1 in schizophrenic patients indicates paranoia?
2
A patient, who has been receiving antipsychotic medication for six weeks, tells the
nurse that the
... [Show More] hallucinations are nearly gone and that concentration has improved.
When the patient reports flulike symptoms, including a fever and a very sore throat,
the nurse should
1
Suggest that the patient take something for his her fever and get extra rest
2
Advise the health care provider that the patient should be admitted to the hospital
Correct3
Arrange for the patient to have blood drawn for a white blood cell count
4
Consider recommending a change of antipsychotic medication
Antipsychotic medications may cause agranulocytosis, the first manifestation of which may
be a sore throat and flulike symptoms.
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3.
Which symptom would NOT be assessed as a positive symptom of schizophrenia?
1
Delusion of persecution
2
Auditory hallucinations
Correct3
Affective flattening
4
Idea of reference
Positive symptoms are those symptoms that should not be present, but are. They include
hallucinations, delusions, bizarre behavior, and paranoia and are referred to as florid
symptoms. Affective flattening is one of the negative symptoms that contribute to rendering
the person inert and unmotivated.
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4.
A patient's dose of haloperidol (Haldol) was increased earlier today. The patient now
is experiencing laryngeal dystonia. What is the nurse's priority action?
1
Document the finding
Correct2
Maintain a patent airway
3
Offer oral fluids to the patient
4
Engage the patient in an alternative activity
Laryngeal dystonia is associated with an acute dystonic reaction and may impair the
integrity of the patient's airway. The nurse will document the events after they are managed.
Oral fluids could be aspirated. Immediate nursing action is indicated; it would be
inappropriate to try to engage the patient in an alternate activity.
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5.
The nurse is performing an assessment of geriatric patients in a community health
care center. The nurse reports that one of the patients is schizophrenic. Which
statement made by the patient while interacting with the nurse supports the nurse's
assessment?
1
"Every morning I enjoy the humming of birds; it relaxes me."
2
"Every day my friends wait for me in front of my gate for our morning walk."
Correct3
"Every day birds sing songs for me and spread flowers on the path where I walk."
4
"Everyone feels as if I am a burden to them; I would like to put an end to their problem."
Patients with schizophrenia have delusions of self-importance and state false events related
to them, like birds singing songs for them and spreading flowers on their path. The
statement that every morning the patient enjoys the humming of birds indicates that the
patient has no impaired perception and is able to connect with reality. The statement that
every morning the patient's friends wait for him or her is normal. The statement that
everyone feels the patient is a burden indicates that the patient feels worthless and has
suicidal intentions. It does not indicate schizophrenic symptoms.
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6.
What symptoms are se h a patient in the acute phase of schizophrenia. Which
assessment findings increase the risk of aggression and violence? Select all that
apply.
1
Hypokalemia
2
Hypocalcemia
Correct3
Hyponatremia
4
Hypercalcemia
In patients with schizophrenia, polydipsia is seen due to dry mouth. Patients experience
excessive thirst due to antipsychotic drugs and drink a lot of water. Polydipsia is
characterized by hyponatremia, confusion, and severe symptoms of schizophrenia. It is
caused by the inability of the kidneys to filter excess fluids. Hypokalemia is a condition seen
due to reduced levels of potassium, which can be caused by antibiotics. Hypocalcemia refers
to decreased levels of calcium due to a deficiency of vitamin D or defective absorption. It
can also happen due to impaired metabolism of vitamin D in the body. Hypercalcemia is an
increase in levels of calcium seen during hyperparathyroidism.
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7.
Which symptom seen in a schizophrenic patient can be categorized as a positive
symptom?
1
Loss of motivation
2
Impaired judgment
Correct3
Delusions
4
Dysphoria
The behavioral traits not normally found in healthy patients are called positive symptoms of
schizophrenia. They include delusions, hallucinations, bizarre behavior, and paranoia. The
behaviors that the patient lacks compared to healthy people are negative symptoms, such
as loss of motivation and alogia (poverty of thought or inability to speak). Impaired judgment
and illogical thinking are the cognitive symptoms associated with schizophrenia. Dysphoria
and suicidal intentions are affective symptoms of schizophrenia. Affective symptoms involve
emotions and their expression.
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8.
A patient diagnosed with schizophrenia states "My, oh my. My mother is brother.
Anytime now it can happen to my mother." How will the nurse respond to the
patient's statement?
1
"You are having problems with your speech. You need to try harder to be clear."
2
"You are confused. I will take you to your room to rest awhile."
3
"I will get you an as-needed medication for agitation."
Correct4
"I'm sorry, I didn't understand that. Do you want to talk more about your mother as we did
yesterday?"
The guidelines that are useful in communicating with a patient with disorganized or bizarre
speech are to place the difficulty in understanding on the nurse, not the patient, and look for
themes that may be helpful in interpreting what the patient wants to say. Telling the patient
to try harder to be clearer is unrealistic because the patient would be unable do this. Taking
the patient to his or her room or getting the patient medication are not useful options in
communicating with this patient and attempting to find common themes.
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9.
A nurse is educating a patient's family about schizophrenia. What is the most
appropriate advice the nurse can give to the patient's family? Select all that
apply.
Correct1
The nurse should advise them to keep in touch with support groups.
2
The nurse should avoid mentioning the side effects of the drugs prescribed.
3
The nurse should advise them to keep the patient in an isolated room.
Correct4
The nurse should advise them to adhere to the treatment plan.
5
The nurse should advise them to immediately stop the medication if the patient's symptoms
are relieved.
The nurse should advise the family of the patient to join support groups such as National
Alliance on Mental Illness and other local support groups. These groups would help to
provide optimal patient care as well as support to the family. Adherence to the treatment
plan would result in positive outcomes for the patient. The patient's family must be
educated about the possible side effects of the prescribed drugs. This would help in effective
monitoring and reducing panic in the patient and family members. The patient should be
encouraged to interact with others. Keeping the patient isolated can make the patient either
aggressive or withdrawn. The medications should not be stopped immediately after the
symptoms are relieved as it could cause relapse of the schizophrenic symptoms. Gradually
decreasing the dosage of the drug would be useful to prevent a relapse.
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10.
A patient diagnosed with disorganized schizophrenia would have greatest difficulty
when the nurse
1
Interacts with a neutral attitude
2
Uses concrete language
Correct3
Gives multistep directions
4
Provides nutritional supplements
The thought processes of the patient with disorganized schizophrenia are severely
disordered, and severe perceptual problems are present, making it extremely difficult for the
patient to understand what others are saying. All communication should be simple and
concrete and may need to be repeated several times.
Which side effect of antipsychotic medication is generally nonreversible?
1
Anticholinergic effects
Incorrect2
Pseudoparkinsonism
3
Dystonic reaction
Correct4
Tardive dyskinesia
Tardive dyskinesia is not always reversible with discontinuation of the medication and has no
proven cure. The side effects in anticholinergic effects, pseudoparkinsonism, and dystonic
reaction often appear early in therapy and can be minimized with treatment.
1
A patient diagnosed with schizophrenia and experiencing command hallucinations
had a brief stay on an inpatient unit. Afterward, the patient was transferred to a
partial hospitalization program. Which outcome is most appropriate to achieve by
the end of the first week of partial hospitalization? The patient will:
1
Express self clearly and in organized sentences.
2
Clearly describe the content and source of the hallucinations.
3
Ask the nurse for medication when experiencing hallucinations.
Correct4
Verbalize an understanding that hallucinations are a sign of the illness.
Anosognosia refers to an inability to realize an illness exists. This problem occurs in many
persons diagnosed with schizophrenia. If the patient recognizes that hallucinations are an
aspect of the illness, he or she has made initial progress in management of the illness. It will
take longer than one week for the patient to communicate clearly and in organized
sentences. The patient does not know the source of hallucinations and it is not productive to
explore their content in detail. The patient should take medication daily, not just when
experiencing hallucinations.
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2.
A patient has reached the stable plateau phase of schizophrenia. An appropriate
clinical focus for planning would be [Show Less]