Question 1

Which response demonstrates both empathy and understanding of the relationship genetics has to the development of schizophrenia in twins?

Accepted Answer

Current research supports the correct option,whereas the remaining options are not factual and show expressed sympathy rather than empathy.

Question 2

A patient has been admitted with disorganized type schizophrenia.The nurse observes blunted affect and social isolation.He occasionally curses or calls another patient a "jerk" without provocation.The nurse asks the patient how he is feeling,and he responds,"Everybody picks on me.They frobitz me." The patient's communication exhibits:

Accepted Answer

A newly coined word having meaning only for the patient is called a neologism (meaning,new word).It is associated with autistic thinking.The patient's speech does not show associative looseness or circumstantiality.The use of a neologism is not delusional in and of itself,but it suggests delusional thinking may be present.

Question 3

Which response by the nurse would best assist a patient in de-escalating aggressive behavior?

Accepted Answer

Using how,what,and when to gather information is a nonthreatening approach.It will promote patient verbalization and explanation of events without causing the patient to become defensive.Mentioning restraints sounds threatening even though it may be meant to remind the patient of limits.Why questions are demanding and threatening to patients.Sending the patient into group therapy sidesteps the problem.

Question 4

Which response is appropriate when a patient's mother expresses guilt over "causing my child to be schizophrenic"?

Accepted Answer

Many individuals in the mental health field attribute the development of schizophrenia to multiple causes centering on biological theories.The remaining options do little to provide the mother with new information.

Question 5

Which of the following interventions should the nurse plan to use to reduce patient focus on delusional thinking?

Accepted Answer

Focusing on feelings suggested by the delusion will help meet patient needs and help the patient stay based in reality.This technique fosters rapport and trust while discouraging the belief without challenging or refuting it.

Question 6

An appropriate intervention for a patient with an identified nursing diagnosis of situational low self-esteem would be:

Accepted Answer

All are useful interventions for a patient with schizophrenia; however,engaging the patient in specifically designed activities is the only option that addresses improving self-esteem.

Question 7

What would be an appropriate short-term outcome for a patient diagnosed with residual schizophrenia who exhibits ambivalence?

Accepted Answer

An early step would be to make choices about nonthreatening matters when presented with limited alternatives.The remaining options represent decisions that are too complicated for the patient to make initially.

Question 8

A 34-year-old male admitted with catatonic schizophrenia has been mute and motionless for several days while at home prior to admission.He still appears stuporous in the hospital.Which nursing intervention would be an initial priority?

Accepted Answer

Patients who are mute and motionless and inattentive to environmental stimuli are at risk for a number of physical problems.Further,they are unable to communicate existing problems.The nurse must make thorough and astute assessments before creating plans to meet the patient's needs.A patient who is stuporous may not be able to attend to information given about unit rules and protocols.While establishing a therapeutic nurse-patient relationship is an important intervention,it does not have priority according to Maslow's hierarchy.Because the patient is mute,one can only suspect lack of reality orientation.While an appropriate intervention,it is not the priority according to Maslow's hierarchy.

Question 9

A newly admitted patient has the diagnosis of catatonic schizophrenia.Which behavior observed in the patient supports that diagnosis?

Accepted Answer

Catatonic schizophrenia is characterized by extremes of psychomotor activity ranging from frenzied behavior to immobilization and may include echopraxia and posturing.Paranoid thinking is characteristic of paranoid schizophrenia.Inappropriate affect and clanging are seen in disorganized schizophrenia.

Question 10

A 19-year-old patient is admitted for the second time in 9 months and is acutely psychotic with a diagnosis of undifferentiated schizophrenia.The patient sits alone rubbing her arms and smiling.She tells the nurse her thoughts cause earthquakes and that the world is burning.The nurse assesses the primary deficit associated with the patient's condition as:

Accepted Answer

The nurse interprets the patient's statements that were not reality-based as indicating disturbed thought processes.Social isolation is not the primary patient problem.No data exist to support the other options.

Question 11

The wife of a patient diagnosed with paranoid schizophrenia asks,"I've been told that my husband's illness is probably related to imbalanced brain chemicals.Can you be more specific?" The response based on the dopamine hypothesis is:

Accepted Answer

The statement is correctly based on the dopamine hypotheses while the remaining options are neither known to be true nor based on that theory

Question 12

What is the basis for the reduction in disturbed thought processes when a patient is administered haloperidol (Haldol)?

Accepted Answer

Excess dopamine is responsible for symptoms of psychosis such as delusions and hallucinations.Blocking dopamine receptors will result in reduction of primary symptoms.The other options do not reflect the action of typical antipsychotic medications.

Question 13

What is the priority nursing diagnosis for a catatonic patient?

Accepted Answer

The highest priority for the patient is maintenance of basic physiologic needs,such as hydration.Mobility is of lesser physiological importance than fluid volume.The remaining options do not have priority over a physiological need.

Question 14

Which initial short-term outcome would be appropriate for a patient who was admitted expressing delusional thoughts?

Accepted Answer

Delusions are not reality oriented; thus an appropriate outcome would be that patient will engage in reality-oriented conversation rather than discussing delusional beliefs.Delusions are fixed,false beliefs.Patients rarely accept anyone using logic to dispute them.Data are not present to suggest boundary disturbance.Explaining the delusion is not progress; it suggests the patient still holds to the belief.

Question 15

Which patient behavior would support the diagnosis of residual schizophrenia with negative symptoms?

Accepted Answer

Blunted affect is considered a negative symptom.The other symptoms would be classified as positive symptoms.

Question 16

Which assessment observation supports a patient's diagnosis of disorganized schizophrenia?

Accepted Answer

The presence of disorganization and inappropriate affect identifies this disorder as disorganized schizophrenia.The symptoms of residual schizophrenia have long periods of remission.Schizoaffective disorder presents with severe mood disorders along with symptoms of schizophrenia.Paranoid schizophrenia is characterized by persecutory or grandiose delusions.

Question 17

A patient has been admitted with disorganized type schizophrenia.The nurse asks the patient how he is feeling,and he responds,"Everybody picks on me.They frobitz me." The best response for the nurse to make would be:

Accepted Answer

This response will help clarify the patient's thinking and change the focus from global to specific.In this situation,sympathizing with the patient is a nonproductive response.The remaining options appear to accept the neologism thus supporting the patient's delusional thinking.

Question 18

By discharge,which outcome is appropriate for a patient who hears voices telling him he is evil?

Accepted Answer

An appropriate outcome for a patient with hallucinations is recognition of events that precede the onset of hallucinations.Trigger events or situations usually cause increased feelings of anxiety.The remaining options are neither desirable nor appropriate.

Question 19

Which nursing diagnosis is appropriate for a patient who insists being called "Your Highness" and demonstrates loosely associated thoughts?

Accepted Answer

Delusions and loose associations suggest disturbed thought processes.The other options are not supported by data in the scenario.

Question 20

A patient tried to gouge out his eye in response to auditory hallucinations commanding,"If thine eye offends thee,pluck it out." The nurse would analyze this behavior as indicating:

Accepted Answer

Command hallucinations may be so intense that the patient cannot control the impulse to do what the hallucination tells him to do; thus the patient has impaired impulse control.This is not an anger management problem.Derealization is a feeling that the environment is distorted or unreal and not suggested in the scenario.No evidence of inappropriate affect is given.

Quiz 13: Schizophrenia and Other Psychotic Disorders