Schizophrenia

A nurse asks a patient diagnosed with schizo, "What is meant by the old saying, 'You can't judge a book by looking at the cover."? a. The table of contents tells what a book is about. b. You can't judge a book by looking at the cover. c. Things are not always as they first appear. d. Why are you asking me about books?

a

A nurse is assessing a client who has delirium. Which of the following findings requires immediate intervention by the nurse? a. Rapid mood swings b. Command hallucinations c. Impaired memory d. Inappropriate speech patterns

a

A nurse is caring for a client who has schizophrenia. The client's employer calls to discuss the client's condition. Which of the following is the appropriate nursing action? a. consult the client b. consult the client's family c. contact the provider d. contact the facility legal department

a

A patient diagnosed with schizo begins to talk about macnabs hiding in the warehouse at work. The term macnabs should be documented as: a. a neologism b. concrete thinking c. thought insertion d. an idea of reference

a

A patient diagnosed with schizo is very disturbed and violent. After several doses of haloperidol (Haldol), the patient is calm. Two hours later the nurse sees the patient head rotated to one side in a stiff position, the lower jaw thrust forward, and drooling. Which problem is most likely? a. An acute dystonic reaction b. tardive dyskinesia c. waxy flexibility d. akathisia

a

A patient diagnosed with schizophrenia was discharged 6 months ago, haloperidol (Haldol) was prescribed. The patient now says, "I stopped taking those pills. They made me feel like a robot." What are common side effects the nurse should validate with the patient? a. sedation and muscle stiffness b. sweating, nausea, and diarrhea c. mild fever, sore throat, and skin rash d. headache, watery eyes, and runny nose

a

A patient is experiencing delusions of persecution about being poisoned. The patient has refused all hospital meals for 3 days. Which intervention is most likely to be acceptable to the patient? a. Allowing the patient supervised access to food vending machines b. Allowing the patient to phone a local restaurant to deliver meals c. Offering to taste each portion on the tray for the patient d. Providing tube feedings or total parenteral nutrition

a

A community mental health nurse wants to establish a relationship with a very withdrawn patient diagnosed with schizo. The patient lives at home with a supportive family. Select the nurses best plan. a. Visit daily for 4 days, then every other day for 1 week; stay with patient for 20 minutes, accept silence; state when the nurse will return. b. Arrange to spend 1 hour each day with the patient; focus on asking questions about what the patient is thinking or experiencing; avoid silence. c. Visit twice daily; sit beside the patient with a hand on the patients arm; leave if the patient does not respond within 10 minutes. d. Visit every other day; remind the patient of the nurses identity; encourage the patient to talk while the nurse works on reports.

a

A newly hospitalized patient experiencing psychosis says, "Red chair out town board." Which term should the nurse use to document this finding? a. word salad b. neologism c. anhedonia d. echolalia

a

An acutely violent patient diagnosed with schizo receives several doses of haloperidol (Haldol). Two hours later the nurse notices the patients head rotated to one side in a stiffly fixed position, the lower jaw thrust forward, and drooling. Which intervention by the nurse is indicated? a. Administer diphenhydramine (Benadryl) 50 mg IM from the PRN medication administration record. b. Reassure the patient that the symptoms will subside. Practice relaxation exercises with the patient. c. Give trihexyphenidyl (Artane) 5 mg orally at the next regularly scheduled medication administration time. d. Administer atropine sulfate 2 mg subcut for the PRN medication administration record.

a

The family of a patient diagnosed with schizo is unfamiliar with the illness and family's role in recovery. Which type of therapy should the nurse recommend? a. psychoeducational b. psychoanalytic c. transactional d. family

a

What assessment findings mark the prodromal stage of schizo? a. withdrawal, misinterpreting, poor concentration, and preoccupation with religion b. auditory hallucinations, ideas of reference, thought insertion, and broadcasting c. stereotyped behavior, echopraxia, echolalia, and waxy flexibility d. loose associations, concrete thinking, and echolalia neologisms

a

A patient diagnosed with schizo was hospitalized after arguing with co-workers and threatening to harm them. The patient is aloof, suspicious, and says, "Two staff members I saw talking were plotting to kill me." Based on data gathered at this point, which nursing diagnoses relate? SATA a. Risk for other-directed violence b. Disturbed thought processes c. Risk for loneliness d. Spiritual distress e. Social isolation

a, b

A charge nurse is discussing manifestations of schizophrenia with a newly licensed nurse. Which of the following manifestations should the charge nurse identify as being effectively treated by first-generation antipsychotics? (Select all that apply.) a. Auditory hallucinations b. Withdrawal from social situations c. Delusions of grandeur d. Severe agitation e. Anhedonia

a, b, e

A nurse at the mental health clinic plans a series of psychoeducational groups for persons newly diagnosed with schizophrenia. Which two topics take priority? a. The importance of taking your medication correctly b. How to complete an application for employment c. How to dress when attending community events d. How to give and receive compliments e. Ways to quit smoking

a, e

What hallucinations necessitates the nurse to implement safety measures? The patient says, a. "I hear angels playing harps." b. "The voices say everyone is trying to kill me." c. "My dead father tells me I am a good person." d. "The voices talk only at night when I'm trying to sleep."

b

A client says, "Facebook has a new tracing capacity. If I use the internet, Homeland Security will detain me as a terrorist." Select the nurse's best initial action. a. Tell the client, Facebook is a safe website. You don't need to worry about Homeland Security b. Tell the client, You are in a safe place where you will be helped. c. Administer a prn dose of an antipsychotic medication d. Tell the client, You don't need to worry about that.

b

A newly admitted patient diagnosed with schizophrenia is hypervigilant and constantly scans the environment. The patient states, "I saw two doctors talking in the hall. They were plotting to kill me." The nurse may correctly assess this behavior as: a. echolalia b. an idea of reference c. a delusion of infidelity d. an auditory hallucination

b

A nurse is admitting a client who has a new diagnosis of schizophrenia and a history of aggression. Which of the following actions should the nurse include in the clients initial plan of care? a. agree with the client when he is upset until he can calm down b. provide physical exercise activity for the client c. avoid eye contact with the client for the first few days d. ignoretheclientshallucinations

b

A nurse is performing a mental status examination for a client who has schizophrenia. The nurse should recognize that which of the following actions requires the client to think abstractly? a. Explain what to do if he misses the bus. b. Determine the meaning of a proverb. c. Name the last three presidents of the USA. d. Count by adding 7 consecutively.

b

A nurse is providing teaching about relapse prevention to a client who has schizophrenia. Which of the following statements by the client indicates an understanding of the teaching? a. "I should avoid being around others if I think I'm having a relapse" b. "I should let my counselor know if I am having trouble sleeping" c. "I shouldn't worry about the voices because they are a part of my illness" d. "I should increase my carbohydrate intake to maintain my energy level"

b

A nurse observes a catatonic patient standing immobile, facing the wall with one arm extended in a salute. The patient remains immobile in this position for 15 minutes, moving only when the nurse gently lowers the arm. What is the name of this phenomenon? a. echolalia b. waxy flexibility c. depersonalization d. thought withdrawal

b

A patient diagnosed with schizo begins a new prescription for lurasidone HCL (Latuda). The patient is 56 and currently weighs 204 lbs. Which topic is most important for the nurse to include in the teaching plan related to this medication? a. how to recognize tardive dyskinesia b. weight management strategies c. ways to manage constipation d. sleep hygiene measures

b

A patient diagnosed with schizo demonstrates little spontaneous movement and has waxy flexibility. The patient's activities of daily living are severely compromised. An appropriate outcome would be that the patient will: a. demonstrate increased interest in the environment by the end of week 1 b. perform self-care activities with coaching by the end of day 3 c. gradually take the initiative for self-care by the end of week 2 d. accept tube feeding without objection by day 2

b

A patient diagnosed with schizo has taken a conventional antipsychotic medication for a year. Hallucinations are less intrusive, but the patient continues to have apathy, poverty of thought, and social isolation. The nurse would expect a change to which medication? a. haloperidol (Haldol) b. olanzapine (Zyprexa) c. chlorpromazine (Thorazine) d. diphenhydramine (Benadryl)

b

A patient diagnosed with schizophrenia says, "My co-workers are out to get me. I also saw two doctors plotting to kill me." How does this patient perceive the environment? a. disorganized b. dangerous c. supportive d. bizarre

b

A patient insistently states, "I can decipher codes of DNA just by looking at someone." Which problem is evident? a. visual hallucinations b. magical thinking c. idea of reference d. thought insertion

b

A patient took trifluoperazine 30mg po daily for 3 years. The clinic nurse notes that the patient grimaces and constantly smacks both lips. The patients neck and shoulders twist in a slow, snakelike motion. Which problem would the nurse suspect? a. agranulocytosis b. tardive dyskinesia c. touretts syndrome d. anticholinergic effects

b

A patient's care plan includes monitoring for auditory hallucinations. Which assessment findings suggest the patient may be hallucinating? a. detachment and overconfidence b. darting eyes, tilted head, mumbling to self c. euphoric mood, hyperactivity, distractibility d. foot tapping and repeatedly writing the same phrase

b

A person has had difficulty keeping a job because of arguing with co-workers and accusing them of conspiracy. Today the person shouts, "They're all plotting to destroy me. Isn't that true?" Select the nurses most therapeutic response. a. Everyone here is trying to help you. No one wants to harm you. b. Feeling that people want to destroy you must be very frightening. c. That is not true. People here are trying to help you if you will let them. d. Staff members are health care professionals who are qualified to help you.

b

A newly admitted patient diagnosed with schizo says, "The voices are bothering me. They yell and tell me I am bad. I have got to get away from them." Select the nurses most helpful reply. a. Do you hear the voices often? b. Do you have a plan for getting away from the voices? c. I'll stay with you. Focus on what we are talking about, not the voices. d. Forget the voices and ask some other patients to play cards with you.

c

A nurse is assessing a client for negative manifestations of schizophrenia. Which of the following findings should the nurse expect? a. Echopraxia b. Delusions c. Anergia d. Tangentiality

c

A nurse is assessing a client who has schizophrenia. The client tells the nurse, "My heart exploded and my blood is draining out" The nurse should interpret this statement as which of the following manifestations? a. concrete thinking b. a visual hallucination c. a somatic delusion d. paranoia

c

A nurse is caring for a client who has schizophrenia and exhibits lack of grooming and a flat affect. The nurse should anticipate a prescription of which of the following medications? a. Chlorpromazine b. Thiothixene c. Risperidone d. Haloperidol

c

A nurse is caring for a client who has schizophrenia and has been taking chlorpromazine for 5 years. Which of the following assessment tools should the nurse use to determine if the client is experiencing adverse effects of the medication? a. Addiction Severity Index (ASI) b. Mood Disorder Questionnaire (MDQ) c. Abnormal Involuntary Movement Scale (AIMS) d. Hamilton Depression Scale

c

A nurse is interviewing a client who has schizophrenia. The client states, "aliens are going to abduct me at midnight tonight" Which of the following responses should the nurse make? a. why are the aliens going to abduct you? b. you are safe from aliens here c. believing that aliens will abduct you must be scary d. have you ever been abducted by aliens before?

c

A patient diagnosed with schizo has taken fluphenazine (Prolixin) 5 mg po bid for 3 weeks. The nurse now observes a shuffling propulsive gait, a mask-like face, and drooling. Which term applies to these symptoms? a. neuroleptic malignant syndrome b. hepatocellular effects c. pseudoparkinsonism d. akathisia

c

A patient diagnosed with schizophrenia exhibits little spontaneous movement and demonstrates waxy flexibility. Which patient needs are of priority importance? a. self-esteem b. psychosocial c. physiological d. self-actualization

c

The nurse assesses a patient diagnosed with schizo. Which assessment finding would the nurse regard as a negative symptom of schizo? a. auditory hallucinations b. delusions of grandeur c. poor personal hygiene d. psychomotor agitation

c

Which finding constitutes a negative symptom associated with schizo? a. hostility b. bizarre behavior c. poverty of thought d. auditory hallucinations

c

The nurse is developing a plan for psychoeducational sessions for several adults diagnosed with schizo. Which goal is best for this group? Members will: a. gain insight into unconscious factors that contribute to their illness b. explore situations that trigger hostility and anger c. learn to manage delusional thinking d. demonstrate improved social skills

d

A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social function. The patient is also overweight and hypertensive. Which drug should the nurse advocate? a. clozapine b. ziprasidone c. olanzapine d. aripiprazole

d

A nurse in a long-term care facility is assessing a client who has dementia. Which of the following findings should the nurse identify as a risk for this client? a. Outside doors have locks b. The bed is in the low position c. Hallways are long distances d. The room has an area rug

d

A nurse is caring for a client who has schizophrenia and is experiencing auditory hallucinations. Which of the following actions should the nurse take first? a. Encourage the client to listen to music b. Monitor the client for indications of anxiety c. Ask the client what she is missing d. Focus the client on reality-based topics

d

A nurse sits with a patient diagnosed with schizo. The patient starts to laugh uncontrollably, although the nurse has not said anything funny. Select the nurse's best response. a. Why are you laughing? b. Please share the joke with me. c. I don't think I said anything funny. d. You're laughing. Tell me what's happening.

d

A patient diagnosed with schizo and auditory hallucinations anxiously tells the nurse, "The voice is telling me to do things." Select the nurse's priority assessment question. a. How long has the voice been directing your behavior? b. Does what the voice tell you to do frighten you? c. Do you recognize the voice speaking to you? d. What is the voice telling you to do?

d

A patient diagnosed with schizo has been stable for a year; however, the family now reports the patient is tense, sleeps 3 to 4 hours per night, and has difficulty concentrating. The patient says, "My computer is sending out infected radiation beams." The nurse can correctly assess this information as an indication of: a. the need for psychoeducation b. medication noncompliance c. chronic deterioration d. relapse

d

A patient diagnosed with schizo says, "Contagious bacteria are everywhere. When they get in your body, you will be locked up with other infected people." Which problem is evident? a. poverty of content b. concrete thinking c. neologisms d. paranoia

d

A patient diagnosed with schizo says, "It's beat. Time to eat. No room for the cat." What type of verbalization is evident? a. neologism b. idea of reference c. thought broadcasting d. associative looseness

d

A patient diagnosed with schizophrenia anxiously says, "I can see the left side of my body merging with the wall, then my face appears and disappears in the mirror." While listening, the nurse should: a. sit close to the patient b. place an arm protectively around the patients shoulders c. place a hand on the patients arm and exert light pressure d. maintain a normal social interaction distance from the patient

d

A patient diagnosed with schizophrenia tells the nurse, "I eat skiller. Tend to end. Easter. It blows away. Get it?" Select the nurse's best response. a. Nothing you are saying is clear. b. Your thoughts are very disconnected. c. Try to organize your thoughts and then tell me again. d. I am having difficulty understanding what you are saying.

d

A patient receiving risperidone (Risperdal) reports severe muscle stiffness at 1030. By 1200, the patient has difficulty swallowing and is drooling. By 1600, vital signs are 102.8 F; pulse 110; respirations 26; 150/90. The patient is diaphoretic. Select the nurse's best analysis and action. a. agranulocytis; institute reverse isolation b. tardive dyskinesia; withhold the next dose of medication c. cholestatic jaundice; begin a high-protein, high-cholesterol diet d. neuroleptic malignant syndrome; notify health care provider stat

d

Anurseinaninpatientmentalhealthfacilityisassessingaclientwhohas schizophrenia and is taking haloperidol. Which of the following clinical findings is the nurse's priority? a. Insomnia b. Urinary hesitancy c. Headache d. High fever

d

Withdrawn patients diagnosed with schizophrenia: a. are usually violent toward caregivers. b. universally fear sexual involvement with therapists. c. exhibit a high degree of hostility as evidenced by rejecting behavior. d. avoid relationships because they become anxious with emotional closeness.

d