Deck 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders

Question 1

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

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.

Answer 1

teach the patient and family about behaviors that indicate impending relapse.

Question 2

Which data gathered from the assessment of a family with a member diagnosed with schizophrenia would be of greatest importance in discharge planning for the patient?

A) The patient is the middle sibling.
B) The patient's mother is a talented artist.
C) The patient's paternal grandfather was eccentric.
D) The patient becomes anxious when family members are critical of one another.

Answer 2

The patient becomes anxious when family members are critical of one another.

Question 3

An appropriate short-term goal for a withdrawn,isolated patient diagnosed with schizophrenia is,"The patient will:

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."

Answer 3

consistently interact with an assigned nurse."

Question 4

A patient displays positive symptoms of schizophrenia as evidenced by psychotic disorders of thinking.The nurse can expect the patient to evidence:

A) delusions and hallucinations.
B) grimacing and mannerisms.
C) echopraxia and echolalia.
D) avolition and anhedonia.

Question 5

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:

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

Question 6

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:

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

Question 7

What part of the brain is dysfunctional in persons with schizophrenia? Research has implicated the:

A) medulla and cortex.
B) cerebellum and cerebrum.
C) hypothalamus and medulla.
D) prefrontal and limbic cortices.

Question 8

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

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 9

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:

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."

Question 10

A severely withdrawn patient diagnosed with schizophrenia will spend time in the dayroom but will not speak to staff or other patients.The most therapeutic nursing intervention in response to this behavior would be to:

A) seat the patient with a group of patients who are talking to each other.
B) ignore the silence and talk about superficial topics such as the weather.
C) point out that the patient makes others uncomfortable by refusing to speak.
D) plan time for staff members to sit with the patient even though the patient does not talk with them.

Question 11

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?

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 12

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:

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 13

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:

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 14

A patient diagnosed with schizophrenia reveals to the nurse that voices have warned of danger and adds,"They're so loud they frighten me.Do you hear them?" The nurse's best initial response would be:

A) "I know these voices are very real to you, but I don't hear them."
B) "Don't worry. You're safe in the hospital. I won't let anything happen to you."
C) "Tell me more about the voices. Are they men or women? How many are there?"
D) "What do you do in order to keep yourself occupied so you don't hear the voices?"

Question 15

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

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 16

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?

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 17

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

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 18

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

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.

Question 19

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

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 20

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:

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 21

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

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 22

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:

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

Question 23

A patient diagnosed with schizophrenia approaches the nurse and says,"I'm cold.Ice cream is cold.Freezers keep ice cream cold." This speech pattern can be assessed as:

A) hyperverbosity.
B) circumstantiality.
C) loose associations.
D) expressing delusions.

Question 24

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:

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

Question 25

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.)

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?"

Question 26

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

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."