Cognition-psychosis- HESI
A client has been prescribed chlorpromazine for the management of positive symptoms of schizophrenia. What is the nurse's response when the client reports difficulty sustaining an erection? 1 Reassuring the client that this side effect will resolve in a few weeks 2 Consulting with the primary healthcare provider regarding alternative medication therapies 3 Explaining that all conventional antipsychotic medications cause impotence 4 Providing additional medication education to explain the medication's side effects in detail
2
A client with the diagnosis of schizophrenia, paranoid type, appears very suspicious of the nurse. What is the most effective therapeutic nursing approach? 1 Assigning various caregivers to the client 2 Making brief, frequent contacts with the client 3 Initiating a discussion about the client's thoughts 4 Allowing the client to stay alone without interruption
2
A delusional client has refused to eat for the past 24 hours, saying "the food is poisoned." How should the nurse respond? 1 "Why do you think that the food is poisoned?" 2 "You feel worried that someone wants to poison you?" 3 "This feeling is a symptom of your illness. It's not real." 4 "You'll be safe with me. I won't let anyone poison you."
2
A nurse is monitoring a client with the diagnosis of schizophrenia who is experiencing opposing emotions simultaneously. When providing a change-of-shift report, how should the nurse refer to this emotional experience of the client? 1 Double bind 2 Ambivalence 3 Loose association 4 Inappropriate affect
2
As a nurse enters a room and approaches a client who has schizophrenia, the client shouts, "Get out of here before I hit you! Go away!" What does the nurse conclude provoked the client's aggressive behavior? 1 Voices are directing his behavior. 2 He felt confined when the nurse walked into the room. 3 He was afraid of doing harm to the nurse if the nurse came closer. 4 He thought that the nurse was similar to someone who had frightened him in the past
2
The nurse is interviewing the family about the onset of problems in a young client with the diagnosis of schizophrenia. In what stage of development does the nurse expect that the client's difficulties with reality testing began? 1 Puberty 2 Adolescence 3 Late childhood 4 Early childhood
2
What should a nurse do when caring for a client whose behavior is characterized by pathologic suspicion? 1 Protect the client from environmental stress. 2 Help the client feel accepted by the staff on the unit. 3 Ask the client to explain the reasons for the feelings. 4 Help the client realize that the suspicions are unrealistic.
2
A nurse is managing the care of a client with recently diagnosed schizophrenia. Effective therapeutic communication will directly affect which client-focused outcomes? Select all that apply. 1 The client will become capable of part-time employment. 2 The client will effectively express emotional and physical needs. 3 The client will demonstrate wellness reflective of physical potential. 4 The client will demonstrate an understanding of the mental health disorder. 5 The client will recognize the issues most important to managing this disorder.
2,4,5
A client in the mental health clinic tells the nurse, "The FBI is out to kill me." What should the nurse document that the client is experiencing? 1 Hallucination 2 Error in judgment 3 Delusion of persecution 4 Self-accusatory delusion
3
A client tells the nurse, "That man on the television is talking only to me." What should the nurse document that the client is exhibiting? 1 Illusion 2 Hallucination 3 Idea of reference 4 Autistic thinking
3
What should a nurse do when a client with the diagnosis of schizophrenia talks about being controlled by others? 1 Express disbelief about the delusion. 2 Acknowledge the feeling tone of the delusion. 3 Determine the content of the delusions of control. 4 Institute an activity that will compete with the delusion
3
A client recently admitted to the psychiatric unit is found to be experiencing command auditory hallucinations. The nurse conducts an initial one-on-one session centered on the development of trust. What is the next important nursing intervention? 1 Identifying the content of the messages in the auditory hallucinations 2 Determining whether the command hallucinations are frightening to the client 3 Helping the client determine whether the voices are outside or inside the client's head 4 Determining the client's ability to refrain from listening to the messages from the voices
1
A client states, "The voices are saying I killed my husband." What is the best response by the nurse? 1 "You're having very frightening thoughts right now." 2 "We'll put you in a private room where you'll be safe." 3 "Tell me more about these worries about your husband." 4 "I just saw your husband, and he seems to be doing fine."
1
A client with depression was prescribed fluoxetine. After two days, the client arrives at the hospital and reports restlessness, confusion, and poor concentration. Upon assessment, the nurse finds an elevated body temperature. Which intervention by the healthcare provider would be beneficial to the client? 1 Withdrawing the drug 2 Administering isocarboxazid 3 Reducing the dose of the drug 4 Informing the client that these are expected side effect
1
A client with paranoid schizophrenia tells the nurse, "My neighbors are spying on me because they want to rob me and take money." While hospitalized, the client complains of being poisoned by the food and of being given the wrong medication. The nurse evaluates the client's response to medications and therapy. Which assessment finding leads the nurse to conclude that the client's reality testing has improved? 1 The client eats the food provided on the hospital tray. 2 The client discusses the discharge plans with the staff. 3 The client questions each medication when it is administered. 4 The client asks permission to make phone calls to the hospital administration.
1
A client with schizophrenia plans an activity schedule with the help of the treatment team. A written copy is posted in the client's room. What should the nurse say when it is time for the client to go for a walk? 1 "It's time for you to go for a walk now." 2 "Do you want to take your scheduled walk now?" 3 "When would you like to go for your walk today?" 4 "You're supposed to be going for your walk now."
1
A nurse is caring for a client who is delusional and talking about people who are plotting to do harm. The staff members note that the client is pacing more than usual, and the primary nurse concludes that the client is beginning to lose control. What is the most therapeutic nursing intervention? 1 Moving the client to a quiet place 2 Urging the client to sit down for a short time 3 Encouraging the client to use a punching bag 4 Allowing the client to continue pacing under supervision
1
In the care of a withdrawn, reclusive psychotic client, the priority goal is for the client to develop what? 1 Trust 2 Self-worth 3 A sense of identity 4 An ability to socialize
1
Olanzapine is prescribed for a client with bipolar disorder, manic episode. What cautionary advice does the nurse give the client? 1 Sit up slowly. 2 Report double vision. 3 Expect increased salivation. 4 Take the medication on an empty stomach.
1
When planning nursing care for a client with severe agoraphobia, what should the nurse do first? 1 Determine the client's degree of impairment. 2 Support the client's self-esteem through verbal interactions. 3 Expose the client gradually to anxiety-provoking situations. 4 Teach the client biofeedback techniques for reducing anxiety
1
The registered nurse is teaching about monoamine oxidase (MAO) inhibitors to a nursing student. Which statement made by the nursing student indicates the need for further teaching? Select all that apply. 1 "Isocarboxazid is a selective MAO-B inhibitor." 2 "MAO inhibitors are prescribed as adjunct to diphenhydramine." 3 "Hypertensive crisis is a reported adverse effect of MAO inhibitors." 4 "MAO inhibitors are prescribed to clients with Parkinson disease." 5 "Interaction of sympathomimetic drugs with MAO inhibitors may cause hypertensive crisis."
1,2
The primary healthcare provider prescribes thioridazine and assigns the nurse to assess the client for orthostatic hypotension. Which interventions would the nurse perform? Select all that apply. 1 Measuring the blood pressure before dosing 2 Reducing the dose if the blood pressure is low 3 Measuring the blood pressure one hour after dosing 4 Measuring the blood pressure one or two minutes after the client sits or stands 5 Avoiding the measurement of blood pressure when the client is lying down
1,3,4
A client is admitted to a psychiatric unit with the diagnosis of schizophrenia, undifferentiated type. When assessing the client, the nurse identifies the presence of several characteristics related to this disorder. What may this include? Select all that apply. 1 Bizarre behavior 2 Extreme negativism 3 Disorganized speech 4 Persecutory delusions 5 Auditory hallucinations
1,3,5
A nurse is preparing a teaching plan to educate a relative of a client with schizophrenia about the early signs of relapse. What signs should the nurse plan to include? Select all that apply. 1 Appearing disheveled 2 Socializing with peers 3 Staying alone in the house 4 Joining a local church singing group 5 Exhibiting indifference to family activities
1,3,5
A client is admitted to the psychiatric unit during the first episode of an acute psychotic disorder. The plan of care calls for psychiatric, medical, and neurologic evaluation. What essential intervention should be included in the plan? 1 Assessing the symptoms and teaching the client about the disorder 2 Encouraging participation in cognitive and social skills enhancement 3 Maintaining a daily routine and instituting family and group therapies 4 Instituting psychopharmacologic prescriptions and supportive communication
4
A client with a diagnosis of bipolar I disorder, manic episode, is started on a regimen of an antipsychotic agent and lithium carbonate. The nurse explains to the client that the rationale behind this regimen is that the antipsychotic has which action? 1 Potentiates the action of lithium for more effective results 2 Interacts with lithium to prevent progression to the depressive phase 3 Helps decrease the risk of lithium toxicity in the first week of therapy 4 Acts to quiet the client while allowing time for the lithium to reach a therapeutic level
4
A client with paranoid schizophrenia wraps the legs in toilet paper, believing that this will provide protection from deadly germs contaminating the floor. What is the best nursing intervention? 1 Limiting the client's access to toilet paper 2 Providing the client with antimicrobial soap 3 Explaining to the client why this action is ineffective 4 Talking with the client about anxiety that focuses on health
4
A client with schizophrenia is demonstrating waxy flexibility. Which intervention is the best way to manage the possible outcome of this behavior? 1 Providing thickened liquids to minimize the risk of aspiration 2 Documenting intake and output each shift to monitor hydration 3 Reinforcing appropriate social boundaries through staff role modeling 4 Performing passive range-of-motion exercises three times a day for effective joint health
4
A client's parents ask about the treatment of their child who has a recent diagnosis of schizophrenia. Before responding, what should the nurse consider? 1 Electroconvulsive therapy is more effective in treating schizophrenia than mood disorders. 2 Family therapy has not been proved effective in the treatment of clients with schizophrenia. 3 Insight therapy has been proved highly successful in the treatment of clients with schizophrenia. 4 Drug therapy, although it does not eliminate the underlying problem, reduces the symptoms of acute schizophrenia.
4
An adult with the diagnosis of schizophrenia is admitted to the psychiatric hospital. The client is ungroomed, appears to be hearing voices, is withdrawn, and has not spoken to anyone for several days. What should the nurse do during the first few hospital days? 1 See that the client bathes and changes clothes daily. 2 Wait and see whether the client approaches the staff. 3 Conduct an admission assessment interview with the client. 4 Seek out the client frequently to spend short periods of time together.
4
The nurse is developing a care plan for a client with postpartum psychosis. Which priority intervention should the nurse implement? 1Teaching the client about normal newborn care 2Ensuring adequate bonding time with the infant 3Giving the client time and space to express her feelings 4. Referring the client to a psychiatric healthcare provider as prescribed
4
The nurse is planning a group session for three chronically ill clients who have the diagnosis of schizophrenia. In light of the symptoms and general characteristics of schizophrenia and long-term mental illness, what is one of the most helpful topics for this group? 1 Relaxation techniques 2 Rational behavior therapy 3 Assertiveness in relationships 4 Social skills in the group setting
4
The nurse notes that a client has been experiencing a somatic delusion. Which statement led to this conclusion? 1 "I am Jesus Christ." 2 "I know I'm dead." 3 "This food has been poisoned." 4 "My stomach has disintegrated."
4
What client behavior indicates to the nurse that a client with schizophrenia, undifferentiated type, is improving and that the client's plan of care can be updated? 1 Avoids other clients 2 Expresses negative feelings freely 3 Describes delusions in meticulous detail 4 Communicates with others in an organized manner
4
When a psychotic, acting-out client's condition improves, the practitioner suggests discharge to a halfway house. The client's family is worried that the client will continue to act out at the halfway house. What is the nurse's best intervention at this time? 1 Having the social worker talk with the family 2 Canceling the discharge plans until the family is reassured 3 Having the client promise the nurse and family not to act out 4 Discussing the concern at a meeting with both the client and the family present
4
