When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first? a) provide large motor activities to relieve the client's pent-up tension b) administer a dose of PRN chlorpromazine to keep the client calm c) call for sufficient help to control the situation safely d) convey to the client that his behavior is unacceptable and will not be permitted

c) call for sufficient help to control the situation safely

A client who has dementia and was admitted to a long-term care facility following the death of her husband. The client states, "I want to go home; my husband is waiting for me to cook dinner." Which of the following responses by the nurse is appropriate? a. "This is where you live now" b. "This is a safer place for you to live." c. "Tell me what you like to cook for dinner." d. "Your family said there is no one to care for you at home."

c. "Tell me what you like to cook for dinner." (C. is correct because it distracts the client from her current thought process. The other options could potentially make the client upset.)

The night nurse finds Mrs. G, a client with Alzheimer's disease, wandering the hallway at 4 a.m. and trying to open the door to the side yard. Which statement by the nurse probably reflects the most accurate assessment of the situation? a. "That door leads out to the patio, Mrs. G. It's nighttime. You don't want to go outside now." b. "You look confused, Mrs. G. What is bothering you?" c. "This is the patio door, Mrs. G. Are you looking for the bathroom?" d. "Are you lonely? Perhaps you'd like to go back to your room and talk for a while."

c. "This is the patio door, Mrs. G. Are you looking for the bathroom?"

Tam has a new diagnosis of panic disorder. Dr. S has written a prn order for alprazolam (Xanax) for when Nancy is feeling anxious. She says to the nurse, "Dr. S prescribed Buspirone for my friend's anxiety. Why did he order something different for me?" The nurse's answer is based on which of the following? a. Buspirone is not an antianxiety medication. b. Alprazolam and buspirone are essentially the same medication, so either one is appropriate. c. Buspirone has delayed onset of action and cannot be used on a prn basis. d. Alprazolam is the only medication that really works for panic disorder.

c. Buspirone has delayed onset of action and cannot be used on a prn basis.

Initial symptoms of lithium toxicity include which of the following? a. Constipation, dry mouth b. Dizziness, thirst c. Vomiting, diarrhea d. Anuria, arrhythmias

c. Vomiting, diarrhea

What kind of treatment does schizophrenia require?

comprehensive and presented in a multidisciplinary effort

A nurse is caring for a group of older adults. Which of the following manifestations indicates one of the clients is experiencing delirium? a. A client continues to search for his checkbook and watch b. A client attempts to climb out of bed and states she needs to leave c. A client makes up events to justify lost time d. A client is agitated and states there are children crying outside.

d. A client is agitated and states there are children crying outside.

Mrs. G, who has NCD due to Alzheimer's disease, has trouble sleeping and wanders around at night. Which of the following nursing actions would be the best to promote sleep in Mrs. G? a. Ask the doctor to prescribe flurazepam (Dalmane) b. Ensure that Mrs. G gets an afternoon nap so she will not be overtired at bedtime c. Make Mrs. G a cup of tea with honey before bedtime d. Ensure that Mrs. G gets regular physical exercise during the day

d. Ensure that Mrs. G gets regular physical exercise during the day

According to Margaret Mahler, predisposition to borderline personality disorder occurs when developmental tasks go unfulfilled in which of the following phases? a. Autistic phase, during which the child's needs for security and comfort go unfulfilled b. Symbiotic phase, during which the child fails to bond with the mother c. Differentiation phase, during which the child fails to recognize a separateness between self and mother d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence

d. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence

Education for the client who is taking MAOIs should include which of the following? a. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment d. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification

d. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification

Kim has a diagnosis of Borderline Personality Disorder. She often exhibits alternating clinging and distancing behaviors. The most appropriate nursing intervention with this type of behavior would be to a. encourage Kim to establish trust in one staff person, with whom all therapeutic interaction should take place. b. secure a verbal contract from Kim that she will discontinue these behaviors. c. withdraw attention if these behaviors continue d. rotate staff members who work with Kim so that she will learn to relate to more than one person

d. rotate staff members who work with Kim so that she will learn to relate to more than one person

The primary focus of family therapy for clients with schizophrenia and their families is a. to discuss concrete problem-solving and adaptive behaviors for coping with stress b. to introduce the family to others with the same problem c. to keep the client and family in touch with the health-care system d. to promote family interaction and increase understanding of the illness

d. to promote family interaction and increase understanding of the illness

Delusional Disorder

delusional thinking for at least 1 month, self or interpersonal functioning is not markedly impaired; false very fixed belief, may come before actual diagnosis

What are the causes of schizophrenia?

genetic predisposition, biochemical dysfunction, physiological factors, psychosocial stress

When is the typical age of onset for schizophrenia?

late teens and early 20s

Of all mental illnesses, schizophrenia causes more..

lengthy hospitalizations, chaos in family life, exorbitant costs to people and governments, fears

Schizoaffective Disorder

meets both the criteria for schizophrenia and depressive or bipolar disorder (mood disorder: depression or mania)

Mutism

no, or very little, ability to speak

Substance abuse may lead to...

non compliance with prescription meds, repeated illness relapse, frequent hospitalizations, declining function, loss of social support

Brief Psychotic Disorder

psychomotor manifestations last between one day and one month

Schizophrenia is defined as...

psychotic thinking or behavior for at least 6 months; areas of functioning impaired: school, work, self care, interpersonal relationships

What is echolalia?

repeating the speech of another person

Echolalia

repeating words or phrases spoken by another

Sterotypy

repetitive, abnormally frequent, non-goal-directed movements

How severe is schizophrenia?

severe; usually life long mental disorder that affects every aspect of human functioning

Substance Induced Psychotic Disorder is directly attributable to...

substance intoxication or withdrawal or exposure to a medicine or toxin

Treatment with medication for schizophrenia controls ______

symptoms associated with the mental health problem.

When does schizophrenia become problematic?

when it interferes with interpersonal relationships, self care and ability to work

Characteristics of Residual phase?

~ Remissions and exacerbation. Followed by active phase of illness. Symptoms similar to those of the prodromal phase ~ Flat affect and impairment in role functioning are prominent This is at this point in which illness pattern is established, disability level may be stabilized, and late improvements may occur.