Schizophrenia and Other Thought Disorders – Flashcards

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question
Although symptoms of schizophrenia occur at various times in the life span, what client would be at risk for the diagnosis? A. A 10 year old girl B. A 20 year old man C. A 50 year old woman D. A 65 year old Man
answer
B. A 20 year old man Symptoms of schizophrenia generally appear in late adolescence or early adulthood. Some studies have indicated that symptoms occur earlier in men than in women
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A nursing instructor is teaching about the etiology of schizophrenia. What statement by the nursing student indicates an understanding of the content presented? A. "Schizophrenia is a disorder of the brain that can be cured with the correct treatment." B. "A person inherits schizophrenia from a parent." C. "Problems in the structure of the brain cause schizophrenia." D. "There are many potential causes for this disease, and its etiology is controversial."
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D. "There are many potential causes for this disease, and it's etiology is controversial." The etiology of schizophrenia remains unclear. No single theory or hypothesis has been populated that substantiates a clear-cut etiology for this disease. The more research that is conducted, the more evidence is compiled to support the concept of multiple causes in development of schizophrenia. The most current theory seems to be that schizophrenia is a biologically based disease with a genetic component. The onset of the disease also influenced by factors in the internal and external environment.
question
What is required for effective treatment of schizophrenia? A. Concentration on pharmacotherapy alone to alter imbalances in affected neurotransmitters. B. Multidisciplinary, comprehensive efforts, which include pharmacotherapy and psychosocial care. C. Emphasis on social and living skills training to help the client fit into society D. Group and family therapy to increase socialization skills.
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B. Effective treatment of schizophrenia requires a comprehensive, multidisciplinary effort, including pharmacotherapy and various forms of psychosocial care includes social and living skills training, rehabilitation, and family therapy
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When one fraternal (dizygotic) twin has been diagnosed with schizophrenia, the other twin has approximately a _____ % chance of developing the disease.
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15%
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When one identical (monozygotic)twin has been diagnosed with schizophrenia, the other twin has approximately a ____% chance of developing the disease.
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50%
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From a biochemical influence perspective, which accurately describes the etiology of schizophrenia? A. Adopted children with no schizophrenic parents, raised by parents diagnosed with schizophrenia have a higher incidence of this disease. B. An excess of dopamine-dependent neuronal activity in the brain C. A higher incidence of schizophrenia occurs after there is prenatal exposure of the mother to influenza D. Poor parent-child interaction and dysfunctional family systems
answer
B. An excess of dopamine-dependent neuronal activity in the brain. The dopamine hypothesis suggests that schizophrenia may be caused by an excess of dopamine-dependent neuronal activity in the brain. The excess activity may be related to increased production, or release, of the substance at nerve terminals; increased receptor sensitivity; too many dopamine receptors; or a combination of these mechanisms. This etiology cal theory is from a biochemical influence perspective
question
A nurse is working with a client diagnosed with schizoid personality disorder. What symptom of this diagnosis should the nurse expect to assess, and at what risk is this client for acquiring schizophrenia? A. Delusions and Hallucinations - high risk B. Limited range of emotional experience and expression - high risk C. Indifferent to social relationships - low risk D. Loner who appears cold and aloof - low risk
answer
B. Limited range of emotional experience and expression - high risk. Individuals diagnosed with schizoid personality disorder are indifferent to social relationships and have a very limited range of emotional experience and expression. They do not enjoy close relationships and prefer to be loners. They appear cold and aloof. Not all individuals who demonstrate the characteristics of schizoid personality disorder progress to schizophrenia, but most individuals diagnosed with schizophrenia show evidence of the characteristics of schizoid personality disorder pre morbidly, putting them at high risk for schizophrenia
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A nurse is assessing a client with a long history of being a loner and having few social relationships. This client's father has been diagnosed with schizophrenia. The nurse would suspect that this client is in what phase of the development of schizophrenia? A. Phase 1 - Schizoid personality. B. Phase 2 - Prodromal phase C. Phase 3 - Schizophrenia D. Phase 4 - Residual phase
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A. Phase 1 - Schizoid Personality Individuals diagnosed with schizoid personality disorder are typically loners who appear cold and aloof and and are indifferent to social relationships. Not all individuals who demonstrates the characteristics of schizoid personality disorder progress to schizophrenia, but because of a family history of schizophrenia, this client's risk for acquiring the disease increases from 1% in general population to 10%
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A client, diagnosed with schizophrenia, is experiencing social withdrawal, flat affect, and impaired role functioning. To distinguish whether this client is in the Prodromal or residual phase of schizophrenia, what questions would the nurse ask the family? A. "Have these symptoms followed an active period of schizophrenic behaviors?" B. "How long have these symptoms been occurring?" C. "Has the client had a change in mood?" D. "Has the client been diagnosed with any developmental disorders?"
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A. "Have these symptoms followed an active period of schizophrenic behaviors?" It is important for the nurse to know if this client has recently experienced an active phase of schizophrenia to distinguish the symptoms presented as indications of the Prodromal or residual phase of schizophrenia. Schizophrenia is characterized by periods of remission and exacerbation. A residual phase usually follows an active phase of the illness. Symptoms during the residual phase are similar to those of the Prodromal phase, with flat affect and impairment in role function being prominent
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The nurse is assessing a client diagnosed with disorganized schizophrenia. Which symptoms should the nurse expect the client to exhibit? A. Markedly regressive, primitive behavior, and extremely poor contact with reality. Affect is flat or grossly inappropriate. Personal appearance is neglected, and social impairment is extreme. B. Marked abnormalities in motor behavior manifested in extreme psychomotor retardation with pronounced decreases in spontaneous movements and activity. Waxy flexibility is exhibited. C. THe client is exhibiting delusions of persecution or grandeur. Auditory hallucinations related to a persecutory theme are present. The client is tense, suspicious, and guarded and may be argumentative, hostile, and aggressive. D. THe client has a history of active psychotic symptoms, such as delusions or auditory and visual hallucinations , but these prominent psychotic symptoms are not exhibited currently.
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A. Markedly regressive, primitive behavior, and extremely poor contact with reality. Affect is flat or grossly inappropriate. Personal appearance is neglected, and social impairment is extreme. When a client exhibits markedly regressive and primitive behavior, and the client's contact with reality is extremely poor, he or she is most likely to be diagnosed with disorganized schizophrenia. In this subcategory, a client's affect is flat or grossly inappropriate. Personal appearance is neglected, and social impairment is extreme
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On an in-patient unit, the nurse is caring for a client who is assuming bizarre positions for long periods of time. To which diagnostic category of schizophrenia would this client most likely be assigned? A. Disorganized schizophrenia B. Catatonic Schizophrenia C. Paranoid Schizophrenia D. Undifferentiated schizophrenia
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B. Canonic Scizophrenia A client diagnosed with catatonic schizophrenia exhibits marked abnormalities in motor behavior manifested in extreme psychomotor retardation with pronounced decreases in spontaneous movements and activity. Waxy flexibility is exhibited. Waxy flexibility is a type of posturing or voluntary assumption of bizarre positions in which the individual may remain for long periods. Efforts to move the individual may be met with rigid bodily resistance. The client described in the question is exhibiting signs and symptoms of canonic schizophrenia
question
A student nurse is assessing a 20 year old client who is experiencing auditory hallucinations. The student states. " I believe the client has schizophrenia." Which of the following instructor responses is the most appropriate? (SELECT ALL THAT APPLY) A. "How long has the client experienced these symptoms?" B. "Has the client taken any drug or medication that could cause these symptoms?" C. "It is not within your scope of practice to assess for a medical diagnosis." D. "Does the client have any mood problems?" E. "What kind of relationships has the client established?"
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A, B, D, E The DSM-IV-TR lists the diagnostic criteria for the diagnosis of schizophrenia A. The duration of symptoms is an important finding to assess to determine the diagnosis of schizophrenia. One of the DSM-IV-TR criteria is that symptoms need to be present for a significant amount of time during a 1-month period and last for 6 months. B. The use of a substance may rule out the diagnosis of schizophrenia. One of the DSM-IV-TR criteria for this diagnosis is that presenting symptoms are not due to the direct physiological effects of the use or abuse of a substance or medication D. The presence of mood disorders is an important finding to assess to determine the diagnosis of schizophrenia. Schizoaffective disorder and mood disorder with psychotic features must be ruled out for the client to meet the criteria for the diagnosis. No major depressive, manic, or mixed episodes should have occurred concurrently with the active-phase symptoms. If mood episodes have occurred during the active-phase symptoms, their total duration should have been brief, relative to the duration of the active and residual periods. E. The ability to form relationships is an important finding to assess to determine the diagnosis of schizophrenia. One of the DSM-IV-TR criteria for this diagnosis is a disturbance in one or more major areas of functioning, such as work, interpersonal relationships, or self-care. When the onset is in adolescence, there should be a failure to achieve expected levels of interpersonal or academic functioning
question
A 21 year old client, being treated for asthma with s steroid medication, has been experiencing delusions of persecution and disorganized thinking for the past 6 months. Which factor may rule out a diagnosis of schizophrenia? A. The client has experienced the signs and symptoms for only 6 months. B. THe client must hear voices to be diagnosed with schizophrenia C. The client's age is not typical fort this diagnosis. D. The client is receiving medication that could lead to thought disturbances.
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D. The client is receiving medication that could lead to thought disturbances Steroid medications could precipitate the thought disorders experienced by the client and potentially rule out the diagnosis of schizophrenia. According to the DSM-IV-TR criteria for this diagnosis, the thought disturbance cannot be due to the direct physiological effects of a substance
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A client is brought to the emergency department after being found wandering the streets and talking to unseen others. Which situation is further evidence of a diagnosis of schizophrenia for this client? A. THe client exhibits a developmental disorder, such as autism. B. THe client has a medical condition that could contribute to the symptoms. C. The client experiences manic or depressive signs and symptoms D. THe client's signs and symptoms last for 6 months.
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D. The client's signs and symptoms last for 6 months The client's signs and symptoms lasting for 6 months is further evidence for the diagnosis of schizophrenia. Two or more characteristic symptoms must be present for a significant amount of time during a 1-month period and must last for 6 months to meet the criteria for the diagnosis of schizophrenia.
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A client on an in-patient psychiatric unit refuses to take medications because "The pill has a special code written on it that will make it poisonous." What kind of delusion is this client experiencing? A. An erotomanic delusion B. A grandiose delusion C. A persecutory delusion D. A somatic delusion
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C. A persecutory delusion A persecutory delusion is a type of delusion in which the individual believes he or she is being malevolently treated in some way. Frequent themes include being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harasses, or obstructed in the pursuit of long-term goals.The situation described in the question reflects this type of delusion
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The nurse is performing an admission assessment on a client diagnosed with paranoid schizophrenia. To receive the most accurate assessment information, which should the nurse consider? A. This client will be able to make a significant contribution to history data collection B. Data will need to be gained by reviewing old records and talking with family C. This client's assessment will be easy because of the consistent nature of the symptoms. D. THe nurse can primarily rely on the client's global assessment of functioning
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B. Data will need to be gained by reviewing old records and talking with family Background assessment information must be gathered from numerous sources, including family members and old records. A client in an acute episode would be unable to provide accurate and insightful assessment information because of deficits in communication and thought.
question
The nurse is interviewing a client who states, "The dentist put a filling in my tooth; I now receive transmissions that control what I think and do." The nurse accurately documents this symptom with which charting entry? A. "Client is experiencing a delusion of persecution." B. "Client is experiencing a delusion of grandeur." C. "Client is experiencing a somatic delusion." D. "Client is experiencing a delusion of influence."
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D. "Client is experiencing a delusion of influence." A delusion of influence or control occurs when a client believes certain objects or persons have control over his or her behavior. The statement of the client is reflective of a delusion of influence.
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The children's saying "Step on a crack and you break your mother's back" is an example of which type of thinking? A. Concrete thinking B. Thinking using neologisms C. Magical thinking D. Thinking using clang associations
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C. Magical Thinking Magical thinking occurs when the individual believes that his or her thoughts or behaviors have control over specific situations or people. It is commonly seen during cognitive development in childhood. The statement presented is an example of magical thinking.
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The nurse is assessing a client diagnosed with schizophrenia. The client states, "We wanted to take the bus, but the airport took all the traffic." Which charting entry accurately documents this symptom? A. "The client is experiencing associative looseness." B. "The client is attempting to communicate by the use of word salad." C. "The client is experiencing delusional thinking" D. "The client is experiencing an illusion involving planes."
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A. "The client is experiencing associative looseness." Associative looseness is thinking characterized by speech in which ideas shift from one unrelated subject or another. The client is unaware that the topics are unconnected. The client statement is an example of associative looseness
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The nurse reports that a client diagnosed with a thought disorder is experiencing religiosity. Which client statement would confirm this finding? A. "I see Jesus in my bathroom." B. "I read the Bible every hour so that I will know what to do next." C. "I have no heart. I'm dead and in heaven today." D. "I can't read my Bible because the CIA has poisoned the pages."
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B. "I read the Bible every hour so that I will know what to do next." The statement "I read the Bible every hour so that I will know what to do next" is evidence of the symptom of religiosity. Religiosity is an excessive demonstration of or obsession with religious ideas and behavior. The client may use religious ideas in an attempt to provide rational meaning and structure to behavior
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The nurse states, "It's time for lunch." A client diagnosed with schizophrenia responds, " It's time for lunch, lunch, lunch." Which type of communication process is the client using, and what is the underlying reason for its use? A. Echopraxia, which is an attempt to identify with the person speaking. B. Echolalia, which is an attempt to acquire a sense of self and identity. C. Unconscious identification to reinforce weak ego boundaries D. Depersonalizations to stabilize self-identity
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B. Echolalia, which is an attempt to acquire a sense of self and identity When client's diagnosed with schizophrenia repeat words that they hear, they are exhibiting echolalia. This is an indication of alterations in the client's sense of self. Weak ego boundaries cause these client's to lack feelings of uniqueness. Echolalia is an attempt to identify with the person speaking
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Client's diagnosed with schizophrenia may have difficulty knowing where their ego boundaries end and others' begin. Which client behavior reflects this deficit? A. The client eats only prepackaged food B. The client believes that family members are adding poison to food C. The client looks for actual animals when others state, "It's raining cats and dogs." D. The client imitates other people's physical movements.
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D. The client imitates other people's physical movements. When client's imitate other people's physical movements, they are experiencing echopraxia. The behavior of echopraxia is an indication of alterations in the client's sense of self. These client's have been difficulty knowing where their ego boundaries end and others' begin. Weak ego boundaries cause these client's to lack feelings of uniqueness. Echopraxia is an attempt to identify with others.
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The nurse documents that a client diagnosed with schizophrenia is expressing a flat affect. What is an example of this symptoms? A. The client laughs when told of the death of his or her mother B. The client sits alone and does not interact with others C. The client exhibits no emotional expression D. The client experiences no emotional feelings
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C. The client exhibits no emotional expression Flat affect is described as affect devoid of emotional tone. Having no emotional expression is an indication of flat affect.
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Which client is most likely to benefit from group therapy? A. A client diagnosed with schizophrenia being followed up in an out-patient clinic B. A client diagnosed with schizophrenia newly admitted to an in-patient unit for stabilization C. A client experiencing an exacerbation of the signs and symptoms of schizophrenia D. A client diagnosed with schizophrenia who is not compliant with antipsychotic medications.
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A. A client diagnosed with schizophrenia being followed up in an out-patient clinic. Group therapy for client's diagnosed with thought disorders has been shown to be effective, particularly in an out-patient setting and when combined with medication management.
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In the United States, which diagnosis has the lowest percentage of occurrence? A. Major Depressive disorder B. Generalized anxiety disorder C. Obsessive-compulsive disorder D. Schizophrenia
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D. Schizophrenia In the United States, the prevalence of schizophrenia is approximately 1%. It is recorded that 1.7 million American adults are diagnosed with the brain disorder of schizophrenia
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A client who is hearing and seeing things others do not is brought to the emergency department. Lab values indicate a sodium level of 160 mEq/L. Which nursing diagnosis would take priority? A. Altered thought process R/T low blood sodium levels. B. Altered communication processes R/T altered thought processes. C. Risk for impaired tissue integrity R/T dry oral mucous membranes D. Imbalanced fluid volume R/T increased serum sodium levels.
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D. Imbalanced fluid volume R/T increased serum levels All physiological problems must be corrected before evaluating thought disorders. In this situation, the psychotic symptoms may be related to the critically high sodium level. If the cause is physiological in nature, the nurse's priority is to assist in correcting the physiological problem. If the client's fluid volume imbalance is corrected, the psychotic symptoms, which are due to the medical condition of hyper atresia, would be eliminated, resulting in an improvement in sensory perceptual symptoms. This would improve the client's ability to communicate effectively and decrease the risk of dry mucous membranes.
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A client diagnosed with schizophrenia is experiencing anhedonia. Which nursing diagnosis addresses the client's problem that this symptom may generate? A. Disturbed thought processes B. Disturbed sensory perception C.Risk for suicide D. Impaired verbal communication
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C. Risk for suicide Risk for suicide is defined as a risk for self-inflicted, life-threatening injury. The negative symptom of anhedonia is defined as the inability to experience pleasure. This is a particularly distressing symptom that generates hopelessness and compels some client's to attempt suicide.
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A client diagnosed with a thought disorder is experiencing clang associations. Which nursing diagnosis reflects this client's problem? A. Impaired verbal communication B. Risk for violence C. Ineffective health maintenance D. Disturbed sensory perception
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A. Impaired verbal communication Impaired verbal communication is defined as the decreased, delayed, or absent ability to receive, process, transmit, and use a system of symbols. Clang associations are choices of words that are governed by sound. Words often take a form of rhyming. An example of a clang association is "It is cold. I am bold. The gold has been sold." This type of language is an impairment to verbal communication.
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A disheveled client diagnosed with a thought disorder has body odor and halitosis. Which nursing diagnosis reflects this client's current problem? A. Social isolation B. Impaired home maintenance C. Interrupted family processes D. Self-care deficit
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D. Self-Care deficit Self-care deficit is defined as the impaired ability to perform or complete activities of daily living. The client's symptoms of body odor, halitosis, and a disheveled appearance are directly related to a self-care deficit problems
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A client's family is having a difficult time accepting the client's diagnosis of schizophrenia, and this has led to family conflict. Which nursing diagnosis reflects this problem? A. Impaired home maintenance B. Interrupted family processes C. Social isolation D. Disturbed thought processes
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B. Interrupted family processes The nursing diagnosis of interrupted family processes is defined as a change in family relationships or functioning or both. This nursing diagnosis is reflected in the family's conflict related to an inability to accept the family member's diagnosis of schizophrenia
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A client diagnosed with paranoid schizophrenia tells the nurse about three previous suicide attempts. Which nursing diagnosis would take priority and reflect this client's problem? A. Disturbed thought processes B. Risk for suicide C. Violence: directed toward others D. Risk for altered sensory perception
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B. Risk for Suicide Risk for suicide is defined as the risk for self-inflicted, life-threatening injury. A past history of suicide attempts greatly increases the risk for suicide and makes this an appropriate diagnosis for this client. Because client safety is always the main consideration this diagnosis should be prioritized.
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A client has the nursing diagnosis of impaired home maintenance R/T regression. Which behavior confirms this diagnosis? A. The client fails to take antipsychotic medications B. The client states, "I haven't bathed in a week." C. The client lives in an unsafe and unclean environment D. The client states, "You can't draw my blood without crayons."
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C. The client lives in an unsafe and unclean environment Impaired home maintenance can be related to regression, withdrawal, lack of knowledge or resources, or impaired physical or cognitive functioning in client's experiencing thought disorders. This is evidenced by an unsafe, unclean, disorderly home environment.
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Which outcome should the nurse expect from a client with a nursing diagnosis of social isolation? A. The client will recognize distortions of reality by day 4 B. THe client will use appropriate verbal communication when interacting by day 3 C. THe client will actively participate in unit activities by discharge D. The client will rate anxiety as 5/10 by discharge
answer
C. THe Client will actively participate in unit activities by discharge Actively participating in unit activities by discharge is an outcome for the nursing diagnosis of social isolation. Participation in unit activities indicates interaction with others on the unit, which leads to decreased social isolation.
question
Which outcomes should the nurse expect from a client diagnosed with schizophrenia who is hearing and seeing things others do not hear and see? A. The client will recognize distortions of reality by discharge B. The client will demonstrate the ability to trust by day 2 C. The client will recognize delusional thinking by day 3. D. The client will experience no auditory hallucinations by discharge.
answer
A. The client will recognize distortions of reality by discharge When a client is hearing and seeing things others do not, the client is experiencing a hallucination, which is altered sensory perception. A hallucination is defined as a false sensory perception not associated with real external stimuli. Hallucinations may involve any of the five senses. Because schizophrenia is a chronic disease, some individuals, even when he compliant with antipsychotic medications, continue, continue to experience hallucinations. Recognizing distortions of reality by discharge is an appropriate outcome for the nursing diagnosis of altered sensory perception.
question
A client admitted to an in-patient setting has not been adherent with antipsychotic medications prescribed for schizophrenia. Which outcome related to this client's problem should the nurse expect the client to achieve? A. The client will maintain anxiety as a reasonable level by day 2 B. The client will take antipsychotic medications by discharge C. The client will communicate to staff any paranoid thoughts by day 3 D. The client will take responsibility for self-care by day 4
answer
B. The client will take antipsychotic medications by discharge Taking antipsychotic medications by discharge is an appropriate outcome for this client's problem of no adherence. The outcome is realistic, client centered, and measurable.
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A client taking olanzapine (Zyprexa) has a nursing diagnosis of altered sensory perception R/T command hallucinations. Which outcome would be appropriate for this client's problems? A. The client will verbalize feelings related to depression and suicidal ideations. B. The client will limit caloric intake because of the side effect of weight gain. C. The client will notify staff members of bothersome hallucinations D. The client will tell staff members if experiencing thoughts of self-harm.
answer
C. The client will notify staff members of bothersome hallucinations When the client has the insight to recognize hallucinations and report them to staff members, the client is in better touch with reality and moving toward remission. This is an outcome that relates to the client's problem of altered sensory perception. Reporting to staff members also can assist in preventing the client from following through with the commands given by auditory hallucinations.
question
A homeless client, diagnosed with schizophrenia, is seen in the mental health clinic complaining of insects infesting arms and legs. Which intervention should the nurse implement first? A. Check the client for body lice. B. Present reality regarding somatic delusions C. Explain the origin of persecutory delusions. D. Refer for in-patient hospitalization because of substance-induced psychosis.
answer
A. Check the client for body lice Before assuming that the client is experiencing a somatic delusion, the nurse first must rule out a physical cause for the client's symptoms, such as body lice. A somatic delusion occurs when an individual has an unsubstantiated belief that he or she is experiencing a physical defect, disorder, or disease.
question
A client states to the nurse, "I see headless people walking down the hall at night." Which nursing response is appropriate? A. "What makes you think there are headless people here?" B. "Now let's think about this. A headless person would not be able to walk down the hall." C. "It must be frightening. I realize this is real to you, but I see no headless people." D. "I don't see those people you are talking about."
answer
C. "It must be frightening. I realize this is real to you, but I see no headless people." Empathize get with the client about the altered perception encourages trust and promotes further client communication about hallucinations. The nurse must follow this by presenting the reality of the situation. Client's must be assisted in accepting that the perception is unreal to maintain reality orientation.
question
A client with a nursing diagnosis of disturbed thought processes has an expected outcome of recognizing delusional thinking. Which interventions would the nurse first implement to address this problem? A. Reinforce and focus on reality B. Appreciate that the client has experienced disturbing delusional thinking. C. Indicate that the nurse does not share the belief D. Present logical information to refute the delusional thinking.
answer
B. Appreciate that the client has experienced disturbing delusional thinking. When the nurse conveys understanding that the client is experiencing delusional thinking, the nurse is showing empathy for the client's situation and building trust. This should be the first step to address the problem of disturbed thought processes. All further interventions would be based on the relationship's being established by generating trust.
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A client is in the active phase of paranoid schizophrenia. Which nursing intervention would aid in facilitating other interventions? A. Assign consistent staff members B. Convey acceptance of the delusional belief C. Help the client understand that anxiety causes hallucinations D. Encourage participation in group activities
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A. Assign consistent staff members Individuals with paranoia have extreme suspicious of others and their actions. It is difficult to establish trust with client's experiencing paranoia. All interventions would be suspect. Only by assigning consistent staff members would there be hope to establish a trusting nurse-client relationship and increase the effectiveness of further nursing interventions
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A client newly admitted to an in-patient psychiatric unit is scanning the environment continuously. Which nursing intervention is most appropriate to address this client's behavior? A. Offer self to build a therapeutic relationship with the client B. Assist the client in formulating a plan of action for discharge C. Involve the family in discussions about dealing with the client's behaviors D. Reinforce the need for medication adherence on discharge
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A. Offer self to build a therapeutic relationship with the client The client described in the question is exhibiting signs of paranoia. Client's with this symptom have trouble trusting others. The nurse should use the therapeutic technique of offering self to assist in building a trusting relationship with this client
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Which interaction is most reflective of an appropriate psychotherapeutic approach when interacting with a client diagnosed with schizophrenia? A. The nurse should exhibit exaggerated warmth to counteract client loneliness. B. The nurse should profess friendship to decrease social isolation C. THe nurse should attempt closeness with the client to decrease suspiciousness D. The nurse should establish a relationship by respecting the client's dignity
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D. The nurse should establish a relationship the client's dignity Successful interventions may best be achieved with honesty, simple directness, and a manner that respects the client's privacy and human dignity.
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The nurse is educating the family members of a client diagnosed with schizophrenia about the efforts of psychotherapy. Which statement should be included in the teaching plan? A. "Psychotherapy is a short-term intervention that is usually successful." B. "Much patience is required during psychotherapy because client's often relapse" C. "Major changes in client symptoms can be attributed to immediate psychotherapy" D. "Independent functioning can be gained by immediate psychotherapy"
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B. "Much patience is required during psychotherapy because client's often relapse" The psychotherapist requires much patience when treating client's diagnosed with schizophrenia. Depending on the severity of the illness, psychotherapeutic treatment may continue for many years before client's regain some degree of independent functioning.
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A client diagnosed with schizoid personality disorder asks the nurse in the mental health clinic, "Does this mean I will get schizophrenia?" What nursing response would be most appropriate? A. "Does that possibility upset you?" B. "Not all client's diagnosed with schizoid personality disorders progress to schizophrenia." C. "Few client's with a diagnosis of schizophrenia show evidence of early personality changes" D. "What do you know about schizophrenia?"
answer
B. "Not all client's diagnosed with schizoid personality disorders progress to schizophrenia." Not all individuals who demonstrate the characteristics of schizoid personality disorder progress to schizophrenia. However, most individuals diagnosed with schizophrenia show evidence of having schizoid personality characteristics in the pre morbid state.
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Which intervention used for clients diagnosed with thought disorders is a behavioral therapy approach? A. Offer opportunities for learning about psychotropic medications. B. Attach consequences to adaptive and maladaptive behaviors C. Establish trust within a relationship D. Encourage discussions of feelings related to delusions
answer
B. Attach consequences to adaptive and maladaptive behaviors When the nurse attaches consequences to adaptive or maladaptive behaviors, the nurse is using behavioral therapy approach. Behavior therapy can be a powerful treatment tool for helping clients change undesirable behaviors
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Which intervention used for clients diagnosed with thought disorders is a milieu therapy approach? A. Assist family members in dealing with life stressors caused by interactions with the client B. One-on-one interactions to discuss family dynamics C. Role-play to enhance motor and interpersonal skills D. Emphasize the rules and expectations of social interactions mediated by peer pressure.
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D. Emphasize the rules and expectations of social interactions mediated by peer pressure. When the nurse emphasizes the rules and expectations of social interactions mediated by peer pressure, the nurse is using milieu therapy emphasizes group and social interaction. Rules and expectations are mediated by peer pressure for normalization of adaptation.
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Which of the following clients has the best chance of a positive prognosis after being diagnosed with schizophrenia? SELECT ALL THAT APPLY A. A client diagnosed at age 35 B. A male client experiencing a gradual onset of signs and symptoms C. A female client whose signs and symptoms began after a rape D. A client who has family history of schizophrenia E. A client who has a family history of a mood disorder diagnosis
answer
A, C, E A. Symptoms of schizophrenia generally appear in late adolescence or early adulthood. Onset at a later age is associated with a more positive prognosis C. Abrupt onset of symptoms precipitated by a stressful event, such as rape, is associated with a more positive prognosis. Being female also is associated with a more positive prognosis E. A family history of mood disorder is associated with a more positive prognosis
question
The nurse is teaching a client diagnosed with schizophreniform disorder about what may affect a good prognosis. Which of the following features should the nurse include? SELECT ALL THAT APPLY A. Confusion and perplexity at the height of the psychotic episode B. Good premorbid social and occupational functioning C. Absence of blunted or flat affect D. Predominance of negative symptoms E. Onset of psychotic symptoms within 4 weeks of noticeable behavioral change
answer
A, B, C E
question
Which symptom experienced by a client diagnosed with schizophrenia would predict a less positive prognosis? A. Hearing hostile voices B. Thinking the TV is controlling his or her behavior C. Continuously repeating what has been said D. Onset of psychotic symptoms within 4 weeks of noticeable behavioral change.
answer
D. Onset of psychotic symptoms within 4 weeks of noticeable behavioral change. When a client has little or no interest in work or school activities, the client is exhibiting the negative symptom of apathy. Apathy is indifference to, or disinterest in, the environment. Flat affect is a manifestation of emotional apathy. Because this client is exhibiting a negative symptom, the client has the potential for a poorer prognosis.
question
The nurse is educating the family of a client diagnosed with schizophrenia about the importance of medication adherence. Which statement indicates that learning has occurred? A. "After stabilization, the relapse rate is high, even if antipsychotic medications are taken regularly" B. "My brother will have only about a 30% chance of relapse if he takes his medications consistently" C. "Because the disease is multifaceted, taking antipsychotic medications has little effect on relapse rates." D. "Because schizophrenia is a chronic disease, taking antipsychotic medications has little effect on relapse rates."
answer
B. Research shows that with continuous antipsychotic drug treatment, the relapse rate of clients diagnosed with schizophrenia can be reduced to approximately 30%
question
The nurse documents that a client diagnosed with a thought disorder is experiencing anticholinergic side effects from long-term use of thioridazine (Mellaril). Which symptoms has the nurse noted? A. Akinesia, dystonia, and pseudoparkinsonism B. Muscle rigity, hyperpyrexia, and tachycardia C. Hyperglycemia and diabetes D. Dry mouth, constipation, and urinary retention
answer
D
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A client has a history of schizophrenia, controlled by haloperidol (Haldol). During an assessment, the nurse notes continuous restlessness. Which medication would the nurse expect the physician to prescribe for this client? A. Haloperidol (Haldol) B. Fluphenazine deconate (Prolixin Decanoate) C. Clozapine (Clozaril) D. Benztropine mesylate (Cogentin)
answer
D
question
A client diagnosed with schizophrenia takes (Clozaril) 25 mg qd. Lab results reveal: RBC 4.7 million/mcL, WBC 2000/mcL, and TSH 1.3 mc-IU. Which would the nurse expect the physician to order? A. "Levothyroxine sodium (Synthroid) 150 mcg qd" B. "Ferrous sulfate (Feosol) 100 mg tid" C. "Dicontinue clozapine" D. "Discontinue clozapine and start levothyroxine sodium (Syntroid) 150 mcg qd."
answer
c
question
The nurse is discussing the side effects experienced by a female client taking antipsychotic medications. The client states, " I haven't had a period in 4 months" Which client teaching should the nurse include in the plan of care? A. Antipsychotic medications can cause a decreased libido . B. Antipsychotic medications can interfere with the effectiveness of birth control C. Antipsychotic medications can cause amenorrhea, but ovulation still occurs D. Antipsychotic medications can decrease red blood cells, leading to amenorrhea
answer
C
question
For the past year, a client has received haloperidol (Haldol). The nurse administering the client's next dose notes a twitch on the right side of the client's face and tongue movements. Which nursing intervention takes priority? A. Give Haloperidol (Haldol) and benztropine (Cogentin) 1 mg IM prn per order B. Assess for other signs of hyperglycemia resulting from the use of the haloperidol. C. Check the client's temperature, and assess mental status D. Hold the haloperidol, and call the physician
answer
D
question
A client has been prescribed ziprasidone (Geodon) 40 mg bid. Which of the following interventions are important related to this medication? SELECT ALL THAT APPLY A. Obtain a baseline EKG initially and periodically throughout treatment. B. Teach the client to take the medication with meals C. Monitor the client's pulse because of the possibility of palpations D. Institute seizure precautions, and monitor closely E. Watch for signs and symptoms of a manic episode
answer
A, B, C
question
A client prescribed quetiapine (Seroquel) 50 mg bid has a nursing diagnosis of risk for injury R/T sedation. Which nursing intervention appropriately addresses this client's problem? A. Assess for homicidal and suicidal ideations B. Remove clutter from the environment to prevent injury C. Monitor orthostatic changes in pulse or blood pressure D. Evaluate for auditory and visual hallucinations
answer
B
question
(64) Lithium carbonate(lithium) is to mania as clozapine (Clozaril) is to: A. Anxiety B. Depression C. Psychosis D. Akathisia
answer
C Clozapine (Clozaril), an atypical antipsychotic, is used to treat symptoms of thought disorders, such as, but not limited to, psychoses.
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