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Homework answers / question archive / Chapter 26: Schizophrenia and Other Psychotic Disorders Multiple Choice Identify the choice that best completes the statement or answers the question

Chapter 26: Schizophrenia and Other Psychotic Disorders Multiple Choice Identify the choice that best completes the statement or answers the question

Nursing

Chapter 26: Schizophrenia and Other Psychotic Disorders

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____       1)   A paranoid client presents with bizarre behaviors, neologisms, and thought insertion. Which nursing action should be prioritized to maintain this client’s safety?

A.

Assess for medication noncompliance

B.

Note escalating behaviors and intervene immediately

C.

Interpret attempts at communication

D.

Assess triggers for bizarre, inappropriate behaviors

 

 

____       2.   A client diagnosed with schizoaffective disorder is admitted for social skills training. Which information should be taught by the nurse?

A.

The side effects of medications

B.

Deep breathing techniques to decrease stress

C.

How to make eye contact when communicating

D.

How to be a leader

 

 

____       3.   A 16-year-old-client diagnosed with paranoid schizophrenia experiences command hallucinations to harm others. The client’s parents ask a nurse, “Where do the voices come from?” Which is the appropriate nursing reply?

A.

“Your child has a chemical imbalance of the brain which leads to altered thoughts.”

B.

“Your child’s hallucinations are caused by medication interactions.”

C.

“Your child has too little serotonin in the brain causing delusions and hallucinations.”

D.

“Your child’s abnormal hormonal changes have precipitated auditory hallucinations.”

 

 

____       4.   Parents ask a nurse how they should reply when their child, diagnosed with paranoid schizophrenia, tells them that voices command him to harm others. Which is the appropriate nursing reply?

A.

“Tell him to stop discussing the voices.”

B.

“Ignore what he is saying, while attempting to discover the underlying cause.”

C.

“Focus on the feelings generated by the hallucinations and present reality.”

D.

“Present objective evidence that the voices are not real.”

 

 

____       5.   A nurse is assessing a client diagnosed with paranoid schizophrenia. The nurse asks the client, “Do you receive special messages from certain sources, such as the television or radio?” Which potential symptom of this disorder is the nurse assessing?

A.

Thought insertion

B.

Paranoid delusions

C.

Magical thinking

D.

Delusions of reference

 

 

____       6.   A client diagnosed with schizophrenia tells a nurse, “The ‘Shopatouliens’ took my shoes out of my room last night.” Which is an appropriate charting entry to describe this client’s statement?

A.

“The client is experiencing command hallucinations.”

B.

“The client is expressing a neologism.”

C.

“The client is experiencing a paranoid delusion.”

D.

“The client is verbalizing a word salad.”

 

 

____       7.   During an admission assessment, a nurse asks a client diagnosed with schizophrenia, “Have you ever felt that certain objects or persons have control over your behavior?” The nurse is assessing for which type of thought disruption?

A.

Delusions of persecution

B.

Delusions of influence

C.

Delusions of reference

D.

Delusions of grandeur

 

 

____       8.   A client diagnosed with schizophrenia states, “Can’t you hear him? It’s the devil. He’s telling me I’m going to hell.” Which is the most appropriate nursing reply?

A.

“Did you take your medicine this morning?”

B.

“You are not going to hell. You are a good person.”

C.

“I’m sure the voices sound scary. The devil is not talking to you. This is part of your illness.”

D.

“The devil only talks to people who are receptive to his influence.”

 

 

____       9.   A client diagnosed with psychosis NOS (not otherwise specified) tells a nurse about voices telling him to kill the president. Which nursing diagnosis should the nurse prioritize for this client?

A.

Disturbed sensory perception

B.

Altered thought processes

C.

Risk for violence: directed toward others

D.

Risk for injury

 

 

____     10.   Which nursing intervention would be most appropriate when caring for an acutely agitated client diagnosed with paranoid schizophrenia?

A.

Provide neon lights and soft music.

B.

Maintain continual eye contact throughout the interview.

C.

Use therapeutic touch to increase trust and rapport.

D.

Provide personal space to respect the client’s boundaries.

 

 

____     11.   Which nursing behavior will enhance the establishment of a trusting relationship with a client diagnosed with schizophrenia?

A.

Establishing personal contact with family members.

B.

Being reliable, honest, and consistent during interactions.

C.

Sharing limited personal information.

D.

Sitting close to the client to establish rapport.

 

 

____     12.   A client diagnosed with paranoid schizophrenia states, “My psychiatrist is out to get me. I’m sad that the voice is telling me to stop him.” What symptom is the client exhibiting, and what is the nurse’s legal responsibility related to this symptom?

A.

Magical thinking; administer an antipsychotic medication

B.

Persecutory delusions; orient the client to reality

C.

Command hallucinations; warn the psychiatrist

D.

Altered thought processes; call an emergency treatment team meeting

 

 

____     13.   Which statement should indicate to a nurse that an individual is experiencing a delusion?

A.

“There’s an alien growing in my liver.”

B.

“I see my dead husband everywhere I go.”

C.

“The IRS may audit my taxes.”

D.

“I’m not going to eat my food. It smells like brimstone.”

 

 

____     14.   A client diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication should a nurse expect a physician to order to address this type of symptom?

A.

Haloperidol (Haldol) to address the negative symptom

B.

Clonazepam (Klonopin) to address the positive symptom

C.

Risperidone (Risperdal) to address the positive symptom

D.

Clozapine (Clozaril) to address the negative symptom

 

 

____     15.   A client is diagnosed with schizophrenia. A physician orders haloperidol (Haldol) 50 mg bid, benztropine (Cogentin) 1 mg prn, and zolpidem (Ambien) 10 mg HS. Which client behavior would warrant the nurse to administer benztropine?

A.

Tactile hallucinations

B.

Tardive dyskinesia

C.

Restlessness and muscle rigidity

D.

Reports of hearing disturbing voices

 

 

____     16.   A nurse is caring for a client who is experiencing a flat affect, paranoid delusions, anhedonia, anergia, neologisms, and echolalia. Which statement correctly differentiates the client’s positive and negative symptoms of schizophrenia?

A.

Paranoid delusions, anhedonia, and anergia are positive symptoms of schizophrenia.

B.

Paranoid delusions, neologisms, and echolalia are positive symptoms of schizophrenia.

C.

Paranoid delusions, anergia, and echolalia are negative symptoms of schizophrenia.

D.

Paranoid delusions, flat affect, and anhedonia are negative symptoms of schizophrenia.

 

 

____     17.   A client diagnosed with chronic schizophrenia presents in an emergency department (ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect the physician to recognize which condition and implement which treatment?

A.

Neuroleptic malignant syndrome and treat by discontinuing antipsychotic medications

B.

Agranulocytosis and treat by administration of clozapine (Clozaril)

C.

Extrapyramidal symptoms and treat by administration of benztropine (Cogentin)

D.

Tardive dyskinesia and treat by discontinuing antipsychotic medications

 

 

____     18.   After taking chlorpromazine (Thorazine) for 1 month, a client presents to an emergency department (ED) with severe muscle rigidity, tachycardia, and a temperature of 105oF (40.5°C). The nurse expects the physician to recognize which condition and implement which treatment?

A.

Neuroleptic malignant syndrome and treat by discontinuing Thorazine and administering dantrolene (Dantrium)

B.

Neuroleptic malignant syndrome and treat by increasing Thorazine dosage and administering an antianxiety medication

C.

Dystonia and treat by administering trihexyphenidyl (Artane)

D.

Dystonia and treat by administering bromocriptine (Parlodel)

 

 

____     19.   A client diagnosed with schizophrenia takes an antipsychotic agent daily. Which assessment finding should a nurse immediately report to the client’s attending psychiatrist?

A.

Respirations of 22 beats/minute

B.

Weight gain of 8 pounds in 2 months

C.

Temperature of 104°F (40°C)

D.

Excessive salivation

 

 

____     20.   An aging client diagnosed with chronic schizophrenia takes an antipsychotic and a beta-adrenergic blocking agent (propranolol) for hypertension. Understanding the combined side effects of these drugs, which statement by a nurse is most appropriate?

A.

“Make sure you concentrate on taking slow, deep, cleansing breaths.”

B.

“Watch your diet and try to engage in some regular physical activity.”

C.

“Rise slowly when you change position from lying to sitting or sitting to standing.”

D.

“Wear sunscreen and try to avoid midday sun exposure.”

 

 

____     21.   A client diagnosed with schizophrenia is prescribed clozapine (Clozaril). Which client symptoms related to the side effects of this medication should prompt a nurse to intervene immediately?

A.

Sore throat, fever, and malaise

B.

Akathisia and hypersalivation

C.

Akinesia and insomnia

D.

Dry mouth and urinary retention

 

 

____     22.   If clozapine (Clozaril) therapy is being considered, the nurse should evaluate which laboratory test to establish a baseline for comparison in order to recognize a potentially life-threatening side effect?

A.

White blood cell count

B.

Liver function studies

C.

Creatinine clearance

D.

Blood urea nitrogen

 

 

____     23.   During an admission assessment, a nurse notes that a client diagnosed with schizophrenia has allergies to penicillin, prochlorperazine (Compazine), and bee stings. Based on this assessment data, which antipsychotic medication would be contraindicated?

A.

Haloperidol (Haldol), because it is used only in elderly patients

B.

Clozapine (Clozaril), because of a cross-sensitivity to penicillin

C.

Risperidone (Risperdal), because it exacerbates symptoms of depression

D.

Thioridazine (Mellaril), because of cross-sensitivity among phenothiazines

 

 

____     24.   A college student has quit attending classes, isolates self due to hearing voices, and yells accusations at fellow students. Based on this information, which nursing diagnosis should the nurse prioritize?

A.

Altered thought processes R/T hearing voices AEB increased anxiety

B.

Risk for other-directed violence R/T yelling accusations

C.

Social isolation R/T paranoia AEB absence from classes

D.

Risk for self-directed violence R/T depressed mood

 

 

____     25.   A client has been recently admitted to an inpatient psychiatric unit. Which intervention should the nurse plan to use to reduce the client’s focus on delusional thinking?

A.

Present evidence that supports the reality of the situation

B.

Focus on feelings suggested by the delusion

C.

Address the delusion with logical explanations

D.

Explore reasons why the client has the delusion

 

 

____     26.   A client states, “I hear voices that tell me that I am evil.” Which outcome related to these symptoms should the nurse expect this client to accomplish by discharge?

A.

The client will verbalize the reason the voices make derogatory statements.

B.

The client will not hear auditory hallucinations.

C.

The client will identify events that increase anxiety and illicit hallucinations.

D.

The client will positively integrate the voices into the client’s personality structure.

 

 

____     27.   A newly admitted client has taken thioridazine (Mellaril) for 2 years with good symptom control. Symptoms exhibited on admission included paranoid delusions and hallucinations. The nurse should recognize which potential cause for the return of these symptoms?

A.

The client has developed tolerance to the antipsychotic medication.

B.

The client has not taken the medication with food.

C.

The client has not taken the medication as prescribed.

D.

The client has combined alcohol with the medication.

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____     28.   Which of the following components should a nurse recognize as an integral part of a rehabilitative program when planning care for clients diagnosed with schizophrenia? (Select all that apply.)

A.

Group therapy

B.

Medication management

C.

Deterrent therapy

D.

Supportive family therapy

E.

Social skills training

 

 

____     29.   A nurse is administering risperidone (Risperdal) to a client diagnosed with schizophrenia. The therapeutic effect of this medication would most effectively address which of the following symptoms? (Select all that apply.)

A.

Somatic delusions

B.

Social isolation

C.

Gustatory hallucinations

D.

Flat affect

E.

Clang associations

 

 

____     30.   Laboratory results reveal decreased levels of prolactin in a client diagnosed with schizophrenia. When assessing the client, which symptoms should a nurse expect to observe?(Select all that apply.)

A.

Apathy

B.

Social withdrawal

C.

Anhedonia

D.

Auditory hallucinations

E.

Delusions

 

 

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