SCHIZOPHRENIA MH NURSING CHAPTER 15.
SCHIZOPHRENIA SPECTRUM AND OTHER
PSYCHOTIC DISORDERS QUESTIONS WITH
COMPLETE SOLUTIONS
1. A nurse is caring for a client who has schizophrenia and
exhibits a lack of grooming and a flat
affect. The nurse should expect a prescription for which of the
following medications?
A. Chlorpromazine
B. Thiothixene
C. Risperidone
D. Haloperidol Correct Answer 1. A. First-generation
antipsychotics (chlorpromazine) are used mainly to control
positive, rather than
negative, symptoms of schizophrenia.
B. First-generation antipsychotics (thiothixene) are used mainly
to control positive symptoms of schizophrenia.
C. CORRECT: Second-generation antipsychotics (risperidone)
are effective in treating negative symptoms of schizophrenia
(lack of grooming and flat affect).
D. First-generation antipsychotics (haloperidol) are used mainly
to control positive symptoms of schizophrenia.
1. A nurse is caring for a client who has substance-induced
psychotic disorder and is experiencing auditory hallucinations.
The client states, "The voices won't leave me alone!" Which of
the following statements should the nurse make? (Select all that
apply.)
A. "When did you start hearing these things?"
,B. "The voices are not real, or else we would both hear them."
C. "It must be scary to hear voices."
D. "Are the voices you hear telling you to hurt yourself?"
E. "Why are the voices talking to only you?" Correct Answer
A. CORRECT: Ask the client directly about the hallucination.
B. Do not argue with the client's view of the situation.
C. CORRECT: Focus on the client's feelings rather than
agreeing with the client's hallucination.
D. CORRECT: Assess for command hallucinations and the
client's risk for injury to self or others.
E. Avoid asking a "why" question, which is nontherapeutic and
can promote a defensive client response.
1. A paranoid client presents with bizarre behaviors, neologisms,
and thought insertion. Which nursing action should be
prioritized to maintain this client's safety?
1. Assess for medication nonadherence.
2. Note escalating behaviors and intervene immediately.
3. Interpret attempts at communication.
4. Assess triggers for bizarre, inappropriate behaviors. Correct
Answer ANS: 2
Rationale: The nurse should note escalating behaviors and
intervene immediately, to maintain this clients safety. Early
intervention may prevent an aggressive response and keep the
client and others safe.
1. A person has had difficulty keeping a job because of arguing
with co-workers and accusing them of conspiracy. Today the
person shouts, Theyre all plotting to destroy me. Isnt that true?
Select the nurses most therapeutic response.
,a. Everyone here is trying to help you. No one wants to harm
you.
b. Feeling that people want to destroy you must be very
frightening.
c. That is not true. People here are trying to help you if you will
let them.
d. Staff members are health care professionals who are qualified
to help you. Correct Answer ANS: B
Resist focusing on content; instead, focus on the feelings the
patient is expressing. This strategy prevents arguing about the
reality of delusional beliefs. Such arguments increase patient
anxiety and the tenacity with which the patient holds to the
delusion. The other options focus on content and provide
opportunity for argument.
1. Although symptoms of schizophrenia occur at various times
in the life span, what client would be at highest risk for the
diagnosis?
1. A 10-year-old girl.
2. A 20-year-old man.
3. A 50-year-old woman.
4. A 65-year-old man. Correct Answer 1. CORRECT 2.
Symptoms of schizophrenia generally appear in late adolescence
or early adulthood. Some studies have indicated that symptoms
occur earlier in men than in women.
1. Recent research on the RAISE approach to the treatment of
schizophrenia incorporates which of the following elements as
important to improving outcomes? (Select all that apply.)
, a. Early intervention at the first episode of psychosis
b. Support for employment or educational pursuits
c. Rapid high-dose loading with antipsychotic medication
d. Court-ordered sanctions for treatment
e. Recovery-focused psychotherapy Correct Answer A: 1. a, b,
e
10. A client reports to the nurse that his foot is on fire and he
thinks the demons are trying to burn off his flesh. The priority
nursing intervention for this symptom is to:
a. Administer prn haloperidol as ordered.
b. Evaluate the client's foot to rule out physical causes for his
complaint.
c. Administer prn benztropine as ordered.
d. Ask the client if he would like to speak with a chaplain.
Correct Answer A: 10. b
10. 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.î The nurse would best
describe this type of thinking as which of the following?
A) Referential delusion
B) Grandiose delusion
C) Thought insertion
D) Personalization Correct Answer Ans: A
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