MENTAL HEALTH SCHIZOPHRENIA DISORDERS QUESTIONS

MENTAL HEALTH

SCHIZOPHRENIA DISORDERS QUESTIONS

1.A nurse is caring for a male client who was admitted to the mental health unit with the diagnosis of schizophrenia. The client is hostile and experiencing auditory hallucinations and states that the voices are saying that they are going to poison him because he is bad. What type of schizophrenic behavior does the nurse identify?

A: PARANOID

R: Clients with paranoid schizophrenia tend to experience persecutory or grandiose delusions and auditory hallucinations and exhibit behavioral changes such as anger, hostility, or violence.Residual schizophrenia is characterized by the negative symptoms of schizophrenia, but the client does not experience delusions, hallucinations, disorganized speech, or disorganized or catatonic behavior. Catatonia is a state in which the client displays extreme psychomotor retardation to the point of not talking or moving. There may be brief intermittent hyperactive episodes with catatonia. Disorganized schizophrenia is characterized by a disintegration of the personality and withdrawn behavior.

2.A client with schizophrenia is speaking made-up words that have no meaning to other people. What term should the nurse use to document these verbalizations?

A: NEOLOGISMS

R: Neologisms are unique words with personal meanings only to the client. Avolition is the lack of motivation associated with a reduced emotional [removed]flat affect). Echolalia is parrotlike echoing of spoken words or sounds. Anhedonia is the loss of enjoyment of things that were formerly enjoyed 3.What defense mechanism should the nurse anticipate that a client with the diagnosis of schizophrenia, undifferentiated type, will most often exhibit?

A: REGRESSION

R: Regression is the defense mechanism that is commonly used by clients with schizophrenia, undifferentiated type, to reduce anxiety by returning to earlier behavior. Projection is an organized defense used by clients with schizophrenia, paranoid type, in which the delusional system is well systematized. Repression, or unconscious forgetting, is not a major defense used by clients with schizophrenia; if it were, they would not need to break with reality. Rationalization, in which the individual blames others for problems and attempts to justify actions, is seldom used by clients with schizophrenia.

4.During a one-on-one interaction with a client with paranoid-type schizophrenia, the client says to the nurse, "I’ve figured out how foreign agents have infiltrated the news media. They want to shut me up before I spill the beans." How should the nurse describe this statement when documenting this client’s response?

A: DELUSIONS OF PERSECUTION

R: Thoughts of being pursued by powerful agents because of one's special attributes or powers are fixed false beliefs and are referred to as delusions of persecution. There is no evidence to indicate that there are nihilistic delusions of total or partial nonexistence. There is also no evidence to support that external forces are controlling the client (delusions of control) or that the client has false beliefs of being a famous figure (delusions of grandeur).

5.A client who has been admitted with a diagnosis of schizophrenia says to the nurse, "Yes, it's March. March is Little Women. That's literal, you know." What do these statements illustrate?

A: LOOSENING OF ASSOCIATIONS

R: Loose associations are thoughts that are presented without the logical connections that are usually necessary for the listener to interpret the message. Echolalia is the purposeless repetition of words spoken by others or repetition of overheard sounds. Neologisms are new meaningless words coined by the client or new, unique meanings given to old words. Flight of ideas is the rapid skipping from one thought to another; these thoughts usually have only superficial or chance relationships.

6.A 24-year-old woman states that she no longer enjoys any of the activities that she once found fun and pleasurable, such as socializing, sports, and hobbies. What term should the nurse use to describe this condition?

A: ANHEDONIA

R: Anhedonia is the inability to experience pleasure in events or activities that once were enjoyable. Anergia is lethargy and a decreased level of energy. Grandiosity is a symptom seen during manic episodes in which an individual displays an inflated self-esteem. Learned helplessness is a theory proposing that depression occurs when an individual believes that he or she has no control over life situations. This results in the individual's giving up and becoming passive and dependent.

7.Despite repeated nursing interventions to improve reality orientation, a client insists that he is the commander of an alien spaceship. What is the client experiencing?

A: DELUSION

R: A delusion is a fixed false belief. An illusion is a false sense interpretation of an external stimulus. Confabulation is the client's attempt to fill gaps in memory with imaginary events. A hallucination is a false sensory perception with no external stimulu

8.A client in the psychiatric hospital is attempting to communicate by stating, "Sky, flower, angry, green, opposite, blanket." The nurse recognizes what term as describing this type of communication?

A: WORD SALAD

R: Word salad is an incoherent mixture of words. Echolalia is a pathologic repetition of another's words or phrases. Confabulation is the unconscious filling in of memory gaps with imagined or untrue experiences. Flight of ideas is a speech pattern of rapid transition from topic to topic. The client's statement is too limited to be considered flight of ideas.

9.A nurse is caring for a client with the diagnosis of schizophrenia who is started on fluphenazine decanoate. What is the primary advantage of this medication?

A: IT HAS LONG-LASTING EFFECT

R: This medication may be taken every 2 weeks instead of every day. The side effects and the routine monitoring of the client’s laboratory results are the same as for most other antipsychotic drugs. The action of this drug during pregnancy is uncertain; animal studies have demonstrated an adverse effect on the fetus.

10.A client with schizophrenia is started on an antipsychotic/neuroleptic medication. The nurse explains to a family member that this drug primarily is used to achieve what purpose?

A: MAKE THE CLIENT MORE RECEPTIVE TO PSYHCOTHERAPHY

11.A client who is being treated for schizophrenia, paranoid type, arrives at the clinic demonstrating a shuffling gait and tilting the head toward one shoulder. What does the nurse conclude about these clinical manifestations?

A: POSSIBLE SIDE EFEFCTS OF THE ANTIPSYCHOTIC MEDICATION

R: Shuffling gait and torticollis are symptoms of pseudoparkinsonism that are caused by antipsychotic medications, particularly the typical antipsychotics. Expected characteristics of schizophrenia, paranoid type, include delusions, hallucinations, suspiciousness, anger, hostility, and paranoia. An acute exacerbation of the illness reflects an increased intensity of the expected characteristics associated with paranoid schizophrenia, which include pressured speech, suicidal ideation, and aggressive, agitated behavior. Although these physical manifestations require intervention, they are not life threatening.

12.A client with schizophrenia who has type II (negative) symptoms is prescribed risperidone.Which outcomes indicate that the medication has minimized these symptoms? Select all that apply

A: MORE INTEREST IS SHOWN IN UNIT ACTIVITIES

THE CLIENT PERFORMS ADL INDEPEDENTLY

R: Apathy is a common type II (negative) symptom; flat affect and lack of socialization are also common. Therefore increased interest in unit activities indicates minimized symptoms. A lack of interest in performing daily self-care activities is a common type II (negative) symptom; performing activities of daily living independently represents a reduction in this symptom. Interest in unit activities is a type I (positive) symptom. Delusions and hallucinations are type I (positive) symptoms.

13.A client with the diagnosis of schizophrenia is given one of the antipsychotic drugs. The nurse understands that antipsychotic drugs can cause extrapyramidal side effects. Which effect may be irreversible?

A: TARDIVE DYSKINESIA

R: Tardive dyskinesia, an extrapyramidal response characterized by vermicular movements and protrusion of the tongue, chewing and puckering movements of the mouth, and puffing of the cheeks, is often irreversible, even when the antipsychotic medication is withdrawn. Akathisia (motor restlessness), parkinsonian syndrome (a disorder featuring signs and symptoms of Parkinson disease such as resting tremors, muscle weakness, reduced movement, and festinating gait), and dystonia (impairment of muscle tonus) can usually be treated with antiparkinsonian or anticholinergic drugs while the antipsychotic medication is continued.

14.A psychotic male client is admitted to the hospital for evaluation. While obtaining the history, the nurse asks why he was brought to the hospital by his parents. The client states, "They lied about me. They said I murdered my mother. You killed her. She died before I was born." What does the nurse recognize that the client is experiencing?

A: PERSECUTORY DELUSIONS

R: The client's verbalization reflects feelings that others are blaming the client for negative actions. There are no data to demonstrate the client is having feelings of greatness or power.There are no data to demonstrate the client is experiencing confusing misinterpretations of stimuli. There are no data to demonstrate the client is hearing voices at this time.

15.The nurse is assigned to work with a 20-year-old client on an inpatient unit. In assessing the woman, the nurse notes that she is mute, does not show any type of movement, is unresponsive, and appears unaware of her surroundings. What is the best term for the nurse to use to describe these symptoms?

A: CATATONIA