Question 1

A college student has quit attending classes,isolates self because of hearing voices,and yells accusations at fellow students.Based on this information,which nursing diagnosis should the nurse prioritize?

Accepted Answer

The nursing diagnosis that must be prioritized in this situation is risk for other-directed violence R/T yelling accusations.Hearing voices and yelling accusations indicate a potential for violence,and this potential safety issue should be prioritized.

Question 2

Which of the following components should a nurse recognize as an integral part of a rehabilitative program when planning care for clients diagnosed with schizophrenia? Select all that apply.

Accepted Answer

The nurse should recognize that group therapy,medication management,supportive family therapy,and social skills training all play an integral part in rehabilitative programs for clients diagnosed with schizophrenia.Schizophrenia results from various combinations of genetic predispositions,biochemical dysfunctions,physiological factors,and psychological stress.Effective treatment requires a comprehensive,multidisciplinary effort.

Question 3

A nurse is administering risperidone (Risperdal)to a client diagnosed with schizophrenia.The therapeutic effect of this medication would most effectively address which of the following symptoms? Select all that apply.

Accepted Answer

The nurse should expect that risperidone (Risperdal)would be effective treatment for somatic delusions,gustatory hallucinations,and clang associations.Risperidone is an atypical antipsychotic that has been effective in the treatment of the positive symptoms of schizophrenia and in maintenance therapy to prevent exacerbation of schizophrenic symptoms.

Question 4

If clozapine (Clozaril)therapy is being considered,the nurse should evaluate which laboratory test to establish a baseline for comparison in order to recognize a potentially life-threatening side effect?

Accepted Answer

The nurse should establish a baseline white blood cell count to evaluate a potentially life-threatening side effect if clozapine (Clozaril)is being considered as a treatment option.Clozapine can have a serious side effect of agranulocytosis,in which a potentially fatal drop in white blood cells can occur.

Question 5

A client has been recently admitted to an inpatient psychiatric unit.Which intervention should the nurse plan to use to reduce the client's focus on delusional thinking?

Accepted Answer

The nurse should focus on the client's feelings rather than attempt to change the client's delusional thinking by the use of evidence or logical explanations.Delusional thinking is usually fixed,and clients will continue to have the belief in spite of obvious proof that the belief is false or irrational.

Question 6

A newly admitted client has taken thioridazine (Mellaril)for 2 years,with good symptom control.Symptoms exhibited on admission included paranoia and hallucinations.The nurse should recognize which potential cause for the return of these symptoms?

Accepted Answer

Altered thinking can affect a client's insight into the necessity for taking antipsychotic medications consistently.When symptoms are no longer bothersome,clients may stop taking medications that cause disturbing side effects.Clients may miss the connection between taking the medications and an improved symptom profile.

Question 7

A client states,"I hear voices that tell me that I am evil." Which outcome related to these symptoms should the nurse expect this client to accomplish by discharge?

Accepted Answer

It is unrealistic to expect the client to completely stop hearing voices.Even when compliant with antipsychotic medications,clients may still hear voices.It would be realistic to expect the client to associate stressful events with an increase in auditory hallucinations.By this recognition the client can anticipate symptoms and initiate appropriate coping skills.

Question 8

During an admission assessment,a nurse notes that a client diagnosed with schizophrenia has allergies to penicillin,prochlorperazine (Compazine),and bee stings.On the basis of this assessment data,which antipsychotic medication would be contraindicated?

Accepted Answer

The nurse should know that thioridazine (Mellaril)would be contraindicated because of cross-sensitivity among phenothiazines.Prochlorperazine (Compazine)and thioridazine are both classified as phenothiazines.

Question 9

A client diagnosed with schizophrenia is prescribed clozapine (Clozaril).Which client symptoms related to the side effects of this medication should prompt a nurse to intervene immediately?

Accepted Answer

The nurse should intervene immediately if the client experiences a sore throat,fever,and malaise when taking the atypical antipsychotic drug clozapine (Clozaril).Clozapine can have a serious side effect of agranulocytosis,in which a potentially fatal drop in white blood cells can occur.Symptoms of infectious processes would alert the nurse to this potential.

Question 10

Laboratory results reveal elevated levels of prolactin in a client diagnosed with schizophrenia.When assessing the client,the nurse should expect to observe which symptoms? Select all that apply.

Accepted Answer

Dopamine blockage,an expected action of antipsychotic medications,also results in prolactin elevation.Galactorrhea and gynecomastia are symptoms of prolactin elevation.

Quiz 24: Schizophrenia Spectrum and Other Psychotic Disorders

A college student has quit attending classes,isolates self because of hearing voices,and yells accusations at fellow students.Based on this information,which nursing diagnosis should the nurse prioritize?

Which of the following components should a nurse recognize as an integral part of a rehabilitative program when planning care for clients diagnosed with schizophrenia? Select all that apply.

A nurse is administering risperidone (Risperdal) to a client diagnosed with schizophrenia.The therapeutic effect of this medication would most effectively address which of the following symptoms? Select all that apply.

If clozapine (Clozaril) therapy is being considered,the nurse should evaluate which laboratory test to establish a baseline for comparison in order to recognize a potentially life-threatening side effect?

A client has been recently admitted to an inpatient psychiatric unit.Which intervention should the nurse plan to use to reduce the client's focus on delusional thinking?

A newly admitted client has taken thioridazine (Mellaril) for 2 years,with good symptom control.Symptoms exhibited on admission included paranoia and hallucinations.The nurse should recognize which potential cause for the return of these symptoms?

A client states,"I hear voices that tell me that I am evil." Which outcome related to these symptoms should the nurse expect this client to accomplish by discharge?

During an admission assessment,a nurse notes that a client diagnosed with schizophrenia has allergies to penicillin,prochlorperazine (Compazine) ,and bee stings.On the basis of this assessment data,which antipsychotic medication would be contraindicated?

A client diagnosed with schizophrenia is prescribed clozapine (Clozaril) .Which client symptoms related to the side effects of this medication should prompt a nurse to intervene immediately?

Laboratory results reveal elevated levels of prolactin in a client diagnosed with schizophrenia.When assessing the client,the nurse should expect to observe which symptoms? Select all that apply.