Deck 17: Schizophrenia Spectrum and Other Psychotic Disorders

Question 1

The nurse caring for a patient with schizophrenic spectrum disorder notes that the patient imitates the nurse's movements during the assessment. Which symptom is the patient experiencing?

A) Echolalia
B) Echopraxia
C) Loose associations
D) Automatic obedience

Answer 1

Echopraxia

Question 2

The nurse caring for a patient with schizophrenia recognizes which symptoms as characteristic of formal thought disorder? Select all that apply.

A) Echolalia
B) Asterognosis
C) Circumstantiality
D) Cognitive constancy
E) Loose associations

Answer 2

Circumstantiality
Loose associations

Question 3

The nurse is caring for a patient with schizophrenia spectrum disorder who is taking olanzapine (Zyprexa). The nurse knows the patient requires education related to avoiding which drugs and/or foods?

A) Phenytoin
B) Grapefruit juice
C) Dexamethasone
D) Garlic supplements

Answer 3

Phenytoin

Question 4

The nurse caring for a patient with schizophrenia spectrum disorder knows that the appearance of hard signs indicates which types of impairment? Select all that apply.

A) Reflexes
B) Grimacing
C) Asterognosis
D) Increased blink rates
E) Oculomotor abnormalities

Question 5

When working with patients who have had psychotic episodes, the nurse knows to monitor for which laboratory analysis for the patient taking clozapine (Clozaril)?

A) WBC
B) RBC count
C) Fasting blood sugar
D) Pro-times and creatine kinase

Question 6

A patient with schizophrenia spectrum disorder presents to the emergency department (ED) with a temperature of 103.5^o F. The nurse suspects the patient is experiencing neuroleptic malignant syndrome (NMS), an adverse effect of his antipsychotic medications. For what other symptoms of NMS will nurse assess? Select all that apply.

A) Grimacing
B) Diaphoresis
C) Muscle rigidity
D) Increased blink rates
E) Autonomic dysfunction

Question 7

The nurse is caring for a patient experiencing a relapse of a schizophrenia spectrum disorder. As the nurse considers the plan of care, which type of nursing intervention will the nurse give priority?

A) Patient education
B) Direct action
C) Disease prevention
D) Family involvement

Question 8

The nurse caring for a patient with schizophrenia spectrum disorder will include which factors in the patient assessment? Select all that apply.

A) Medical history
B) Pain assessment
C) Home safety check
D) Suicide assessment
E) Height and weight assessment

Question 9

The nurse knows that the patient taking aripiprazole (Abilify) 20 mg/day PO requires which specific follow-up assessment?

A) Vital signs each visit
B) Height and weight at each visit
C) Weekly assessment for extrapyramidal symptoms
D) Every six month checks for tardive dyskinesia

Question 10

The nurse caring for a patient with schizophrenia spectrum disorder knows that the risk of disease increases according to which neurochemical explanations? Select all that apply.

A) Use of drugs that increase dopaminergic activity
B) A decrease in dopaminergic activity in the brain
C) An increase in gray matter in the anterior cingulate and hippocampus
D) A reduction in the structural gray matter of the bilateral frontal lobe and amygdala
E) Mitochondrial reduction of density and volume, including defective mitochondrial energy production

Question 11

The nurse is caring for a patient with delusional verbalizations. Which is an appropriate intervention for patients exhibiting this symptom?

A) Allow patient to determine delusion and truth through reflection.
B) Provide family members with educational material regarding medication adherence.
C) If delusions are expressed, present patient with reality without arguing.
D) Provide teaching related to titration of medication based on patient perception of symptoms.

Question 12

A patient tells the nurse, "I refuse to take quetiapine (Seroquel) because it is manufactured by terrorists. If I take it, I'll die." The nurse recognizes the patient's statement as indicative of what symptoms commonly seen in schizophrenia?

A) Alogia
B) Delusion
C) Ambivalence
D) Avolition

Question 13

A nurse is caring for a patient with schizophrenia. Which accurately describes genetic and environmental causes of schizophrenia?

A) One single gene is responsible for producing schizophrenia.
B) The chance of both monozygotic twins having schizophrenia is 100%.
C) Environmental factors do not affect the risk of developing schizophrenia.
D) First-degree relatives have an increased risk of developing schizophrenia.

Question 14

When working with patients who have had psychotic episodes, the nurse knows that which is a critical feature for psychological adjustment?

A) Reflection on psychological milestones
B) Insight into learning how to cope with life
C) Progressive goal direction through thought processes
D) Re-engagement in normal daily interactions

Question 15

The nurse caring for a patient with schizophrenia spectrum disorder (SSD) knows that, as a result of severe impairments in the sociocultural domain, the patient may experience which type of event?

A) Loss of job
B) Re-establishment of identity
C) Return to independent functioning
D) Distraction from symptoms

Question 16

The nurse is reviewing the etiology of schizophrenia. What statement is correct regarding the brain structure of individuals with schizophrenia?

A) The brain displays changes in the hippocampal area.
B) The brain displays no changes in the mesocortical pathway.
C) The brains display no changes from those without schizophrenia.
D) The brain displays changes in the bilateral occipital lobe cortical gray matter.

Question 17

The nurse is assessing the patient with schizophrenia. Which will the nurse recognize as negative symptoms associated with the disorder? Select all that apply.

A) The patient is withdrawn.
B) The patient has a blunted affect.
C) The patient reports auditory hallucinations.
D) The patient reports lack of motivation.
E) The patient introduces himself as Pope Francis.

Question 18

The nurse understands that which alteration or deficit explains the memory alterations observed in patients with schizophrenia spectrum disorder?

A) Neuropathology
B) Biochemical alterations
C) Neural circuitry deficits
D) Brain metabolism dysfunction

Question 19

The patient tells the nurse, "The world will end tonight at midnight. Armageddon is upon us!!" This statement indicates the patient is experiencing which type of delusion?

A) Religious
B) Grandiose
C) Nihilistic
D) Persecutory

Question 20

A nurse is caring for a patient with schizophrenia who is prescribed antipsychotic medications. Which statement is accurate regarding schizophrenia and medication treatment?

A) Typical antipsychotic medications block serotonin and dopamine.
B) Dopamine receptors exist in only one region of the brain, making treatment difficult.
C) Atypical antipsychotic medications cause fewer extrapyramidal side effects than traditional antipsychotic medications.
D) Positive symptoms of schizophrenia respond more readily to atypical antipsychotic medications than traditional medications.

Question 21

The nurse knows that the patient taking olanzapine for SSD will need to be followed in order to help manage which aspect of care?

A) Weight
B) Anxiety
C) Vital signs
D) Physical competence

Question 22

Which intervention will increase the patient's likelihood of taking psychotropic medications for the treatment of schizophrenia?

A) Encourage the patient to use measures to manage side effects.
B) Encourage the patient to take all medications at the same time.
C) Give family members information about the patient's medication.
D) Give the patient a pamphlet explaining the positive effects of psychotropic medication.

Question 23

The nurse is helping a patient with schizophrenia develop an exercise plan. The patient has obtained medical clearance for walking and light exercise. Which nursing interventions are the most appropriate? Select all that apply.

A) Assess medication adherence.
B) Assess patient confidence level.
C) Provide memory prompts.
D) Provide reality orientation.
E) Assess body mass index.

Question 24

A patient is pacing in the hall when the nurse overhears the patient say, "Leave me alone. I am not in the Mafia." What is the best response from the nurse?

A) "Tell me, are you hearing voices again?"
B) "Tell me what you are hearing right now."
C) "You are safe from the Mafia here in the hospital."
D) "You need to attend the next recreation group. That will help you ignore the voices."

Question 25

When planning nursing care for patients with schizophrenia spectrum disorders whose symptoms do not respond to medication, the nurse will discuss which therapy with the prescribing provider?

A) Exercise therapy
B) Social skills therapy
C) Cognitive-behavioral therapy
D) Alternative medication therapy

Question 26

The nurse is assessing a patient who is experiencing a relapse of symptoms of schizophrenia. The nurse knows that the patient's abilities in which areas will have the greatest impact on the plan of care? Select all that apply.

A) Listening
B) Concentration
C) Decision making
D) Retaining new information
E) Maintaining adequate coping strategies

Question 27

The nurse knows when planning lifestyle interventions for patients with schizophrenia spectrum disorders which aspect is most important?

A) Nicotine replacement
B) Spiritual counseling
C) Reduction of triggers
D) Reminders and repetition

Question 28

A patient is admitted to the inpatient unit with a diagnosis of schizophrenia. What is the priority nursing diagnosis for this patient?

A) Disturbed Thought Process
B) Impaired Social Interaction
C) Impaired Verbal Communication
D) Risk for Injury