Schizophrenia: Q&A Evolve – Flashcards
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Schizophrenia is best characterized as:
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-Deteriorating personality -The course of the disease is marked by recurrent acute exacerbations. With each relapse of psychosis, an increase in residual dysfunction and deterioration occurs. Text page: 311
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Name a descriptor subtype of schizophrenia:
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-Disorganized -Disorganized schizophrenia is a subtype of schizophrenia listed in the DSM-IV-TR and refers to the most regressed and socially impaired of all the schizophrenic disorders. Text page: 307
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Anhedonia is considered negative or positive symptom of schizophrenia?
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-Negative -Negative symptoms include the crippling symptoms of affective blunting, anergia, anhedonia avolition, poverty of content of speech, poverty of speech, and thought blocking. Text page: 312
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The type of altered perception most commonly experienced by clients with schizophrenia is:
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-Auditory hallucinations -Hallucinations, especially auditory hallucinations, are the major example of alterations of perception in schizophrenia. They are experienced by as many as 90% of schizophrenic individuals. Text page: 316
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What is the most common course of schizophrenia? Initial episode followed by:
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-Recurrent acute exacerbations and deterioration -Schizophrenia is usually a disorder marked by an initial episode followed by recurrent acute exacerbations. With each relapse of psychosis an increase in residual dysfunction and deterioration occurs. Text page: 311
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The causation of schizophrenia is currently understood to be:
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-A combination of inherited and nongenetic factors -Causation is a complicated matter. Schizophrenia most likely occurs as a result of a combination of inherited genetic factors and extreme nongenetic factors (such as virus, birth injuries, nutritional factors) that can affect the genes governing the brain or directly injure the brain. Text page: 309
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Name positive symptoms of schizophrenia:
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-The attention getting symptoms such as hallucination, delusions, bizarre behavior, and paranoia. -hey are referred to as florid symptoms. Affective flattening is one of the negative symptoms that contribute to rendering the person inert and unmotivated. Text page: 312
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A withdrawn client is assessed as having distorted thinking that is not reality based. A nursing diagnosis that should be considered for her would be:
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-Disturbed thought processes -Disturbed thought processes is a nursing diagnosis defined as a state in which an individual experiences a disruption in cognitive operations and activities. Text page: 320
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When a client with schizophrenia hears hallucinated voices saying he is a vile human being, the nurse can correctly assume that the hallucination:
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-Is a projection of the client's own feelings. -One theory about derogatory hallucinations is that the content is a projection of the individual's feelings about self. The derogatory hallucinations are an extension of the strong feelings of rejection and lack of self-respect experienced by the individual during the prodromal period. Text page: 316
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Which side effect of antipsychotic medication has no known treatment?
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-Tardive dyskinesia -Tardive dyskinesia is not always reversible with discontinuation of the medication and has no proven cure. Anticholinergic effects, pseudoparkinsonism, and dystonic reaction often appear early in therapy and can be minimized with treatment. Text page: 331
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A client with residual schizophrenia is uninterested in community activities. He lacks initiative, demonstrates both poverty of content of speech and poverty of speech, and seems unable to follow the schedule for taking his antipsychotic medication. The case manager continues to direct his care with the knowledge that his behavior is most likely prompted by:
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-Neural dysfunction -Schizophrenia is considered a neurobiological disorder. The course of schizophrenia involves recurrences. With each relapse further deterioration is noted. Residual schizophrenia refers to the disorder when active phase symptoms are no longer present and the individual is left with two or more of the following symptoms: lack of initiative, social withdrawal, impaired role function, marked speech deficits, and odd beliefs. Text page: 309
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A client with paranoid schizophrenia refuses food. He states the voices are telling him the food is contaminated and will change him from a male to a female. A therapeutic response for the nurse would be:
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-"I understand that the voices are very real to you, but I do not hear them." -This reply acknowledges the client's reality but offers the nurse's perception that he or she is not experiencing the same thing. Text page: 323
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A client with disorganized schizophrenia would have greatest difficulty with the nurse:
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-Giving multistep directions -The thought processes of the client with disorganized schizophrenia are severely disordered and severe perceptual problems are present, making it extremely difficult for the client to understand what others are saying. All communication should be simple and concrete and may need to be repeated several times. Text page: 335
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A nursing intervention designed to help a schizophrenic client manage relapse is to:
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-Teach the client and family about behaviors associated with relapse -By knowing what behaviors signal impending relapse, interventions can be quickly invoked when the behaviors occur. The earlier the intervention, the greater the likelihood that a recurrence can be averted. Text page: 325
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A client with paranoid schizophrenia tells the nurse "I have to get away. The volmers are coming to execute me." The term "volmers" can be assessed as:
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-A neologism -A neologism is a newly coined word that has meaning only for the client. Text page 315
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When a client with paranoid schizophrenia tells the nurse "I have to get away. The volmers are coming to execute me," an appropriate response for the nurse would be:
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-"It must be frightening to think something is going to harm you." -This response focuses on the client's feelings and neither directly supports the delusion nor denies the client's experience. Option 1 gives global reassurance. Option 2 encourages elaboration about the delusion. Option 3 asks for information that the client will likely be unable to answer. Text page: 323
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A desired outcome for a client with schizophrenia who has a nursing diagnosis of Disturbed sensory perception: auditory hallucinations related to neurobiological dysfunction would be that the client will:
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-Ask for validation of reality -Beginning to question his/her own altered perceptions by seeking input from staff is highly desirable. Text page: 321.
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A client has reached the stable plateau phase of schizophrenia. An appropriate clinical focus for planning would be:
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-Social, vocational, and self-care skills -During the stable plateau phase of schizophrenia, planning is geared toward client and family education and skills training that will help maintain the optimal functioning of schizophrenic individuals in the community. Text page: 321
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A client has been receiving antipsychotic medication for 6 weeks. At her clinic appointment she tells the nurse that her hallucinations are nearly gone and that she can concentrate fairly well. She states her only problem is "the flu" that she's had for 2 days. She mentions having a fever and a very sore throat. The nurse should:
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-Arrange for the client to have blood drawn for a white blood cell count. -Antipsychotic medications may cause agranulocytosis, the first manifestation of which may be a sore throat and flulike symptoms. Text page: 330
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The purpose for a nurse periodically performing the Abnormal Involuntary Movement Scale (AIMS) assessment on a persistently mentally ill client who has schizophrenia is early detection of:
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-Tardive dyskinesia -An AIMS assessment should be performed periodically on clients who are being treated with antipsychotic medication known to cause tardive dyskinesia. Text page: 331
