Deck 24: Schizophrenia Spectrum and Other Psychotic Disorders

Question 1

An initial short-term outcome for a withdrawn, socially isolated patient diagnosed with schizophrenia is that the patient will:

A) participate in scheduled activities.
B) identify barriers to social communication.
C) consistently interact with an assigned nurse.
D) share feelings of isolation with group members.

Answer 1

consistently interact with an assigned nurse.

Question 2

Research on neurostructural theories of schizophrenia indicates that pathoanatomic findings often include:

A) ventricular enlargement, brain atrophy, and diminished cerebral blood flow.
B) ventricular blocking, brain swelling, and enhanced cerebral blood flow.
C) decreased cortical thickness and hippocampal hyperplasia.
D) increased cortical thickness and temporal lobe scarring.

Answer 2

ventricular enlargement, brain atrophy, and diminished cerebral blood flow.

Question 3

A patient diagnosed with schizophrenia expresses fear of being pursued by hostile forces. The patient carries a tablet and writes notes in a code. The patient says, "I'm the only one who understands this code." What is the priority nursing diagnosis?

A) Impaired environmental interpretation syndrome related to inability to reason
B) Disturbed thought processes related to thinking not based on reality
C) Risk for other-directed violence related to persecutory delusions
D) Powerlessness related to feelings of persecution

Answer 3

Disturbed thought processes related to thinking not based on reality

Question 4

How long must the symptoms of schizophrenia be present before a diagnosis can be made?

A) At least 6 months
B) At least 1 month
C) More than 1 week
D) On at least three occasions in the past year

Question 5

Which therapeutic activity would be most important in helping a patient diagnosed with schizophrenia remain in the work force?

A) Social skills training
B) Physical therapy to develop muscle strength
C) Occupational therapy to improve coordination
D) Group therapy to improve motivation for working

Question 6

A patient diagnosed with schizophrenia expresses fear of being pursued by hostile forces. The patient carries a tablet and writes notes in a code. The patient says, "I'm the only one who understands this code." Select a realistic and desirable outcome for this patient. The patient will:

A) express a willingness to be supervised by staff by day 2.
B) report feeling safe from harm by others by day 3.
C) allow the nurse to read coded writings by day 2.
D) recognize the need for medication by day 1.

Question 7

A patient tells the nurse, "Air Force jets flying overhead are looking for me. They want to capture me." The patient has not previously verbalized this information. The nurse's initial interventions should:

A) set firm limits on disruptive behaviors.
B) forcefully refute all perceptual distortions.
C) encourage complete description of delusions.
D) voice doubt about delusions without arguing.

Question 8

A patient laughs while saying, "My dog died yesterday." The nurse documents this behavior using what terminology?

A) Autistic
B) Ambivalence
C) Inappropriate affect
D) Associative looseness

Question 9

Parents of a 17-year-old patient diagnosed with schizophrenia ask the nurse what the future will be like for their child. The nurse's solve
should be based on knowledge that the usual course of illness is:

A) a steady lessening of symptoms until stability is achieved.
B) characterized by alternating acute and stable phases.
C) totally different for each individual patient.
D) progressive deterioration.

Question 10

A nurse at the mental health clinic plans a series of psychoeducational groups for persons with schizophrenia. Which topics would take priority?

A) The importance of taking your medication correctly
B) How to complete an application for employment
C) How to dress when attending community events
D) How to give and receive compliments
E) Ways to quit smoking

Question 11

Genetic evidence regarding twins and the risk for schizophrenia supports which fact?

A) Identical and fraternal twins are equal in concordancy for schizophrenia.
B) Monozygotic twins have a lower concordancy rate for schizophrenia than the general population.
C) Fraternal twins have a higher concordancy rate for schizophrenia than monozygotic twins.
D) Monozygotic twins are significantly more likely than the general population to be concordant for schizophrenia.

Question 12

A patient diagnosed with schizophrenia expresses fear of being pursued by hostile forces. The patient carries a tablet and writes notes in a code. The patient says, "I'm the only one who understands this code." How should the nurse document these findings?

A) Grandiose and paranoid delusions
B) Affective blunting and anhedonia
C) Autism and loose associations
D) Delusions of reference

Question 13

The nurse should focus assessment for a patient with type I schizophrenia primarily on gathering data about:

A) cognition and perception.
B) attention and motivation.
C) grooming and hygiene.
D) abstract thinking skills.

Question 14

The family of a patient with type I schizophrenia asks, "Did this illness occur because of all the chaos in our family?" Select the nurse's best response.

A) "It is likely that the chaos in your family caused the disorder. It is very important for every family member to keep calm."
B) "Stress in your family may make the disorder more difficult to manage, but it is not the cause."
C) "Too little is known about the cause of this illness for anyone to speculate."
D) "That question would be best solveed by the psychiatrist."

Question 15

Which type of perceptual alteration is most commonly displayed by patients with schizophrenia?

A) Auditory hallucinations
B) Inappropriate affect
C) Loose associations
D) Illusions

Question 16

A patient displays disorganized speech and behavior as well as a flat affect. The patient prefers to sit alone and often appears to be listening and responding to unseen stimuli. To begin a therapeutic relationship, the nurse should:

A) take the patient to a medication education class.
B) offer a simple activity, and sit with the patient.
C) ask the patient what the voices are saying.
D) quietly watch television with the patient.

Question 17

When a patient experiencing a first episode of type I schizophrenia is hospitalized, the nurse can expect to administer:

A) a typical antipsychotic drug.
B) an atypical antipsychotic drug.
C) a mood-stabilizing anticonvulsant.
D) a selective serotonin reuptake inhibitor.

Question 18

A therapist believes that persons diagnosed with schizophrenia have ego disintegration. This concept is based on which model?

A) Biologic
B) Interpersonal
C) Developmental
D) Stress-vulnerability

Question 19

A newly admitted patient is mute, immobile, and holds a fixed body position for long periods. The nurse caring for this patient should:

A) assign unlicensed assistance personnel to feed the patient.
B) provide a stimulating, active environment.
C) encourage independent social behaviors.
D) forewarn the patient before touching.

Question 20

A highly suspicious patient tells the nurse, "When I sit in the dayroom I can see other people whispering about me and laughing. It makes me want to punch them." The direction that the nurse should give staff is:

A) "Gently and frequently touch the patient while conversing."
B) "Stop laughing immediately when the patient enters the room."
C) "Be direct. Do not whisper, laugh, or look sideways at the patient."
D) "Engage the patient in conversation by leaning close to speak softly."