Question 1

The client is receiving risperidone (Risperdal)for the treatment of schizophrenia.Which client statement indicates the medication is effective?
A) "I promise not to skip breakfast anymore."
B) "I am not hearing the voices anymore."
C) "I will start going to group therapy."
D) "I feel better and I am ready to go home."

Accepted Answer

A) Among the therapeutic effects of risperidone (Risperdal) is the remission of a range of psychotic symptoms that include delusions, paranoia, auditory hallucinations, and irrational behavior. A client stating he feels better and is ready to go home, stating he will go to group therapy, or stating he will not skip breakfast does not indicate the remission of any psychotic symptoms.
B) Among the therapeutic effects of risperidone (Risperdal) is the remission of a range of psychotic symptoms that include delusions, paranoia, auditory hallucinations, and irrational behavior. A client stating he feels better and is ready to go home, stating he will go to group therapy, or stating he will not skip breakfast does not indicate the remission of any psychotic symptoms.
C) Among the therapeutic effects of risperidone (Risperdal) is the remission of a range of psychotic symptoms that include delusions, paranoia, auditory hallucinations, and irrational behavior. A client stating he feels better and is ready to go home, stating he will go to group therapy, or stating he will not skip breakfast does not indicate the remission of any psychotic symptoms.
D) Among the therapeutic effects of risperidone (Risperdal) is the remission of a range of psychotic symptoms that include delusions, paranoia, auditory hallucinations, and irrational behavior. A client stating he feels better and is ready to go home, stating he will go to group therapy, or stating he will not skip breakfast does not indicate the remission of any psychotic symptoms.

Question 2

A nurse working in a psychiatric unit is caring for a client with schizophrenia who manifests positive symptoms of the disease.Based on this data,which does the nurse anticipate when providing care?
A) Social withdrawal
B) Hallucinations
C) Anhedonia
D) Concrete thinking

Accepted Answer

A) The major manifestations of schizophrenia are described as either positive symptoms or negative symptoms, depending on whether they involve the presence of unusual behaviors or the absence of typical behaviors. Hallucinations is a positive symptom; all other choices are negative symptoms.
B) The major manifestations of schizophrenia are described as either positive symptoms or negative symptoms, depending on whether they involve the presence of unusual behaviors or the absence of typical behaviors. Hallucinations is a positive symptom; all other choices are negative symptoms.
C) The major manifestations of schizophrenia are described as either positive symptoms or negative symptoms, depending on whether they involve the presence of unusual behaviors or the absence of typical behaviors. Hallucinations is a positive symptom; all other choices are negative symptoms.
D) The major manifestations of schizophrenia are described as either positive symptoms or negative symptoms, depending on whether they involve the presence of unusual behaviors or the absence of typical behaviors. Hallucinations is a positive symptom; all other choices are negative symptoms.

Question 3

A nurse is caring for a client with schizophrenia.The client asks the nurse what causes the disease.Which response indicating the pathophysiology and etiology of the disease is appropriate by the nurse?
A) "Reduced blood flow to the thalamus interferes with the brain's filter, turning the normal flow of sensory information into an overload."
B) "There is an increased number of nicotinic receptors in the hippocampus, which makes it harder to form new memories and interpret sensory stimuli.
C) "Genetics do not seem to factor into the cause of the disease."
D) "The ventricles and sulci of the brain are decreased in size."

Accepted Answer

A) There are many abnormalities of the central nervous system in a client with schizophrenia. Reduced blood flow to the thalamus interferes with the brain's filter, turning the normal flow of sensory information into an overload. A decreased number of nicotinic receptors in the hippocampus makes it harder for the client with schizophrenia to form new memories and interpret sensory stimuli. Genetics seem to factor into the cause of the disease, as familial patterns of the disease are noted. In the client with schizophrenia, the ventricle and sulci of the brain are increased in size.
B) There are many abnormalities of the central nervous system in a client with schizophrenia. Reduced blood flow to the thalamus interferes with the brain's filter, turning the normal flow of sensory information into an overload. A decreased number of nicotinic receptors in the hippocampus makes it harder for the client with schizophrenia to form new memories and interpret sensory stimuli. Genetics seem to factor into the cause of the disease, as familial patterns of the disease are noted. In the client with schizophrenia, the ventricle and sulci of the brain are increased in size.
C) There are many abnormalities of the central nervous system in a client with schizophrenia. Reduced blood flow to the thalamus interferes with the brain's filter, turning the normal flow of sensory information into an overload. A decreased number of nicotinic receptors in the hippocampus makes it harder for the client with schizophrenia to form new memories and interpret sensory stimuli. Genetics seem to factor into the cause of the disease, as familial patterns of the disease are noted. In the client with schizophrenia, the ventricle and sulci of the brain are increased in size.
D) There are many abnormalities of the central nervous system in a client with schizophrenia. Reduced blood flow to the thalamus interferes with the brain's filter, turning the normal flow of sensory information into an overload. A decreased number of nicotinic receptors in the hippocampus makes it harder for the client with schizophrenia to form new memories and interpret sensory stimuli. Genetics seem to factor into the cause of the disease, as familial patterns of the disease are noted. In the client with schizophrenia, the ventricle and sulci of the brain are increased in size.

Question 4

An adolescent client is admitted to the hospital for the treatment of schizophrenia.The client's mother is confused and wants to know what she did to cause this to occur.Which responses by the nurse are appropriate? Select all that apply.
A) "Schizophrenia is a biological brain disorder."
B) "Research indicates that schizophrenia is a genetic disorder."
C) "Research indicates that a very stressful environment causes schizophrenia."
D) "Schizophrenia is due to too much dopamine in certain parts of the brain."
E) "Schizophrenia is linked to drinking alcohol during pregnancy."

Accepted Answer

A) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.
B) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.
C) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.
D) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.
E) Theories explaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and overactive dopaminergic pathways in the basal nuclei. There is no evidence to support a link between schizophrenia and alcohol consumption during pregnancy. A stressful environment will exacerbate the symptoms of schizophrenia but does not cause the illness.

Question 5

The nurse is providing family therapy for the family of an adolescent diagnosed with schizophrenia.When planning care for this client,which is the focus for the nursing interventions? Select all that apply.
A) Establishing boundaries
B) Coping mechanisms
C) Providing happiness
D) Preventing future episodes
E) Improving communication

Accepted Answer

A) In family therapy, the family system is treated as a unit and the focus is on family dynamics. The goal is to help families cope, improve their communication and interpersonal skills, establish boundaries, and moderate family cohesion and flexibility. The nurse may not be able to prevent future psychological episodes. Emotional support is warranted, but happiness is subjective.
B) In family therapy, the family system is treated as a unit and the focus is on family dynamics. The goal is to help families cope, improve their communication and interpersonal skills, establish boundaries, and moderate family cohesion and flexibility. The nurse may not be able to prevent future psychological episodes. Emotional support is warranted, but happiness is subjective.
C) In family therapy, the family system is treated as a unit and the focus is on family dynamics. The goal is to help families cope, improve their communication and interpersonal skills, establish boundaries, and moderate family cohesion and flexibility. The nurse may not be able to prevent future psychological episodes. Emotional support is warranted, but happiness is subjective.
D) In family therapy, the family system is treated as a unit and the focus is on family dynamics. The goal is to help families cope, improve their communication and interpersonal skills, establish boundaries, and moderate family cohesion and flexibility. The nurse may not be able to prevent future psychological episodes. Emotional support is warranted, but happiness is subjective.
E) In family therapy, the family system is treated as a unit and the focus is on family dynamics. The goal is to help families cope, improve their communication and interpersonal skills, establish boundaries, and moderate family cohesion and flexibility. The nurse may not be able to prevent future psychological episodes. Emotional support is warranted, but happiness is subjective.

Question 6

A client with schizophrenia is exhibiting attention deficit and difficulty remembering recent events.Which is an appropriate expected outcome for this client?
A) Client will interact well with others before discharge.
B) Client will develop occupational skills by discharge.
C) Client will exhibit an increased attention span in 1 week.
D) Client will deny auditory hallucinations within 7 days.

Accepted Answer

A) This client is exhibiting the cognitive disturbances of attention deficit and difficulty remembering. The only outcome applicable to this situation is that the client will exhibit an increased attention span.
B) This client is exhibiting the cognitive disturbances of attention deficit and difficulty remembering. The only outcome applicable to this situation is that the client will exhibit an increased attention span.
C) This client is exhibiting the cognitive disturbances of attention deficit and difficulty remembering. The only outcome applicable to this situation is that the client will exhibit an increased attention span.
D) This client is exhibiting the cognitive disturbances of attention deficit and difficulty remembering. The only outcome applicable to this situation is that the client will exhibit an increased attention span.

Question 7

The healthcare provider prescribes aripiprazole (Abilify)for the client with schizophrenia.Which is the priority outcome for the client?
A) The client will report a decrease in auditory hallucinations.
B) The client will report symptoms of restlessness.
C) The client will consume adequate fluids and a high-fiber diet.
D) The client will be compliant with taking the medication as prescribed.

Accepted Answer

A) Medication compliance is a priority for clients with schizophrenia. Relapse of symptoms will occur without the medications. The symptom of restlessness is known as akathisia. This would be important to report, but is not the priority outcome. Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an expected effect of aripiprazole (Abilify), but this is not the priority outcome.
B) Medication compliance is a priority for clients with schizophrenia. Relapse of symptoms will occur without the medications. The symptom of restlessness is known as akathisia. This would be important to report, but is not the priority outcome. Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an expected effect of aripiprazole (Abilify), but this is not the priority outcome.
C) Medication compliance is a priority for clients with schizophrenia. Relapse of symptoms will occur without the medications. The symptom of restlessness is known as akathisia. This would be important to report, but is not the priority outcome. Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an expected effect of aripiprazole (Abilify), but this is not the priority outcome.
D) Medication compliance is a priority for clients with schizophrenia. Relapse of symptoms will occur without the medications. The symptom of restlessness is known as akathisia. This would be important to report, but is not the priority outcome. Adequate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an expected effect of aripiprazole (Abilify), but this is not the priority outcome.

Question 8

The nurse is providing discharge instructions to the family of a client with schizophrenia.What should the nurse teach regarding effective communication skills? Select all that apply.
A) Talk with family or friends.
B) Pick a time and topic to practice.
C) Decrease external stimuli.
D) Leave the client alone.
E) Increase the dose of medication.

Accepted Answer

A) Increasing communication in a safe setting with family and friends helps to stimulate both self-confidence and the fostering of important relationships. Asking the family to pick a time and topic to practice at home prepares them for help they can provide the client. The more the client practices skills, the more automatic they will become. Decreasing external stimuli may help the client to cope and enhance the client's ability to communicate. Increasing the dose of medication is not indicated without contacting a physician. Leaving a client alone is not a strategy to implement effective communication skills. It may overwhelm the client's ability to cope.
B) Increasing communication in a safe setting with family and friends helps to stimulate both self-confidence and the fostering of important relationships. Asking the family to pick a time and topic to practice at home prepares them for help they can provide the client. The more the client practices skills, the more automatic they will become. Decreasing external stimuli may help the client to cope and enhance the client's ability to communicate. Increasing the dose of medication is not indicated without contacting a physician. Leaving a client alone is not a strategy to implement effective communication skills. It may overwhelm the client's ability to cope.
C) Increasing communication in a safe setting with family and friends helps to stimulate both self-confidence and the fostering of important relationships. Asking the family to pick a time and topic to practice at home prepares them for help they can provide the client. The more the client practices skills, the more automatic they will become. Decreasing external stimuli may help the client to cope and enhance the client's ability to communicate. Increasing the dose of medication is not indicated without contacting a physician. Leaving a client alone is not a strategy to implement effective communication skills. It may overwhelm the client's ability to cope.
D) Increasing communication in a safe setting with family and friends helps to stimulate both self-confidence and the fostering of important relationships. Asking the family to pick a time and topic to practice at home prepares them for help they can provide the client. The more the client practices skills, the more automatic they will become. Decreasing external stimuli may help the client to cope and enhance the client's ability to communicate. Increasing the dose of medication is not indicated without contacting a physician. Leaving a client alone is not a strategy to implement effective communication skills. It may overwhelm the client's ability to cope.
E) Increasing communication in a safe setting with family and friends helps to stimulate both self-confidence and the fostering of important relationships. Asking the family to pick a time and topic to practice at home prepares them for help they can provide the client. The more the client practices skills, the more automatic they will become. Decreasing external stimuli may help the client to cope and enhance the client's ability to communicate. Increasing the dose of medication is not indicated without contacting a physician. Leaving a client alone is not a strategy to implement effective communication skills. It may overwhelm the client's ability to cope.

Question 9

The nurse is helping the family of an adolescent understand why their child has been diagnosed with schizophrenia.Which risk factor in the client's history supports the current diagnosis?
A) Association with psychotic clients
B) Smoking
C) Genetic predisposition
D) Allergy to shellfish

Accepted Answer

A) Studies have shown that there is a genetic predisposition to the development of schizophrenia. Smoking, allergies to foods, and association with others have not been shown to cause schizophrenia.
B) Studies have shown that there is a genetic predisposition to the development of schizophrenia. Smoking, allergies to foods, and association with others have not been shown to cause schizophrenia.
C) Studies have shown that there is a genetic predisposition to the development of schizophrenia. Smoking, allergies to foods, and association with others have not been shown to cause schizophrenia.
D) Studies have shown that there is a genetic predisposition to the development of schizophrenia. Smoking, allergies to foods, and association with others have not been shown to cause schizophrenia.

Question 10

The nurse is caring for a client who is experiencing auditory hallucinations.Which is the priority nursing diagnosis for this client?
A) Disturbed Thought Processes
B) Individual Ineffective Coping
C) Impaired Verbal Communication
D) Risk for Violence, Self-Directed or Other-Directed

Accepted Answer

A) Maintaining a safe environment is the priority diagnosis. Although the client has impaired thought processes, this is not the priority diagnosis at this time. Individual Ineffective Coping and Impaired Verbal Communication are also correct diagnoses, but the key word here is "priority," and this client has a potential or risk for harm to self or others.
B) Maintaining a safe environment is the priority diagnosis. Although the client has impaired thought processes, this is not the priority diagnosis at this time. Individual Ineffective Coping and Impaired Verbal Communication are also correct diagnoses, but the key word here is "priority," and this client has a potential or risk for harm to self or others.
C) Maintaining a safe environment is the priority diagnosis. Although the client has impaired thought processes, this is not the priority diagnosis at this time. Individual Ineffective Coping and Impaired Verbal Communication are also correct diagnoses, but the key word here is "priority," and this client has a potential or risk for harm to self or others.
D) Maintaining a safe environment is the priority diagnosis. Although the client has impaired thought processes, this is not the priority diagnosis at this time. Individual Ineffective Coping and Impaired Verbal Communication are also correct diagnoses, but the key word here is "priority," and this client has a potential or risk for harm to self or others.

Question 11

A client receiving chlorpromazine (Thorazine)for the treatment of schizophrenia is demonstrating signs of tardive dyskinesia.Which assessment findings does the nurse anticipate for this client? Select all that apply.
A) Wormlike motions of the tongue
B) Lip smacking
C) Unusual facial movements
D) Muscle spasms of the neck
E) Shuffling gait

Accepted Answer

A) Tardive dyskinesia is characterized by unusual tongue and face movements such as lip smacking and wormlike motions of the tongue. Severe muscle spasms of the back, neck, and tongue are known as acute dystonia, not tardive dyskinesia.
B) Tardive dyskinesia is characterized by unusual tongue and face movements such as lip smacking and wormlike motions of the tongue. Severe muscle spasms of the back, neck, and tongue are known as acute dystonia, not tardive dyskinesia.
C) Tardive dyskinesia is characterized by unusual tongue and face movements such as lip smacking and wormlike motions of the tongue. Severe muscle spasms of the back, neck, and tongue are known as acute dystonia, not tardive dyskinesia.
D) Tardive dyskinesia is characterized by unusual tongue and face movements such as lip smacking and wormlike motions of the tongue. Severe muscle spasms of the back, neck, and tongue are known as acute dystonia, not tardive dyskinesia.
E) Tardive dyskinesia is characterized by unusual tongue and face movements such as lip smacking and wormlike motions of the tongue. Severe muscle spasms of the back, neck, and tongue are known as acute dystonia, not tardive dyskinesia.

Quiz 23: Cognition

The client is receiving risperidone (Risperdal) for the treatment of schizophrenia.Which client statement indicates the medication is effective?

A nurse working in a psychiatric unit is caring for a client with schizophrenia who manifests positive symptoms of the disease.Based on this data,which does the nurse anticipate when providing care?

A nurse is caring for a client with schizophrenia.The client asks the nurse what causes the disease.Which response indicating the pathophysiology and etiology of the disease is appropriate by the nurse?

An adolescent client is admitted to the hospital for the treatment of schizophrenia.The client's mother is confused and wants to know what she did to cause this to occur.Which responses by the nurse are appropriate? Select all that apply.

The nurse is providing family therapy for the family of an adolescent diagnosed with schizophrenia.When planning care for this client,which is the focus for the nursing interventions? Select all that apply.

A client with schizophrenia is exhibiting attention deficit and difficulty remembering recent events.Which is an appropriate expected outcome for this client?

The healthcare provider prescribes aripiprazole (Abilify) for the client with schizophrenia.Which is the priority outcome for the client?

The nurse is providing discharge instructions to the family of a client with schizophrenia.What should the nurse teach regarding effective communication skills? Select all that apply.

The nurse is helping the family of an adolescent understand why their child has been diagnosed with schizophrenia.Which risk factor in the client's history supports the current diagnosis?

The nurse is caring for a client who is experiencing auditory hallucinations.Which is the priority nursing diagnosis for this client?

A client receiving chlorpromazine (Thorazine) for the treatment of schizophrenia is demonstrating signs of tardive dyskinesia.Which assessment findings does the nurse anticipate for this client? Select all that apply.