Question 1

A patient has taken trifluoperazine (Stelazine) 30 mg/day orally for 3 years. The clinic nurse notes that the patient grimaces and constantly smacks both lips. The patient's neck and shoulders twist in a slow, snakelike motion. Which problem would the nurse suspect?

Accepted Answer

A)   Agranulocytosis
B)   Tardive dyskinesia
C)   Tourette syndrome
D)   Anticholinergic effects B

Question 2

What assessment findings mark the prodromal stage of schizophrenia?

Accepted Answer

A)   Withdrawal, misinterpreting, poor concentration, and preoccupation with religion
B)   Auditory hallucinations, ideas of reference, thought insertion, and broadcasting
C)   Stereotyped behavior, echopraxia, echolalia, and waxy flexibility
D)   Loose associations, concrete thinking, and echolalia neologisms A

Question 3

A patient diagnosed with schizophrenia has auditory hallucinations. The patient anxiously tells the nurse, "The voice is telling me to do things." Select the nurse's priority assessment question.

Accepted Answer

A)   "How long has the voice been directing your behavior?"
B)   "Do the messages from the voice frighten you?"
C)   "Do you recognize the voice speaking to you?"
D)   "What is the voice telling you to do?" D

Question 4

A patient diagnosed with schizophrenia says, "Everyone has skin lice that jump on you and contaminate your blood." Which problem is evident?

Accepted Answer

A)   Poverty of content
B)   Concrete thinking
C)   Neologisms
D)   Paranoia

Question 5

A patient diagnosed with schizophrenia begins a new prescription for lurasidone HCl (Latuda). The patient is 5 feet 6 inches tall and currently weighs 204 pounds. Which topic is most important for the nurse to include in the teaching plan related to this medication?

Accepted Answer

A)   How to recognize tardive dyskinesia
B)   Weight management strategies
C)   Ways to manage constipation
D)   Sleep hygiene measures

Question 6

A person diagnosed with schizophrenia has had difficulty keeping a job because of arguing with coworkers and accusing them of conspiracy. Today the person shouts, "They're all plotting to destroy me." Select the nurse's most therapeutic response.

Accepted Answer

A)   "Everyone here is trying to help you. No one wants to harm you."
B)   "Feeling that people want to destroy you must be very frightening."
C)   "That is not true. People here are trying to help if you will let them."
D)   "Staff members are health care professionals who are qualified to help you."

Question 7

A patient diagnosed with schizophrenia has been stable for a year; however, the family now reports the patient is tense, sleeps 3 to 4 hours per night, and has difficulty concentrating. The patient says, "Demons are in the basement and they can come through the floor." The nurse can correctly assess this information as an indication of:

Accepted Answer

A)   need for psychoeducation.
B)   medication noncompliance.
C)   chronic deterioration.
D)   relapse.

Question 8

Which symptoms are expected for a patient diagnosed with schizophrenia who has disorganization?

Accepted Answer

A)   Extremes of motor activity, from excitement to stupor
B)   Socially withdrawal and ineffective communication
C)   Severe anxiety with ritualistic behavior
D)   Highly suspicious, delusional behavior

Question 9

A patient diagnosed with schizophrenia says, "High heat. Last time here. Did you get a coat?" What type of verbalization is evident?

Accepted Answer

A)   Neologism
B)   Idea of reference
C)   Thought broadcasting
D)   Associative looseness

Question 10

Patients diagnosed with schizophrenia who are suspicious and withdrawn:

Accepted Answer

A)   universally fear sexual involvement with therapists.
B)   are socially disabled by the positive symptoms of schizophrenia.
C)   exhibit a high degree of hostility as evidenced by rejecting behavior.
D)   avoid relationships because they become anxious with emotional closeness.

Question 11

A patient's care plan includes monitoring for auditory hallucinations. Which assessment findings suggest the patient may be hallucinating?

Accepted Answer

A)   Aloofness, haughtiness, suspicion
B)   Darting eyes, tilted head, mumbling to self
C)   Elevated mood, hyperactivity, distractibility
D)   Performing rituals, avoiding open places

Question 12

A patient diagnosed with schizophrenia has auditory hallucinations, delusions of grandeur, poor personal hygiene, and motor agitation. Which assessment finding would the nurse regard as a negative symptom of schizophrenia?

Accepted Answer

A)   Auditory hallucinations
B)   Delusions of grandeur
C)   Poor personal hygiene
D)   Motor agitation

Question 13

A patient diagnosed with schizophrenia has catatonia. The patient is stuporous, demonstrates little spontaneous movement, and has waxy flexibility. The patient's activities of daily living are severely compromised. An appropriate outcome is that the patient will:

Accepted Answer

A)   demonstrate increased interest in the environment by the end of week 1.
B)   perform self-care activities with coaching by the end of day 3.
C)   gradually take the initiative for self-care by the end of week 2.
D)   voluntarily accept tube feeding by day 2.

Question 14

A patient diagnosed with schizophrenia says, "My coworkers are out to get me. I also saw two doctors plotting to overdose me." How does this patient perceive the environment?

Accepted Answer

A)   Disorganized
B)   Unpredictable
C)   Dangerous
D)   Bizarre

Question 15

A newly admitted patient diagnosed with schizophrenia is hypervigilant and constantly scans the environment. The patient states, "I saw two doctors talking in the hall. They were plotting to kill me." The nurse may correctly assess this behavior as:

Accepted Answer

A)   echolalia.
B)   an idea of reference.
C)   a delusion of infidelity.
D)   an auditory hallucination.

Question 16

A newly admitted patient diagnosed with schizophrenia says, "The voices are bothering me. They yell and tell me I'm bad. I have got to get away from them." Select the nurse's most helpful reply.

Accepted Answer

A)   "Do you hear the voices often?"
B)   "Do you have a plan for getting away from the voices?"
C)   "I will stay with you. Focus on what we are talking about, not the voices."
D)   "Forget about the voices. Ask some other patients to sit and talk with you."

Question 17

Which patient diagnosed with schizophrenia would be expected to have the lowest level of overall functioning?

Accepted Answer

A)   39 years old; paranoid ideation since age 35 years
B)   32 years old; isolated episodes of catatonia since age 24 years; stable for 3 years
C)   19 years old; diagnosed with schizophreniform disorder 6 months ago
D)   40 years old; frequent relapses since age 18; often does not take medication as prescribed

Question 18

A patient with delusions of persecution about being poisoned has refused all hospital meals for 3 days. Which intervention is most likely to be acceptable to the patient?

Accepted Answer

A)   Allow the patient to have supervised access to food vending machines
B)   Allow the patient to telephone a local restaurant to deliver meals
C)   Offer to taste each portion on the tray for the patient
D)   Begin tube feedings or total parenteral nutrition

Question 19

A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social functioning. The patient is also overweight and has hypertension. Which drug should the nurse advocate?

Accepted Answer

A)   Clozapine (Clozaril) 
B)   Ziprasidone (Geodon) 
C)   Olanzapine (Zyprexa) 
D)   Aripiprazole (Abilify)

Question 20

A nurse observes a patient who is diagnosed with schizophrenia. The patient is standing immobile, facing the wall with one arm extended in a salute. The patient remains immobile in this position for 15 minutes, moving only when the nurse gently lowers the arm. What is the name of this phenomenon?

Accepted Answer

A)   Echolalia
B)   Waxy flexibility
C)   Depersonalization
D)   Thought withdrawal

Exam 17: Schizophrenia Spectrum Disorders and Other Psychotic Disorders