Schizophrenia NCLEX Questions

A client with schizophrenia is prescribed second-generations antipsychotic. The client's mother asks, "About how long will it take until we see any changes in his symptoms?" Which response by the nurse would be most appropriate? 1. "Generally, it takes about one to two weeks to be effective in changing symptoms" 2. "You should see improvement in about 36 to 48 hours" 3. "His symptoms should subside almost immediately" 4. "It will take about 6 to 12 weeks until the drug is effective"

1. "Generally, it takes about one to two weeks to be effective in changing symptoms" Generally, it takes about one to two weeks for antipsychotic drugs to effect a change in symptoms. During the stabilization period, the selected drug should be given an adequate trial, generally 6 to 12 weeks, before considering a change in the drug prescription. If treatment effects are not seen, another antipsychotic agent may be tried

Positive symptoms of schizophrenia, specifically hallucinations and delusions, are thought to be caused by hyperactivity of which neurotransmitter? 1. Dopamine 2. Norepinephrine 3. Acetylcholine 4. Epinephrine

1. Dopamine Positive symptoms of schizophrenia, such as delusions and hallucinations, are thought to be caused by dopamine hyperactivity in the mesolimbic tract at the D2 receptor site in the striatal area, where memory and emotion are regulated. Hyperactivity of acetylcholine, norepinephrine, and epinephrine are not associated with schizophrenia

A nurse is assessing a client diagnosed with schizophrenia. The nurse suspects that the client may be experiencing water intoxication based on which finding? SATA 1. Emotional lability 2. Enhanced attention span 3. Muscle twitching 4. Increase in hallucinations 4. Irritability

1. Emotional lability 3. Muscle twitching 4. Increase in hallucinations 4. Irritability Findings associated with water intoxication include muscle twitching, irritability, increased psychotic symptoms such as hallucinations, and lability. Enhanced attention is not associated with water intoxication

A client with schizophrenia is prescribed clozapine (Clozaril). The nurse would monitor the client closely for specific signs of which of the following? 1. Infection 2. Hypotension 3. Nausea 4. Weight loss

1. Infection Agranulocytosis can develop with the use of all antipsychotic drugs, but it is most likely to develop with clozapine use. Therefore, the nurse needs to be alert for signs of infection, particularly bacterial infection. Hypotension may occur with any antipsychotic drug. Nausea is a common side effect of many drugs. Weight gain, not loss, can occur with olanzapine and clozapine

Which of the following are key diagnostic criteria of schizophrenia? SATA 1. One or more major areas of social or occupational functioning markedly below previously achieved levels 2. Continuous signs for at least six months 3. Delusions present for a significant portion of time during a one-month period 4. Major depression occurring concurrently with active symptoms 5. A direct physiologic effect of a substance or medical condition

1. One or more major areas of social or occupational functioning markedly below previously achieved levels 2. Continuous signs for at least six months 3. Delusions present for a significant portion of time during a one-month period Key diagnostic criteria includes continuous signs for at least six months, one or more major areas of social or occupational functioning markedly below previously achieved levels, and delusions present for a significant portion of time during a one-month period. Other criteria include the absence, or insignificant duration, of major depressive, manic, or mixed episodes occurring concurrently with active symptoms, and that the disease is not a direct physiologic effect of a substance or medical condition

Which of the following is considered a first-generation antipsychotic drug used to treat psychosis in the United States? 1. fluphenazine (Proxlixin) 2. clozapine (Clozaril) 3. olanzapine (Zyprexa) 4. aripiprazole (Abilify)

1. fluphenazine (Proxlixin) Fluphenazine (Proxlixin) is a first-generation antipsychotic medication. Abilify, Clozaril, and Zyprexa are second-generation antipsychotics

When investigating biologic theories related to schizophrenia, which of the following neuroanatomic findings would be consistent with this mental health disorder? 1. Enlarged hippocampus 2. Enlarged lateral ventricle 3. Smaller third ventricle 4. Enlarged brain volume

2. Enlarged lateral ventricle The lateral and third ventricles are somewhat larger, and total brain volume is somewhat smaller, in persons with schizophrenia compared with those without schizophrenia. The thalamus and the medial temporal lobe structures, including the hippocampus, superior temporal, and prefrontal cortices, also tend to be smaller

A client diagnosed with schizophrenia is in anticholinergic crisis. The nurse would expect which finding to be noted upon assessment? 1. Bradycardia 2. Facial flushing 3. Incontinence 4. Hypothermia

2. Facial flushing Clinical manifestations of anticholinergic crisis include facial flushing, tachycardia. urinary retention, and hyperthermia (fever)

Which of the following would the nurse expect to administer to a client with schizophrenia who is experiencing a dystonic reaction? 1. Risperidone (Risperdal) 2. Trihexyphenidyl (Artane) 3. Benztropine (Cogentin) 4. Aripiprazole (Abilify)

3. Benztropine (Cogentin) A client experiencing a dystonic reaction should receive immediate treatment with benztropine (Cogentin). Risperidone (Risperdal) and aripiprzole (Abilify) are antipsychotics that may cause dystonic reactions. Trihexyphenidyl (Artane) is used to treat Parkinsonism due to antipsychotic drugs

After teaching a group of nursing students about neurotransmitters associated with schizophrenia, the nursing instructor determines that the education was successful when the students verify which of the following as playing a role in the positive symptoms of schizophrenia? 1. Glutamate 2. Serotonin 3. Dopamine 4. Gamma-aminobutyric acid (GABA)

3. Dopamine Positive symptoms of schizophrenia, specifically hallucinations and delusions, are thought to be related to dopamine hyperactivity. Studies are revealing that schizophrenia does not result from the dysregulation of a single neurotransmitter or biogenic amine, such as norepinephrine or serotonin. Hypothesis suggests a role for glutamate and GABA. However, dopamine dysfunction is also thought to be involved in psychosis with other disorders

Clients diagnosed with schizophrenia may experience disordered water balance that may lead to water intoxication. Which of the following may occur as a result of water intoxication? 1. Oliguria 2. Hypernatremia 3. Hyponatremia 4. Weight loss

3. Hyponatremia Hyponatremia is a life-threatening complication of unknown cause. When a client ingests an unusually large volume of water, the kidneys' capacity to excrete water is overwhelmed, and serum sodium levels rapidly fall below the normal range of 135 to 145 mEq/L, to a neurological signs such as muscle twitching and irritability, and the client is at risk for seizures, coma or possible death. Polyuria and increased diurnal weight gain may occur.

A client with schizophrenia is experiencing delusions. The client states, "There's a huge apocalypse coming and an end of the world is near." The nurse interprets this statement as which type of delusion? 1. Somatic 2. Grandiose 3. Nihilistic 4. Persecutory

3. Nihilistic A nihilistic delusion involves the belief that one is dead or a calamity is impending. A grandiose delusion involves the belief that one has exceptional powers, wealth, skill, influence, or destiny. A persecutory delusion involves the belief that one is being watched, ridiculed, harmed or plotted against. A somatic delusion involves the belief about abnormalities in bodily structure or functions

A client diagnosed with schizophrenia is having delusions that he is being plotted against by the government. This would be documented as which of the following types of delusion? 1. Somatic 2. Grandiose 3. Persecutory 4. Nihilistic

3. Persecutory A persecutory delusion is a belief that one is being watched, ridiculed, harmed, or plotted against. The belief that one has exceptional powers, wealth. skill, influence, or destiny is a grandiose delusion. A nihilistic delusion is the belief that one is dead or a calamity is impending. A somatic delusion is the belief about abnormalities in bodily functions or structures

Which of the following is an anticholinergic side effect associated with some antipsychotic medications? 1. Increased tearing 2. Salivation 3. Photophobia 4. Diarrhea

3. Photophobia Photophobia, dry mouth, decreased lacrimation, and constipation are anticholinergic side effects associated with some antipsychotic medications

A client has been prescribed clozapine (Clozaril) for treatment of schizophrenia. The patient must be taught to monitor which blood levels weekly while taking this drug? 1. Platelets 2. Hemoglobin 3. WBC 4. Hematocrit

3. WBC Agranulocytosis can develop with the use of all antipsychotic drugs, but it is most likely to develop with clozapine use. Clients taking clozapine should have regular blood tests. White blood cells and granulocyte counts should be measured before treatment is initiated, and at least weekly or twice weekly after treatment begins

When preparing a class presentation about schizophrenia, which of the following would the nurse most likely include? 1. Delusions are more commonly noted in younger children with schizophrenia 2. Schizophrenia is more commonly diagnosed in children than in adolescents 3. Very few individuals with schizophrenia reach older adulthood 4. Improvement in symptoms can occur as a client with a history of schizophrenia reaches older adulthood

4. Improvement in symptoms can occur as a client with a history of schizophrenia reaches older adulthood People with schizophrenia do reach older adulthood and others develop schizophrenia late in life. For older clients who have had schizophrenia since young adulthood, this mat be a times in which they experience some improvement in symptoms or decrease in relapse fluctuations. The diagnosis of schizophrenia in children before adolescence is rare. If it does occur, hallucinations tend to be more visual and delusions are less developed

Which of the following extrapyramidal side effects is noted by the client having bradykinesia and a shuffling gait? 1. Tardive dyskinesia 2. Akathisia 3. Acute dystonia 4. Pseudoparkinsonism

4. Pseudoparkinsonism Pseudoparkinsonism is noted by resting tremor, rigidity, a masklike face, and a shuffling gait. Akathisia occurs when the client has motor restlessness evidenced by pacing, rocking, or shifting from foot to foot. Symptoms of acute dystonia are intermittent or fixed abnormal postures of the eyes, face, tongue, neck, trunk, and extremities