Deck 15: Schizophrenia Spectrum and Other Psychotic Disorders

Question 1

The client diagnosed with schizophrenia spectrum disorder tells the nurse, "I'm sad that the voice is telling me to stop seeing my psychiatrist." Which symptom is the client exhibiting?

A) Magical thinking
B) Persecutory delusions
C) Command hallucinations
D) Altered thought processes

Answer 1

Command hallucinations

Question 2

____________________ disorder is manifested by signs and symptoms of schizophrenia, along with a strong element of symptomatology associated with the mood disorders (depression or mania).

Answer 2

Schizoaffective

Question 3

Parents ask a nurse how they should reply when their son, diagnosed with schizophrenia spectrum disorder, tells them that voices command him to harm others. Which nursing response is appropriate?

A) "Tell him to stop discussing the voices."
B) "Ignore what he is saying, while attempting to discover the underlying cause."
C) "Focus on the feelings generated by the hallucinations and present reality."
D) "Present objective evidence that the voices are not real."

Answer 3

"Focus on the feelings generated by the hallucinations and present reality."

Question 4

The client diagnosed with schizophrenia spectrum disorder tells a nurse about voices commanding him to kill his ex-spouse. Which nursing diagnosis is priority for this client?

A) Disturbed sensory perception
B) Altered thought processes
C) Risk for violence: directed toward others
D) Risk for injury

Question 5

Place the spectrum of schizophrenic and other psychotic disorders as described by the DSM-5 on a gradient of psychopathology from least to most severe (1-4). (Enter the number of each disorder in the proper sequence, using comma and space format, such as: 1, 2, 3, 4)

A) Delusional disorder
B) Schizophrenia
C) Schizophreniform disorder
D) Substance-induced psychotic disorder

Question 6

A client diagnosed with schizophrenia spectrum disorder states, "Can't you hear him? It's the devil. He's telling me I'm going to hell." Which is the most appropriate nursing response?

A) "Did you take your medicine this morning?"
B) "You are not going to hell. You are a good person."
C) "The voices must sound scary, but I do not hear any voices."
D) "The devil only talks to people who are receptive to his influence."

Question 7

The psychiatrist prescribes haloperidol (Haldol) 50 mg bid, benztropine (Cogentin) 1 mg prn, and zolpidem (Ambien) 10 mg at bedtime for a client with schizophrenia spectrum disorder. Which client behavior would warrant the nurse to administer benztropine?

A) Tactile hallucinations
B) Tardive dyskinesia
C) Muscle rigidity
D) Reports of hearing disturbing voices

Question 8

The diagnosis of catatonic disorder due to another medical condition is made when the client's medical history, physical examination, or laboratory findings provide evidence that symptoms are directly attributed to which conditions? (Select all that apply.)

A) Epilepsy
B) Hypothyroidism
C) Hyperadrenalism
D) Encephalitis
E) Hyperaphia

Question 9

Which client assessment finding would alert the nurse to question a diagnosis of brief psychotic disorder?

A) Has impaired reality testing for a 24-hour period.
B) Has auditory hallucinations for the past 3 hours.
C) Has bizarre behavior for 1 day.
D) Has confusion for 3 weeks.

Question 10

An adolescent diagnosed with schizophrenia spectrum disorder experiences command hallucinations to harm others. The client's parents ask a nurse, "Where do the voices come from?" Which response should the nurse make?

A) "Your child has a chemical imbalance of the brain, which leads to altered perceptions."
B) "Your child's hallucinations are caused by medication interactions."
C) "Your child has too little serotonin in the brain, causing delusions and hallucinations."
D) "Your child's abnormal hormonal changes have precipitated auditory hallucinations."

Question 11

A client diagnosed with schizoaffective disorder is admitted for social skills training. Which information should be included in the nurse's teaching?

A) The side effects of medications
B) Deep breathing techniques to decrease stress
C) How to make eye contact when communicating
D) Behaviors needed to be a leader

Question 12

A client with schizophrenia spectrum disorder presents with bizarre behaviors and delusions. Which nursing action should be prioritized to maintain this client's safety?

A) Monitor for medication nonadherence.
B) Note escalating behaviors immediately.
C) Interpret attempts at communication.
D) Assess triggers for bizarre, inappropriate behaviors.

Question 13

The aging client takes an antipsychotic for schizophrenia spectrum disorder and a beta-adrenergic blocking agent for hypertension. Based on an understanding of the combined side effects of these drugs, which statement by a nurse is most appropriate?

A) "Make sure you concentrate on taking slow, deep, cleansing breaths."
B) "Watch your diet and try to engage in some regular physical activity."
C) "Rise slowly when you change position from lying to sitting or sitting to standing."
D) "Wear sunscreen and try to avoid midday sun exposure."

Question 14

The client diagnosed with schizophrenia spectrum disorder is prescribed an antipsychotic. Which client symptoms, related to the side effects of this medication, should prompt a nurse to intervene immediately?

A) Sore throat and malaise
B) Light-colored urine and bradycardia
C) Anosognosia and avolition
D) Dry mouth and urinary retention

Question 15

Which modalities should a nurse recognize as integral parts of a treatment program when planning care for clients diagnosed with schizophrenia spectrum disorder? (Select all that apply.)

A) Group therapy
B) Medication management
C) Deterrent therapy
D) Supportive family therapy
E) Social skills training

Question 16

The nurse asks the client with schizophrenia spectrum disorder, "Do you receive special messages from certain sources, such as the television or radio?" The nurse is assessing which potential symptom of this disorder?

A) Loose associations
B) Paranoid delusions
C) Magical thinking
D) Delusions of reference

Question 17

Which data in the history would the nurse expect to find in a client diagnosed with substance-induced psychotic disorder?

A) Had delirium
B) Had less severe withdrawal symptoms
C) Has an opioid use disorder
D) Has a fluid and electrolyte imbalance

Question 18

The nurse is caring for a client with schizophrenia spectrum disorder who is experiencing a flat affect, paranoid delusions, anhedonia, anergia, neologisms, and echolalia. Which statement correctly differentiates the client's positive and negative symptoms of schizophrenia?

A) Paranoid delusions, anhedonia, and anergia are positive symptoms of schizophrenia.
B) Paranoid delusions, neologisms, and echolalia are positive symptoms of schizophrenia.
C) Paranoid delusions, anergia, and echolalia are negative symptoms of schizophrenia.
D) Paranoid delusions, flat affect, and anhedonia are negative symptoms of schizophrenia.

Question 19

Which action would the nurse take to establish a trusting relationship with a client diagnosed with schizophrenia spectrum disorder?

A) Establish personal contact with family members
B) Be reliable, honest, and consistent during interactions
C) Share limited personal information
D) Sit close to the client to establish rapport

Question 20

Which nursing intervention would be most appropriate when caring for an agitated, suspicious client diagnosed with schizophrenia spectrum disorder?

A) Supply neon lights and soft music.
B) Maintain continual eye contact throughout the interview.
C) Use therapeutic touch to increase trust and rapport.
D) Provide personal space to respect the client's boundaries.

Question 21

______ are false sensory perceptions not associated with real external stimuli and may involve any of the five senses.