Question 1

The client is receiving risperidone (Risperdal)for the treatment of schizophrenia.Which client statement indicates the medication is effectively treating the positive symptoms of schizophrenia?

Accepted Answer

The statement "I am not hearing the voices anymore" indicates that the medication is effectively treating the positive symptoms of schizophrenia, specifically auditory hallucinations. The other statements may indicate improvement, but do not specifically address the positive symptoms of schizophrenia.

Question 2

The nurse is running a group therapy session for clients diagnosed with schizophrenia.Which interventions address the cognitive deficits associated with this disorder?

Accepted Answer

Cognitive deficits associated with schizophrenia include difficulties with memory, attention, and executive functioning. Having clients wear name tags can help with memory difficulties by providing a visual cue to aid in recall. Providing a highly stimulating environment, encouraging open-ended activities, and using humor may be helpful in other areas such as socialization and emotional expression, but do not directly address cognitive deficits.

Question 3

The nurse is caring for a client with schizophrenia whose symptoms of psychosis have resolved.The client's family complains that the client's hygiene remains poor and he lacks motivation and initiative.Which conclusion by the nurse is most appropriate?

Accepted Answer

Poor hygiene and lack of motivation and initiative are characteristic of negative symptoms of schizophrenia, which can persist even after psychotic symptoms have been resolved. This is a common challenge in managing schizophrenia and requires ongoing intervention and support. Disordered thinking may also be present, but the symptoms described by the family are more specifically related to negative symptoms. Misdiagnosis or hearing voices are not relevant to the situation described.

Question 4

The nurse is teaching techniques to improve communication skills to a family with a member with schizophrenia.Which techniques should be included? Select all that apply.

Accepted Answer

Using active listening techniques, such as reflecting and clarifying, can help the family member with schizophrenia feel that their thoughts and feelings are being heard and understood. Making positive, specific requests for change can help the family member feel empowered and understand what is expected of them. Using "I" language to express feelings can help the family member understand the impact their behavior has on others without feeling attacked. Encouraging the client to communicate with only family may be limiting and potentially isolating. Using "you" statements to point out negative behavior can be perceived as blaming and may increase defensiveness.

Question 5

The nurse is providing education related to improving family dynamics for the family of an adolescent diagnosed with schizophrenia.Which topics should be included in the teaching? Select all that apply.

Accepted Answer

Establishing boundaries can help family members understand their roles and responsibilities. Identifying coping mechanisms can help family members manage stress related to caring for an adolescent with schizophrenia. Improving communication can help family members express their concerns and work together to provide support. Discussing childhood memories and preventing future episodes may not be directly related to improving family dynamics.

Question 6

The nurse is caring for a school-age client who was admitted with pneumonia and high fever.The parents are very upset because the child is now unable to recognize them.Which statements should the nurse include while educating the parents on their child's symptoms? Select all that apply.

Accepted Answer

A)The nurse will want to explain that any febrile illness may cause symptoms of delirium and that this symptom will abate when the temperature returns to normal. The presence of parents and family members has been found to reduce the incidence of delirium as well as decrease family stress. Teaching the family how to care for the child during the hospitalization or upon discharge will not necessarily decrease their anxiety. Telling the family the confusion will not last long is not helping them to understand the nature of the symptom.
B)The nurse will want to explain that any febrile illness may cause symptoms of delirium and that this symptom will abate when the temperature returns to normal. The presence of parents and family members has been found to reduce the incidence of delirium as well as decrease family stress. Teaching the family how to care for the child during the hospitalization or upon discharge will not necessarily decrease their anxiety. Telling the family the confusion will not last long is not helping them to understand the nature of the symptom.
C)The nurse will want to explain that any febrile illness may cause symptoms of delirium and that this symptom will abate when the temperature returns to normal. The presence of parents and family members has been found to reduce the incidence of delirium as well as decrease family stress. Teaching the family how to care for the child during the hospitalization or upon discharge will not necessarily decrease their anxiety. Telling the family the confusion will not last long is not helping them to understand the nature of the symptom.
D)The nurse will want to explain that any febrile illness may cause symptoms of delirium and that this symptom will abate when the temperature returns to normal. The presence of parents and family members has been found to reduce the incidence of delirium as well as decrease family stress. Teaching the family how to care for the child during the hospitalization or upon discharge will not necessarily decrease their anxiety. Telling the family the confusion will not last long is not helping them to understand the nature of the symptom.
E)The nurse will want to explain that any febrile illness may cause symptoms of delirium and that this symptom will abate when the temperature returns to normal. The presence of parents and family members has been found to reduce the incidence of delirium as well as decrease family stress. Teaching the family how to care for the child during the hospitalization or upon discharge will not necessarily decrease their anxiety. Telling the family the confusion will not last long is not helping them to understand the nature of the symptom.

Question 7

Which is true regarding the Confusion Assessment Method (CAM)?

Accepted Answer

The Confusion Assessment Method (CAM) is a tool specifically designed to screen for delirium and is not intended to measure the severity of a client's delirium. It consists of four parts and can be completed in a relatively short amount of time. While the CAM may identify cognitive impairment and reversible confusion, it is not designed to screen for depression. Therefore, the only true statement is D) It is effective in screening for cognitive impairment and reversible confusion.

Question 8

A nurse working in a psychiatric unit is caring for a client diagnosed with schizophrenia who manifests positive symptoms of the disease.Based on this data,which manifestation does the nurse expect to identify when providing care?

Accepted Answer

Positive symptoms of schizophrenia refer to abnormal experiences or behaviors that are added on to the person's normal experiences. Examples include hallucinations, delusions, and disorganized thinking/speech. Social withdrawal (A) and anhedonia (C) are negative symptoms, which involve a loss of typical experiences such as lack of interest, emotion, and motivation. Concrete thinking (D) is a cognitive symptom, which involves difficulty with abstract thinking and understanding metaphorical language.

Question 9

Which statement regarding the pathophysiology and etiology of schizophrenia is correct?

Accepted Answer

Brain imaging studies have consistently found abnormalities in the brains of individuals with schizophrenia, including reduced blood flow to the thalamus, frontal lobe, and temporal lobes. This suggests that there is a neurobiological component to schizophrenia. Option B is incorrect, as there is no evidence to support an increased number of nicotinic receptors in the hippocampus in schizophrenia. Option C is incorrect, as research has consistently shown a genetic component to schizophrenia. Option D is incorrect, as studies have found that individuals with schizophrenia have enlarged ventricles and sulci, not decreased size.

Question 10

An adolescent client is admitted to the hospital for the treatment of schizophrenia.The client's mother is confused and wants to know what she did to cause this to occur.Which responses by the nurse are appropriate? Select all that apply.

Accepted Answer

A) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.
B) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.
C) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.
D) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.
E) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.

Question 11

The nurse is caring for the client prescribed thorazine.Which assessment findings alert the nurse to the possibility that the client has developed tardive dyskinesia? Select all that apply.

Accepted Answer

Tardive dyskinesia is a potential side effect of long-term use of antipsychotic medications, including thorazine. It is characterized by involuntary movements of the face, tongue, and extremities. Wormlike motions of the tongue, lip smacking, and unusual facial movements are all signs of tardive dyskinesia. Muscle spasms of the neck and shuffling gait are not typically associated with tardive dyskinesia.

Question 12

The nurse is educating an adolescent client diagnosed with schizophrenia on predisposing risk factors.Which significant risk factor should the nurse include in the teaching?

Accepted Answer

Positive family history is a significant risk factor for developing schizophrenia. Other known risk factors include prenatal complications, birth complications, winter/spring birthdate, and urban living. Parents recently divorced or living in a rural setting have not been consistently linked to an increased risk for schizophrenia.

Question 13

A nurse manager is educating a group of staff nurses on recognizing the differences between confusion and delirium.Which statements should be included in the teaching? Select all that apply.

Accepted Answer

A)Delirium is a reversible condition caused by an acute problem, such as infection, and can occur at any age. Dementia is a cognitive decline generally associated with an aging adult. Older adults are at higher risk for developing delirium, not younger adult females. Also, young children are at greater risk for developing delirium than adolescents because children's bodies are less equipped to cope with insults such as fever, infection, and toxin exposure.
B)Delirium is a reversible condition caused by an acute problem, such as infection, and can occur at any age. Dementia is a cognitive decline generally associated with an aging adult. Older adults are at higher risk for developing delirium, not younger adult females. Also, young children are at greater risk for developing delirium than adolescents because children's bodies are less equipped to cope with insults such as fever, infection, and toxin exposure.
C)Delirium is a reversible condition caused by an acute problem, such as infection, and can occur at any age. Dementia is a cognitive decline generally associated with an aging adult. Older adults are at higher risk for developing delirium, not younger adult females. Also, young children are at greater risk for developing delirium than adolescents because children's bodies are less equipped to cope with insults such as fever, infection, and toxin exposure.
D)Delirium is a reversible condition caused by an acute problem, such as infection, and can occur at any age. Dementia is a cognitive decline generally associated with an aging adult. Older adults are at higher risk for developing delirium, not younger adult females. Also, young children are at greater risk for developing delirium than adolescents because children's bodies are less equipped to cope with insults such as fever, infection, and toxin exposure.
E)Delirium is a reversible condition caused by an acute problem, such as infection, and can occur at any age. Dementia is a cognitive decline generally associated with an aging adult. Older adults are at higher risk for developing delirium, not younger adult females. Also, young children are at greater risk for developing delirium than adolescents because children's bodies are less equipped to cope with insults such as fever, infection, and toxin exposure.

Question 14

The healthcare provider prescribes aripiprazole (Abilify)for the client with schizophrenia.Which is the priority outcome for the client?

Accepted Answer

A)Medication compliance is a priority for clients with schizophrenia. Relapse of symptoms will occur without the medications. The symptom of restlessness is known as akathisia. This would be important to report, but it is not the priority outcome. Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an expected effect of aripiprazole (Abilify), but this is not the priority outcome.
B)Medication compliance is a priority for clients with schizophrenia. Relapse of symptoms will occur without the medications. The symptom of restlessness is known as akathisia. This would be important to report, but it is not the priority outcome. Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an expected effect of aripiprazole (Abilify), but this is not the priority outcome.
C)Medication compliance is a priority for clients with schizophrenia. Relapse of symptoms will occur without the medications. The symptom of restlessness is known as akathisia. This would be important to report, but it is not the priority outcome. Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an expected effect of aripiprazole (Abilify), but this is not the priority outcome.
D)Medication compliance is a priority for clients with schizophrenia. Relapse of symptoms will occur without the medications. The symptom of restlessness is known as akathisia. This would be important to report, but it is not the priority outcome. Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an expected effect of aripiprazole (Abilify), but this is not the priority outcome.

Question 15

The nurse is caring for a client who is experiencing auditory hallucinations.Which is the priority nursing diagnosis for this client?

Accepted Answer

The priority nursing diagnosis for a client experiencing auditory hallucinations would be Risk for Violence, Self-Directed or Other-Directed, as the client may act on the commands they hear from the hallucinations and harm themselves or others. It is important for the nurse to assess the client for any violent tendencies and take appropriate measures to ensure safety. The other options, Disturbed Thought Processes, Individual Ineffective Coping, and Impaired Verbal Communication, may also be appropriate nursing diagnoses for this client but are not as urgent as the risk of violence.

Quiz 23: Cognition

The client is receiving risperidone (Risperdal) for the treatment of schizophrenia.Which client statement indicates the medication is effectively treating the positive symptoms of schizophrenia?