Question 1

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

Accepted Answer

Decreased levels of prolactin in schizophrenia are often associated with negative symptoms such as apathy, social withdrawal, and anhedonia. Auditory hallucinations and delusions are typically positive symptoms not directly linked to prolactin levels.

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

Group therapy, medication management, supportive family therapy, and social skills training are all important components of a rehabilitative program for clients diagnosed with schizophrenia. Deterrent therapy is not a recognized component of rehabilitative programs for schizophrenia.

Question 3

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

Clozapine can cause agranulocytosis, a potentially life-threatening condition that can lead to fever, sore throat, and malaise. These symptoms should be reported immediately to the healthcare provider for further evaluation and possible discontinuation of the medication. The other options, akathisia and hypersalivation, akinesia and insomnia, and dry mouth and urinary retention, are common side effects of many antipsychotic medications, including clozapine, but they are not as urgent as agranulocytosis.

Question 4

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 5

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

Accepted Answer

The priority nursing diagnosis in this scenario is identifying the risk for other-directed violence. The student's behavior of yelling accusations at fellow students poses a threat to their safety and should be addressed immediately. Although the student is experiencing altered thought processes due to hearing voices and experiencing social isolation, these diagnoses can be addressed once the safety of the student and others is ensured. Therefore, option B is the most concerning and should be addressed first.

Question 6

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

The most realistic and therapeutic outcome for a client experiencing auditory hallucinations is for them to identify triggers or events that increase anxiety and may lead to hallucinations. This helps in managing and reducing the occurrence of hallucinations by avoiding or coping with these triggers effectively.

Question 7

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 evaluate the patient's white blood cell count to establish a baseline for comparison in order to recognize a potentially life-threatening side effect, agranulocytosis, which is a rare but serious side effect of clozapine therapy. Agranulocytosis is characterized by a severe decrease in white blood cells, leading to an increased risk of infection. Regular monitoring of the white blood cell count is required throughout clozapine therapy to detect this adverse reaction.

Question 8

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

Accepted Answer

The return of symptoms may indicate that the client has not been taking the medication as prescribed. It is important to assess the client's adherence to the medication regimen and discuss any barriers or challenges that may be contributing to noncompliance. Tolerance to thioridazine is not a common occurrence, and combining alcohol with the medication would likely result in sedation and increased risk of side effects rather than a return of symptoms. Taking the medication with food is important for absorption but would not necessarily be the sole cause for symptom return.

Question 9

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

Presenting evidence that contradicts the client's delusions or offering logical explanations may not be effective as clients may hold strong beliefs despite evidence to the contrary. Instead, the nurse should focus on the emotions behind the delusions and help the client identify and cope with these emotions. This approach is known as emotion-focused therapy and can help reduce the intensity and frequency of delusional thinking. Exploring the reasons behind the delusion may also be helpful, but this should be done with caution as it can inadvertently reinforce the client's beliefs if their delusions are based in part on past experiences or trauma.

Question 10

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

Accepted Answer

Thioridazine (Mellaril) is contraindicated because it is a phenothiazine, and there is a cross-sensitivity risk with prochlorperazine, which is also a phenothiazine.

Quiz 26: Schizophrenia and Other Psychotic Disorders