PrepU Chapter 22- Mental Health

A nurse provides care to a client with schizoaffective disorder during hospitalization for acute psychosis. Nursing interventions to help the client to establish trust with the health care team is best accomplished by what?

Offering reassurance in a non-threatening voice

A client has been prescribed clozapine for treatment of schizophrenia. The client must be taught to monitor which blood concentrations weekly while taking this drug?

white blood cells

A nurse is assessing a client diagnosed with schizophrenia. When documenting the findings, which would the nurse identify as a positive symptom? Select all that apply.

Delusions, Hallucinations

A client with delusional disorder tells the nurse that the client has discovered how to jump to the moon. The nurse would document this belief as what?

Grandiose delusion

The nurse observes a client with schizophrenia sitting alone, laughing occasionally, and turning his head as if listening to another person. The nurse assesses this behavior to indicate that the client is experiencing auditory hallucinations and says ...

Are you hearing something?

When developing the plan of care for a client with schizophrenia who is in the acute phase of illness, the nurse understands that the client is at high risk for what?

Suicide

Which extrapyramidal side effect is noted by a client who has bradykinesia and a shuffling gait?

psuedoparkinsonism

A client diagnosed with schizophrenia is exhibiting disorganized behavior and imitating what the nurse is saying. What term is used to identify this behavior?

Echolalia

A client is considered to have an ultrahigh risk for the development of schizophrenia when the assessment process identifies ...

A sibling who experiences visual hallucinations

After assessing a client with schizophrenia, the nurse notes that the client exhibits signs and symptoms related to being unable to experience pleasure. The nurse documents this finding as what?

Anhedonia

A client diagnosed with schizophreniform disorder must have symptoms present for at least 1 month but with a duration of less than how long?

6 months

The client with schizophrenia believes the student nurses are there to spy on the clients. The client is suffering from which symptom?

Delusions

The nurse is working with a client with schizophrenia who has cognitive deficits. It is time for the client to get up and eat breakfast. Which statement by the nurse would be most effective in helping the client prepare for breakfast?

"First, wash your face and brush your teeth. Then put your clothes on."

Schizoaffective disorder is most likely to be diagnosed at which of the following stages of life?

Early Adulthood

Which increases the risk for neuroleptic malignant syndrome (NMS)?

Dehydration

A client with schizophrenia is seen sitting alone and talking out loud. Suddenly, the client stops and turns as if listening to someone. The nurse approaches and sits down beside the client. Which is the best response by the nurse?

"I don't see or hear anyone else; what are you seeing and hearing?"

The nurse enters the room of a client with schizophrenia the day after the client has been admitted to an inpatient setting and says, "I would like to spend some time talking with you." The client stares straight ahead and remains silent. Which would be the best response by the nurse?

"You don't need to talk right now; I'll just sit with you here for a while"

A college freshman is admitted to the hospital with a diagnosis of schizophrenia. Friends reported that the client had been in the client's room for 2 days in a trance-like state, not eating nor speaking to anyone. Which is the priority for this client?

Assess fluid intake and output

A nurse is developing a plan of care for a client diagnosed with delusional disorder. Which of the following would the nurse need to keep in mind?

Clients with delusional disorder typically have problems with medication adherence.

After teaching a group of nursing students about neurotransmitters associated with schizophrenia, the nursing instructor determines that the education was successful when the students identify what as playing a role in the positive symptoms of schizophrenia?

Dopamine

A nurse is working with a client that has been diagnosed with delusional thoughts. Which is an initial short-term outcome appropriate for this client?

Engage in reality oriented conversation

A client diagnosed with schizoaffective disorder and severe depression is being treated with antipsychotic medications. The client tells the nurse about difficulty with self-care activities. With which intervention should the nurse respond?

Establish a routine and set goals

A client has been taking haloperidol for 5 years when the client is admitted to the inpatient unit for relapse of symptoms of schizophrenia. Upon assessment, the client demonstrates akathisia, dystonia, a stiff gait, and rigid posture. The nurse correctly identifies these symptoms are indicative of what?

Extrapyramidal side effects

Which type of antipsychotic medication is most likely to produce extrapyramidal effects?

First-Generation antipsychotic drugs

A client with schizophrenia is prescribed a second-generation 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?

Generally, it takes about 1 to 2 weeks to be effective in changing symptoms

A psychiatric-mental health nurse is reviewing a journal article about schizophrenia and disorders related to it. The nurse demonstrates understanding of the article by identifying which information as a major factor associated with increasing a person's risk for schizophrenia?

Genetics

A client on the unit suddenly cries out in fear. The nurse notices that the client's head is twisted to one side, the client's back is arched, and the client's eyes have rolled back in the sockets. The client has recently begun drug therapy with haloperidol. Based on this assessment, which would be the first action of the nurse?

Give a PRN dose of benzotropine IM

During an admission assessment, a client with schizoaffective disorder states that the client hears the voice of God in the client's head and the voice is telling the client that the client is worthless. What would the nurse document this symptom as?

Hallucination

Clients diagnosed with schizophrenia may experience disordered water balance that may lead to water intoxication. Which may occur as a result of water intoxication?

Hyponatremia

A client is diagnosed with schizoaffective disorder. The interdisciplinary plan of care includes key family members. The nurse understands that a major reason for doing so involves which of the following?

Strengthening the client's recovery

When preparing a class presentation about schizophrenia, what would the nurse most likely include?

Improvement in symptoms when client reaches older adulthood

Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?

Increased amounts of dopamine

Which is the central focus of persecutory delusions?

Injustice that must be remedied by legal action

A nurse assessing a client with schizoaffective disorder should obtain a detailed history with a description of the full range and duration for which of the following reasons?

It is important to predict outcomes

A client with delusional disorder is hospitalized. When reviewing the client's medical record, the nurse identifies which reason as most likely for the hospitalization?

Legal violation

A client suffers from drug-induced parkinsonism. The nurse notices this client walking with a shuffling gait. What other symptoms might this client show? Select all that apply.

Masklike facies Cogwheel rigidity Drooling Akinesia

A client is diagnosed with schizoaffective disorder (SAD). The nurse understands that in addition to psychosis, the client must also exhibit:

Mood Disorder

A client had been withdrawn in the client's room for 3 days, not eating or sleeping, prior to his admission to the inpatient unit. Upon interview, the client demonstrates difficulty answering questions, appears to have no facial expressions, and cannot follow simple instructions. This cluster of symptoms can be described as what?

Negative symptoms

A client with schizophrenia is receiving antipsychotic therapy. The nurse understands that which is a medical emergency should it develop in the client?

Neuroleptic malignant syndrome

A week after beginning therapy with thiothixene, a client demonstrates muscle rigidity, a temperature of 103°F, an elevated serum creatinine phosphokinase level, stupor, and incontinence. The nurse knows that these symptoms indicate which condition?

Neuroleptic malignant syndrome

All are included in the plan of care for a client with schizophrenia. Which nursing intervention should the nurse perform first when caring for this client?

Observe for signs of fear or agitation

The client was conversing with the nurse when noticeable changes occurred with the client. Which is a term used to describe the occurrence of the eye rolling back in a locked position, which occurs with acute dystonia?

Oculogyric Crisis

A client with delusional disorder believes that the cook at the psychiatric hospital is trying to poison the client. The nurse would record this type of delusion as what?

Persecutory

Which type of delusion refers to a situation whereby a person or someone close to person is being malevolently treated in some way?

Persecutory type

A client with schizophrenia is prescribed an antipsychotic medication. Which immediate side effects would the nurse include in the education plan for this medication?

Potential for sedation

A client with schizophrenia reads the advice column in the newspaper daily. When asked why the client is so interested in the advice column, the client replies, "This person is my guide and tells me what I must do every day." The nurse would best describe this type of thinking as what?

Referential delusion

Some research has suggested that schizophreniform disorder may be an early manifestation of which other mental health condition?

Schizophrenia

The student nurse correctly recognizes that which finding is best supported by genetic studies in the etiology of schizophrenia?

Schizophrenia is at least partially inherited

When reviewing the diagnostic criteria for schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), which would be most accurate?

Schizophrenia lasts at least 6 months and includes at least 1 month of two or more characteristic symptoms.

A client diagnosed with delusional disorder who uses excessive health care resources most likely has which type of delusions?

Somatic

A student nurse is having a first experience in an inpatient psychiatric unit and is frightened by the behaviors of the clients with schizophrenia. The student nurse should take which action to deal with fear?

Stay in an open area while talking to others

A client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. The nurse observes during a therapy session that the client's behavior includes repetitive movements of the mouth and tongue, facial grimacing, and rocking back and forth. The nurse recognizes these behaviors as indicative of what?

Tardive dyskinesia

Research related to the development of schizophrenia has shown what?

The disorder is thought to arise from the interaction of a biological predisposition and environmental stressors.

A client is admitted to the psychiatric hospital with a diagnosis of schizophrenia. During the physical examination, the client's arm remains outstretched after the nurse obtains the pulse and blood pressure, and the nurse must reposition the arm. The nurse interprets this as what?

Waxy flexibility

Assessment of genetic predisposition supports asking a client who is exhibiting symptoms of a delusional disorder what?

Whether any family members have been diagnosed with schizophrenia