Question 1

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

Accepted Answer

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition), the symptoms of schizophrenia must be present for at least 6 months before a diagnosis can be made. This time frame helps to distinguish schizophrenia from other conditions that may cause similar symptoms, but are of a shorter duration.

Question 2

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?

Accepted Answer

The patient's belief of being pursued by hostile forces and the use of a unique code only they understand are indicative of paranoid delusions, where the patient irrationally fears others are out to get them. The belief in having a special code also suggests grandiose delusions, where the patient believes they have exceptional abilities or insights.

Question 3

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

Accepted Answer

Social skills training would be most important in helping a patient diagnosed with schizophrenia remain in the work force as it would help them develop and maintain appropriate interpersonal skills with colleagues and employers, which is crucial for successful employment retention. Physical therapy and occupational therapy may be helpful in improving overall functioning, but they may not directly address the specific social and interpersonal challenges that can impact work performance. Group therapy to improve motivation for working may also be beneficial, but it may not necessarily address the specific social skills deficits that can be present in schizophrenia.

Question 4

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

Accepted Answer

Inappropriate affect refers to a mismatch between an individual's emotional response and the situation or idea that elicits that response. In this case, the patient's laughter in response to the death of a loved one is incongruent with the expected emotional response of sadness or grief.

Question 5

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

Accepted Answer

The concept of ego disintegration is based on the developmental model, which proposes that schizophrenia arises from disturbances during normal psychological development, particularly during the formation and consolidation of the ego.

Question 6

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." What direction should the nurse give staff?

Accepted Answer

The nurse should give clear direction to the staff to not engage in any behavior that could potentially trigger the patient's paranoia or aggression. Being direct, avoiding whispers, laughter and sideways glances are all important to help the patient feel respected and safe. Gently touching or leaning close to the patient may be interpreted as threatening behavior by the patient and escalate their agitation.

Question 7

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

Accepted Answer

Genetic evidence shows that monozygotic twins (who share 100% of their DNA) are significantly more likely than the general population to both have schizophrenia. This suggests a strong genetic component to the disorder. Concordancy rates are much lower in fraternal twins (who share only 50% of their DNA on average), indicating that genetic factors are a major contributor to the risk of developing schizophrenia.

Question 8

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

Accepted Answer

Type I schizophrenia is characterized by positive symptoms such as hallucinations, delusions, and disordered thinking. Therefore, the nurse should primarily focus on assessing cognition and perception, as these symptoms directly affect these areas. Attention, motivation, grooming, hygiene, and abstract thinking skills may also be assessed but are not the primary focus for this type of schizophrenia.

Question 9

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?

Accepted Answer

The patient's belief in being pursued by hostile forces and creating a unique code only they understand are indicative of disturbed thought processes related to delusions, which are thoughts not based on reality. This is a hallmark symptom of schizophrenia.

Question 10

Research on neurostructural theories of schizophrenia indicates the common demonstration of which pathoanatomic findings?

Accepted Answer

Research on neurostructural theories of schizophrenia consistently shows evidence of ventricular enlargement, brain atrophy, and diminished cerebral blood flow in individuals with schizophrenia. These findings suggest that there may be significant changes to brain structure and function in people with the disorder.

Question 11

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 answer should be based on what knowledge concerning the usual course of this illness?

Accepted Answer

Schizophrenia is characterized by alternating acute and stable phases. It is a chronic and lifelong illness with varying degrees of symptom severity and functional impairment. While some individuals may experience a lessening of symptoms and achieve stability, this is not the usual course of the illness. Each individual's experience with schizophrenia can be unique, but the alternating acute and stable phases are a common feature. Progressive deterioration is not typically seen in schizophrenia.

Question 12

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

Accepted Answer

Auditory hallucinations are the most commonly displayed perceptual alteration in patients with schizophrenia. These patients may hear voices that others cannot hear or perceive sounds that do not actually exist.

Question 13

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

Accepted Answer

The answer of When a patient experiencing a first episode...

Question 14

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.What should the nurse's initial intervention be?

Accepted Answer

The nurse's initial intervention should be to voice doubt about the patient's delusions without arguing or dismissing them outright. This can help build rapport and trust with the patient, as well as avoid confrontation or escalation of the patient's paranoid ideation. Setting firm limits on disruptive behaviors or forcefully refuting all perceptual distortions may further alienate the patient and increase their paranoia. Encouraging a complete description of the delusions may be appropriate, but should be done in a non-confrontational and empathetic manner.

Question 15

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

Accepted Answer

While stress and chaos in the family can exacerbate symptoms of schizophrenia, it is not the direct cause of the illness. It is important to offer accurate information and avoid making assumptions or blaming family members for the disorder. The nurse can offer education about available treatments and support resources for the patient and family.

Question 16

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

Accepted Answer

The patient's symptoms suggest catatonia, a condition characterized by motor immobility and behavioral abnormality such as mutism. Forewarning the patient before touching is important to avoid startling them and potentially worsening their condition. The other options do not directly address the specific needs of a patient exhibiting catatonic symptoms.

Question 17

What is an initial short-term outcome for a withdrawn, socially isolated patient diagnosed with schizophrenia?

Accepted Answer

The patient will consistently interact with an assigned nurse.This is an initial short-term outcome because it is a small, achievable goal that can be accomplished in a short period of time. It is also important because it helps the patient to build a relationship with a trusted caregiver, which can help them to feel more comfortable and supported.

Question 18

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.What should the nurse do to begin a therapeutic relationship?

Accepted Answer

Offering a simple activity and sitting with the patient is a non-intrusive way for the nurse to establish rapport with the patient and show support. This can also provide a distraction from any possible hallucinations or delusions. Medication education and asking about voices may not be appropriate for the initial therapeutic relationship, and watching television together may not be an active way of engaging with the patient.

Question 19

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 a realistic and desirable outcome for this patient?

Accepted Answer

While all of the choices may be desirable outcomes, the most immediate concern for this patient is their fear of being pursued by hostile forces. Therefore, the most realistic and desirable outcome for this patient would be for them to report feeling safe from harm by others as soon as possible.

Question 20

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

Accepted Answer

Taking medication correctly is a crucial aspect of managing schizophrenia, as it can help reduce symptoms and prevent relapse. Therefore, it would be the top priority for a psychoeducational group. The other options may be helpful topics to cover but they are not as essential as medication management.

Quiz 24: Schizophrenia Spectrum and Other Psychotic Disorders