Exam 15: Schizophrenia

Select the outcomes most appropriate for a patient in the third (maintenance)phase of treatment for schizophrenia."The patient will _________." Select all that apply.

A patient receiving risperidone (Risperdal)reports severe muscle stiffness midmorning.During lunch he has difficulty swallowing food and speaking,and when vital signs are taken 30 minutes later,he is noted to be stuporous and diaphoretic,with a temperature of 38.8° C,pulse of 110 beats/min,and blood pressure of 150/90 mm Hg.The nurse should suspect _________ and should ______________.

A patient with schizophrenia refuses to take his medication because he believes he is not ill.What phenomenon most likely underlies this presentation?

A highly suspicious patient who has delusions of persecution about being poisoned has refused all hospital meals for 3 days.Which of the following interventions would be most appropriate under these circumstances?

A patient with schizophrenia is admitted to the psychiatric unit in an acutely disturbed,violent state.He is given several doses of haloperidol (Haldol)and becomes calm and approachable.During rounds the nurse notices the patient has his head rotated to one side in a stiffly fixed position.His lower jaw is thrust forward and he appears severely anxious.The patient has _________ ,and the nurse should _________.

A patient with schizophrenia begins to talk about creatures called "volmers" hiding in the warehouse where he works and undoing his work each night.The term "volmers" most likely represents:

A newly admitted patient with schizophrenia approaches the unit nurse and says,"The voices are bothering me.They are yelling and telling me stuff.They are really bad." Which response by the nurse would be most appropriate?

A catatonic patient admitted in a stuporous condition begins to demonstrate increased motor activity.During his assessment,the psychiatrist raises the patient's arm above his head and releases it.The patient maintains the position his arm was placed in,immobile in that position for 15 minutes,moving only when the nurse gently lowers his arm.What symptom is demonstrated by this assessment technique?

A patient with schizophrenia tells the nurse "I don't know,it's just all the same.You never know.It comes,it goes,it blows away.Get it?" The best response for the nurse to make would be:

A patient's nursing care plan includes assessment for auditory hallucinations.Indicators that suggest the patient may be hallucinating include:

A patient is noted to be bending over backward in the group room.A peer asks what he is doing,and he replies,"People say they are bending over backwards to help me,so I am bending over backwards to help myself." This is an example of:

The physician and advanced practice nurse are considering which antipsychotic medication to prescribe for a patient with schizophrenia who demonstrates auditory hallucinations,apathy,anhedonia,and poor social functioning.The patient is overweight and has hypertension.Bearing these facts in mind,the drug the nurse should advocate would be:

A patient with the diagnosis of schizophrenia,disorganized type,approaches the nurse and says,"It's beat,it's eat.No room for doom." The nurse can correctly assess this verbalization as:

When a patient with paranoid schizophrenia has a recurrence of positive symptoms after stopping his antipsychotic medication because of its postural hypotension (orthostasis)side effect,he is readmitted to the mental health unit.What measure should the nurse suggest to help the patient address this side effect?

The physician prescribes haloperidol (Haldol),a first-generation antipsychotic drug,for a patient with schizophrenia who displays delusions,hallucinations,apathy,and social isolation.Which symptoms should most be monitored to evaluate the expected improvement from this medication?

A patient moving from chair to chair in the day room and pacing in the hallway repeatedly,rapidly,and for extended periods is likely demonstrating _________ ,and the nurse should __________.

Police bring a 63-year-old woman to the emergency room,reporting that her behavior is disorganized and disruptive,that her speech makes little sense,and that she does not seem able to take care of herself.The woman has had elective surgeries at the hospital previously and was seen in the ER last week after a fall;records show no history of similar symptoms or mental illness.The ER physician speaks with the patient but does not examine her medically,diagnoses her with schizophrenia,and orders admission to the inpatient psychiatric unit.Which response by the nurse would be most appropriate?

At 11:00 AM,a patient with schizophrenia who exhibits concrete thinking asks the nurse for PRN acetaminophen (Tylenol).However,he last had it at 8:00 AM,and it is ordered only every 4 hours.Which nursing response would be most therapeutic?

A patient was admitted to the mental health unit after arguing with co-workers and threatening to kill them.He is diagnosed with paranoid schizophrenia.On the unit he is aloof and suspicious.He mentioned that two physicians he saw talking were plotting to kill him.On the basis of data gathered at this point,which two primary nursing diagnoses should the nurse consider?

A patient with many positive symptoms of schizophrenia,whose behavior is disorganized and who is highly anxious,tells the nurse in the psychiatric emergency department,"You have got to help me.I do not know what is going on.I think someone is trying to wipe me out.I have to get a gun." The patient,a college student,lives alone and has no family or support system in the immediate area.He has not left his room in 2 weeks,has not eaten in several days,and is unkempt.Of the available treatment settings,the nurse should recommend: