Deck 16: Schizophrenia

Question 1

The most commonly supported neuroanatomic theory of schizophrenia suggests which etiology?

A) Excessive amounts of dopamine and serotonin in the brain
B) Ineffective ability of the brain to use dopamine and serotonin
C) Insufficient amounts of dopamine in the brain
D) Decreased brain tissue in the frontal and temporal regions of the brain

Answer 1

Decreased brain tissue in the frontal and temporal regions of the brain

Question 2

The nurse reviews current literature and identifies that which of the following are included in current studies of biologic theories regarding the etiology of schizophrenia? Select all that apply.

A) That there is a particular pathologic structure associated with the disease.
B) That genetics is the cause of schizophrenia.
C) Persons with schizophrenia have decreased brain volume and abnormal brain function in the frontal and temporal areas of persons with schizophrenia.
D) The brain activity of persons with schizophrenia differs from people who do not have schizophrenia.
E) That the etiology of schizophrenia may be related to the body's response to exposure of a virus.

Answer 2

That genetics is the cause of schizophrenia.
Persons with schizophrenia have decreased brain volume and abnormal brain function in the frontal and temporal areas of persons with schizophrenia.
The brain activity of persons with schizophrenia differs from people who do not have schizophrenia.
That the etiology of schizophrenia may be related to the body's response to exposure of a virus.

Question 3

The student nurse correctly recognizes that which one of the following findings is best supported by genetic studies in the etiology of schizophrenia?

A) If a person has schizophrenia, distant relatives are also at risk.
B) That there is no relationship at all between schizophrenia and genetics.
C) That there is a weak correlation between genetics and schizophrenia.
D) That schizophrenia is at least partially inherited.

Answer 3

That schizophrenia is at least partially inherited.

Question 4

The nurse is assessing for negative symptoms of schizophrenia in a newly admitted client. The nurse would note which behavior as indicative of a negative symptom?

A) Difficulty staying on subject when responding to assessment questions
B) Belief of owning a transportation device allowing for travel to the center of the Earth
C) Hesitant to answer the nurse's questions during the assessment interview
D) Mimicking the postural changes made by the nurse during the assessment interview

Question 5

The client with schizophrenia believes the student nurses are there to spy on the clients. The client is suffering from which of the following symptoms?

A) Hallucinations
B) Delusions
C) Anhedonia
D) Ideas of reference

Question 6

The client with schizophrenia makes the following statement, I just don't know how to count. The sky turned to fire. I have a ball in my head. The nurse documents this entire statement as an example of

A) flight of ideas.
B) ideas of reference.
C) delusional thinking.
D) associative looseness.

Question 7

A person suffering from schizophrenia has little emotional expression when interacting with others. The nurse would document the client's affect as which of the following? Select all that apply.

A) Flat
B) Blunt
C) Bright
D) Inappropriate
E) Pleasant

Question 8

A client who has schizophrenia is having a conversation with the nurse suddenly stops talking in the middle of a sentence. The client is experiencing which type of thought disruption?

A) Thought withdrawal
B) Thought insertion
C) Thought blocking
D) Thought broadcasting

Question 9

During the nursing assessment, a client describes constantly hearing voices mumbling in the background. The client denies that the voices are telling him to do anything harmful. The nurse documents that the client is experiencing which of the following?

A) Command hallucinations
B) Auditory hallucinations
C) Olfactory hallucinations
D) Gustatory hallucinations

Question 10

A client with schizophrenia reads the advice column in the newspaper daily. When asked why the client is so interested in the advice column, the client replies, This person is my guide and tells me what I must do every day. The nurse would best describe this type of thinking as which of the following?

A) Referential delusion
B) Grandiose delusion
C) Thought insertion
D) Personalization

Question 11

The nurse is preparing a client with schizophrenia for discharge. The nurse asks the client, How are you going to care for yourself at home? The purpose of the nurse's question is to assess the client's

A) self concept.
B) judgment.
C) insight.
D) social support system.

Question 12

All of the following are nursing diagnoses identified for a client with schizophrenia. The student nurse correctly anticipates which diagnosis will resolve when the client's negative symptoms improve?

A) Impaired verbal communication
B) Risk for other-directed violence
C) Disturbed thought processes
D) Social isolation

Question 13

All of the following are included in the plan of care for a client with schizophrenia. Which nursing intervention should the nurse perform first when caring for this client?

A) Observe for signs of fear or agitation
B) Maintain reality through frequent contact
C) Encourage to participate in the treatment milieu
D) Assess community support systems

Question 14

A client with schizophrenia is seen sitting alone and talking out loud. Suddenly, the client stops and turns as if listening to someone. The nurse approaches and sits down beside the client. Which of the following is the best initial response by the nurse?

A) You must be pretty bored to be sitting here talking to an invisible person.
B) I don't hear or see anyone else; what are you hearing and seeing?
C) I can tell you are hearing voices, but they are not real.
D) How long have you known the person you are talking to?

Question 15

A client states, I am dead. I have come back from the dead. An appropriate response by the nurse is,

A) What is it like to feel dead?
B) No you did not die. People don't come back from the dead.
C) Show me what you did in art therapy this morning.
D) I'll get your medicine and you'll feel better.

Question 16

A client diagnosed with schizophrenia is laughing and talking while sitting alone. Which of the following is the best response by the nurse?

A) State, Can you share your joke with me?
B) To sit with the client quietly until the client is ready to talk
C) State, Tell me what's happening.
D) State, You look lonely here. Let's join the others in the day room.

Question 17

A college freshman is admitted to the hospital with a diagnosis of schizophrenia. Friends reported that she had been in her room for 2 days in a trance-like state, not eating nor speaking to anyone. Which of the following is the highest priority for this client?

A) Assessing fluid intake and output
B) Completing an assessment of mental status
C) Obtaining more data about her college experiences
D) Providing for adequate rest

Question 18

The client with schizophrenia tells the nurse that rats have started to eat his brain. The best response by the nurse would be,

A) Have you discussed this with your physician?
B) How could that be possible?
C) You cannot have rats in your brain.
D) You look OK to me.

Question 19

A client who has suspicion has been placed in a room with a roommate. The night nurse reports that this client has been awake for the past 3 nights. The likely explanation for his wakefulness is which of the following?

A) He is fearful of what his roommate might do to him while he sleeps.
B) He is a light sleeper and unaccustomed to a roommate.
C) He is watching for an opportunity to escape.
D) He is worrying about his family problems.

Question 20

A client with schizophrenia is reluctant to take his prescribed oral medication. The most therapeutic response by the nurse to this refusal is,

A) I can see that you're uncomfortable now, so we can wait until tomorrow.
B) If you refuse these pills, you'll have to get an injection.
C) What is it about the medicine that you don't like?
D) You know you have to take this medicine for your own good.

Question 21

The nurse observes a client with schizophrenia sitting alone, laughing occasionally, and turning his head as if listening to another person. The nurse assesses this behavior to indicate that the client is experiencing auditory hallucinations and says,

A) Are you hearing something?
B) It's a beautiful day, isn't it?
C) Would you like to go to your room to talk?
D) Would you like to take some of your PRN medication?

Question 22

A client with schizophrenia is admitted to the inpatient unit. He does not speak when spoken to but has been observed talking to himself on occasion. What would be the priority objective at this time?

A) The client will begin talking with other clients
B) The client will express his feelings freely
C) The client will increase his socialization with others
D) The client will increase his reality orientation

Question 23

The nurse enters the room of a client with schizophrenia the day after he has been admitted to an inpatient setting and says, I would like to spend some time talking with you. The client stares straight ahead and remains silent. The best response by the nurse would be,

A) I can see you want to be alone. I'll come back another time.
B) You don't need to talk right now. I'll just sit here for a few minutes.
C) I've got some other things I can do now. I hope you'll feel like talking later.
D) You would feel better if you would tell me what you're thinking.

Question 24

One evening, a client with schizophrenia leaves his room and begins marching in the hall. When approached by the nurse, the client says, God says I'm supposed to guard the area. Which of the following responses would be best?

A) I understand you hear a voice. You and I are the only ones in the hall, and I don't hear a voice.
B) The voices are part of your illness, and they will leave in time.
C) This guarding responsibility can make you tired. You rest for now, and I'll guard a while.
D) You are just imagining these things. Do not pay any attention to the voices.

Question 25

When performing discharge planning for a client who has schizophrenia, the nurse anticipates barriers to adhering to the medication regimen. The nurse assesses which of the following as improving the likelihood that the client will follow the prescribed medication regimen? Select all that apply.

A) Short-term memory intact
B) History of missing appointments
C) Receives monthly disability checks
D) Walking is primary mode of transportation
E) States location of pharmacy nearest his residence

Question 26

A client with schizophrenia is attending a follow-up appointment at the community mental health clinic. The client reports to the nurse, I stopped taking the antipsychotic medication because I can't get a hard-on with my girlfriend anymore. Which of the following should the nurse recommend to enhance the client's well-being?

A) It sounds like that is a problem for you. Don't you still find her to be sexy enough?
B) Sexual dysfunction is a temporary side effect and should get better once your body is used to the medication.
C) You should avoid having sex with your girlfriend anyway. Do you really want her to get pregnant?
D) It is important for you to take an antipsychotic medication. You may need a different type that will be less likely to affect your sexual functioning. I would like to call your physician about this.

Question 27

Which of the following questions would best help the nurse to evaluate the effectiveness of antipsychotic medications for a client who has schizophrenia? Select all that apply.

A) Have the symptoms you were experiencing disappeared?
B) If the symptoms have not disappeared, are you able to carry out your daily life despite the persistence of some psychotic symptoms?
C) Are you committed to taking the medication as prescribed?
D) Are you satisfied with your quality of life?
E) Do you have access to community agencies that will help you to live successfully in this community?

Question 28

A client with schizophrenia has returned to the clinic because of an increase in symptoms. The client reports he stopped taking his meds because he did not like the side effects. The nurse educates the client about managing uncomfortable side effects. Which of the following is included in the teaching plan? Select all that apply.

A) Suck on hard candy as desired
B) Spend at least 30 minutes outside in the sun daily
C) Use stool softeners as needed
D) Decrease the amount of daily fluid intake
E) Maintain a balanced calorie-controlled diet

Question 29

The nurse is working with a client with schizophrenia, disorganized type. It is time for the client to get up and eat breakfast. Which of the following statements by the nurse would be most effective in helping the client prepare for breakfast?

A) I'll expect you in the dining room in 20 minutes.
B) It's time to put your dress on now.
C) Stay right there and I'll get your clothes for you.
D) Why don't you stay here and I'll get your tray for you.

Question 30

The parents of a young adult male who has schizophrenia ask how they can recognize when their son is beginning to relapse. The nurse teaches the family to look for which of the following? Select all that apply.

A) Excessive sleeping
B) Fatigue
C) Irritability
D) Increased inhibition
E) Negativity

Question 31

A client asks the nurse upon discharge, What should I do if I forget to take my medicine? The nurse should explain to the client which of the following?

A) Just double the dose next time it is scheduled.
B) Skip that dose and resume your regular with the next dose.
C) Don't miss doses, or you will not maintain therapeutic drug levels.
D) If you remember within 3 to 4 hours later than it is due, take it then. If you remember more than 4 hours after it was due, do not take that dose.

Question 32

Which of the following are central components of a psychiatric rehabilitation and recovery program? Select all that apply.

A) Working with clients to have an improved quality of life according to society's point of view
B) Working with clients to manage their own lives
C) Working with clients to make effective treatment decisions
D) Working with clients to have an improved quality of life according to his or her point of view.
E) Working with clients to diagnose their problem early

Question 33

A student nurse is having a first experience in an inpatient psychiatric unit and is frightened by the behaviors of the clients with schizophrenia. The student should take which of the following actions to deal with fear?

A) Express fear to the psychiatrist during rounds
B) Pretend to not be afraid
C) Stay in an open area while talking with the clients
D) Insist that the instructor accompanies the student at all times.

Question 34

Which of the following attitudes would be best for the nurse when the client who has schizophrenia acts as though the nurse is not trustworthy or that his or her integrity is being questioned?

A) That the client is correct and the nurse is not trustworthy
B) That the client wants to insult the nurse
C) That the client's behavior is a part of the illness
D) That the nurse's actions have failed