Question 1

The nurse is caring for a patient experiencing auditory hallucinations who says,"When I first heard the voices they said nice things about me but now they say bad things." Which question will have an impact on the care this patient is initially provided? (Select all that apply.)

Accepted Answer

A)   "Do you trust me to help you with the voices?"
B)   "Are the voices commanding you to hurt yourself?"
C)   "How often during 24 hours do you hear the voices?"
D)   "Do you hear the voices if you're busy in a noisy environment?"
E)   "When did you first start hearing voices that were saying bad things?" B,C,D

Question 2

The nursing diagnosis most likely to be applicable for a person who has schizophrenia,paranoid type,is:

Accepted Answer

A)   social isolation related to impaired ability to trust.
B)   impaired mobility related to fear of losing control of hostile impulses.
C)   fear of being alone related to lack of confidence in significant others.
D)   impaired memory related to poor information processing associated with brain deficits. A

Question 3

An appropriate short-term goal for a withdrawn,isolated patient diagnosed with schizophrenia is,"The patient will:

Accepted Answer

A)   participate in all therapeutic activities."
B)   define major barriers to communication."
C)   talk about feelings of withdrawal in group."
D)   consistently interact with an assigned nurse." D

Question 4

During occupational therapy a patient diagnosed with schizophrenia sits staring at a piece of paper.Which response is most therapeutic at this time?

Accepted Answer

A)   "If you prefer to sit and stare for a time, it is acceptable for you to leave."
B)   "You seem immobilized by anxiety. Is there anything I can do to help?"
C)   "Are you having trouble deciding where you want to glue that piece?"
D)   "Rub the glue stick on the back of the paper."

Question 5

A patient who has been hospitalized for 2 days remains anxious and continues to be preoccupied with paranoid delusions.What intervention will best help the patient focus less on the delusions?

Accepted Answer

A)   Schedule time for the patient to read and listen to music.
B)   Plan activities that require physical skills and constructive use of time.
C)   Begin planning for discharge by engaging the patient in psychoeducation.
D)   Discuss personal goals related to improved socialization with the patient.

Question 6

A patient diagnosed with schizophrenia is standing naked after showering and appears dazed and indecisive.The nursing intervention that will be most helpful to promote dressing would be:

Accepted Answer

A)   saying, "These are your clothes. Please get dressed."
B)   saying, "These are your underpants. I'll help you put them on."
C)   asking, "Which of these two outfits would you like to wear now?"
D)   asking, "Is something the matter with your clothes that makes you not want to dress?"

Question 7

The medical record of a patient diagnosed with schizophrenia states that the patient has cognitive dysfunction.From this statement,the nurse can expect to see evidence of:

Accepted Answer

A)   anxiety, fear, and agitation.
B)   aggression, anger, hostility, or violence.
C)   blunted or flat affect or inappropriate affective responses.
D)   impaired memory and attention as well as formal thought disorder.

Question 8

A most useful strategy for helping a patient with schizophrenia prevent a potential relapse is to:

Accepted Answer

A)   have the patient attend group therapy.
B)   educate the patient on the need to take prescribed medication daily.
C)   teach the patient and family about behaviors that indicate impending relapse.
D)   schedule appointments for blood tests to determine serum medication levels.

Question 9

Which neurological deficits would the nurse be most likely to encounter when assessing a patient diagnosed with schizophrenia?

Accepted Answer

A)   Weakness and loss of function
B)   Paralysis and diminished reflexes
C)   Droopy eyelids and reddened cornea
D)   Increased blinking and impaired fine motor skills

Question 10

A patient with schizophrenia repeatedly asks for directions and the time of day.The nurse should:

Accepted Answer

A)   repeat the information in a kind, matter-of-fact manner.
B)   write out the information so the patient can easily refer to it.
C)   share that the habit of frequent questioning is annoying and should be avoided.
D)   initially provide the facts and then remind the patient that the question was already asked.

Question 11

A patient is delusional and has auditory hallucinations.The best statement to make when approaching the patient with an oral electronic thermometer would be:

Accepted Answer

A)   "I need your vital signs. Put this in your mouth. This will not hurt. "
B)   "I hope I can count on you to hold still while I take your temperature."
C)   "Please sit here while I put the thermometer under your tongue for a little while."
D)   "This probe is only a thermometer that will tell us whether you have a fever. It will be all over in just a few seconds."

Question 12

A patient diagnosed with schizophrenia has difficulty completing tasks and seems forgetful and disinterested in activities.A nurse can best select successful strategies by understanding that these behaviors are due to:

Accepted Answer

A)   a lack of self-esteem.
B)   manipulative tendencies.
C)   shyness and embarrassment.
D)   problems in cognitive functioning.

Question 13

A patient reports,"The government has implanted a device in my head." What outcome would the nurse identify as being appropriate for the patient to achieve within 1 week of admission?

Accepted Answer

A)   Taking antipsychotic medication as prescribed without objection
B)   Giving coherent data to support beliefs that a device has been implanted
C)   Interpreting reality correctly by stating that no implantation has occurred
D)   Reporting feeling less anxious about having the government listening to interior thoughts

Question 14

A patient reports,"My brain is controlled by government agents who can trace my whereabouts and listen to my thoughts." An appropriate nursing response to this information would be:

Accepted Answer

A)   "Your story is very strange and too bizarre for me to believe."
B)   "Tell me why you think your brain is being controlled by the government."
C)   "Were you experiencing any stress just before you began to think your brain was being controlled?"
D)   "Are you feeling frightened or angry about the government violating your body and controlling your brain?"

Question 15

Which teaching point will have the most positive effect on patients diagnosed with schizophrenia and their families concerning the risk of relapses?

Accepted Answer

A)   Patients who take their medications will not relapse.
B)   Caffeine and nicotine can reduce the effectiveness of antipsychotic drugs.
C)   With support, education, and adherence to treatment, patients will not relapse.
D)   Schizophrenia is a chronic disorder that is characterized by repeated relapses.

Question 16

A patient diagnosed with schizophrenia was rehospitalized after a relapse.A priority intervention in designing a discharge plan to prevent relapses will be:

Accepted Answer

A)   helping the patient's family develop tolerance for the cognitive symptoms.
B)   mobilizing the family to provide structure to reduce social dysfunction.
C)   working on self-concept to reduce avolition, anhedonia, and dysphoria.
D)   early identification of signs of impending relapse and coping strategies.

Question 17

A patient tells the nurse,"I can't go to any unit meetings because everyone can hear my thoughts." The nurse can correctly assess this symptom as:

Accepted Answer

A)   concrete thinking.
B)   loose associations.
C)   thought broadcasting.
D)   auditory hallucinations.

Question 18

A patient admitted in a semistuporous catatonic state has neither left the apartment nor attended to personal hygiene for several weeks.The patient's last 48 hours have been spent lying in bed,mute and motionless.The priority nursing diagnosis is:

Accepted Answer

A)   self-care deficit.
B)   situational low self-esteem.
C)   disturbed thought processes.
D)   impaired verbal communication.

Question 19

A nurse observes a patient who is sitting alone in a room muttering,"You don't know what you're talking about! Leave me alone." The nurse attempts to validate whether the patient is:

Accepted Answer

A)   seeking the attention of staff.
B)   inappropriately expressing emotion.
C)   experiencing auditory hallucinations.
D)   displaying negative symptoms of schizophrenia.

Question 20

A novice nurse asks the assigned mentor,"Why should I avoid telling the patient that his ideas are bizarre and simply not logical?" The mentor responds,"If you do that:

Accepted Answer

A)   it will give the patient the basis for beginning to self-reflect on the delusions."
B)   the patient will probably incorporate you into the delusions as a persecutor."
C)   it will be difficult to use empathy and calmness to foster the patient's trust."
D)   you will have little chance of gaining the patient's cooperation."

Exam 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders