Deck 15: Schizophrenia Spectrum and Other Psychotic Disorders

Question 1

A client diagnosed with schizophrenia spectrum disorder tells a nurse about voices commanding him to kill the president. Which is the priority nursing diagnosis for this client?

A) Disturbed sensory perception
B) Altered thought processes
C) Risk for violence: directed toward others
D) Risk for injury

Answer 1

Risk for violence: directed toward others

Question 2

A client diagnosed with schizoaffective disorder is admitted for social skills training. Which information should be included in the nurse's teaching?

A) The side effects of medications
B) Deep breathing techniques to decrease stress
C) How to make eye contact when communicating
D) How to be a leader

Answer 2

How to make eye contact when communicating

Question 3

Order the spectrum of schizophrenic and other psychotic disorders as described by the DSM-5 on a gradient of psychopathology from least to most severe.
________ Delusional disorder
________ Schizotypal personality disorder
________ Schizophrenia
________ Brief psychotic disorder
________ Psychotic disorder associated with another medical condition
________ Catatonic disorder associated with another medical condition
________ Schizoaffective disorder
________ Schizophreniform disorder
________ Substance-induced psychotic disorder

Answer 3

The correct order is 2, 1, 9, 3, 5, 6, 8, 7, 4

Question 4

A client is diagnosed with schizophrenia spectrum disorder. A physician orders haloperidol (Haldol) 50 mg bid, benztropine (Cogentin) 1 mg prn, and zolpidem (Ambien) 10 mg HS. Which client behavior would warrant the nurse to administer benztropine?

A) Tactile hallucinations
B) Tardive dyskinesia
C) Restlessness and muscle rigidity
D) Reports of hearing disturbing voices

Question 5

Which nursing intervention would be most appropriate when caring for an acutely agitated paranoid client diagnosed with schizophrenia spectrum disorder?

A) Provide neon lights and soft music.
B) Maintain continual eye contact throughout the interview.
C) Use therapeutic touch to increase trust and rapport.
D) Provide personal space to respect the client's boundaries.

Question 6

A 16-year-old client diagnosed with schizophrenia spectrum disorder experiences command hallucinations to harm others. The client's parents ask a nurse, "Where do the voices come from?" Which is the appropriate nursing response?

A) "Your child has a chemical imbalance of the brain, which leads to altered perceptions."
B) "Your child's hallucinations are caused by medication interactions."
C) "Your child has too little serotonin in the brain, causing delusions and hallucinations."
D) "Your child's abnormal hormonal changes have precipitated auditory hallucinations."

Question 7

An aging client diagnosed with schizophrenia spectrum disorder takes an antipsychotic and a beta-adrenergic blocking agent for hypertension. Understanding the combined side effects of these drugs, which statement by a nurse is most appropriate?

A) "Make sure you concentrate on taking slow, deep, cleansing breaths."
B) "Watch your diet and try to engage in some regular physical activity."
C) "Rise slowly when you change position from lying to sitting or sitting to standing."
D) "Wear sunscreen and try to avoid midday sun exposure."

Question 8

___________________________ disorder is manifested by schizophrenic behaviors, with a strong element of symptomatology associated with the mood disorders (depression or mania).

Question 9

A client has been assigned an admission diagnosis of brief psychotic disorder. Which assessment information would alert the nurse to question this diagnosis?

A) The client has experienced impaired reality testing for a 24-hour period.
B) The client has experienced auditory hallucinations for the past 3 hours.
C) The client has experienced bizarre behavior for 1 day.
D) The client has experienced confusion for 3 weeks.

Question 10

The diagnosis of catatonic disorder associated with another medical condition is made when the client's medical history, physical examination, or laboratory findings provide evidence that symptoms are directly attributed to which of the following?

A) Hyperthyroidism
B) Hypothyroidism
C) Hyperadrenalism
D) Hypoadrenalism
E) Hyperaphia
Other

Question 11

A client diagnosed with schizophrenia spectrum disorder states, "Can't you hear him? It's the devil. He's telling me I'm going to hell." Which is the most appropriate nursing response?

A) "Did you take your medicine this morning?"
B) "You are not going to hell. You are a good person."
C) "The voices must sound scary, but the devil is not talking to you. This is part of your illness."
D) "The devil only talks to people who are receptive to his influence."

Question 12

A paranoid client presents with bizarre behaviors, neologisms, and thought insertion. Which nursing action should be prioritized to maintain this client's safety?

A) Assess for medication nonadherence.
B) Note escalating behaviors and intervene immediately.
C) Interpret attempts at communication.
D) Assess triggers for bizarre, inappropriate behaviors.

Question 13

A client diagnosed with schizophrenia spectrum disorder is prescribed clozapine (Clozaril). Which client symptoms, related to the side effects of this medication, should prompt a nurse to intervene immediately?

A) Sore throat, fever, and malaise
B) Akathisia and hypersalivation
C) Akinesia and insomnia
D) Dry mouth and urinary retention

Question 14

Which nursing behavior will enhance the establishment of a trusting relationship with a client diagnosed with schizophrenia spectrum disorder?

A) Establishing personal contact with family members
B) Being reliable, honest, and consistent during interactions
C) Sharing limited personal information
D) Sitting close to the client to establish rapport

Question 15

A nurse is assessing a client diagnosed with substance induced psychotic disorder (SIPD). What would differentiate this client's symptoms from the symptoms of a client diagnosed with brief psychotic disorder (BPD)?

A) Clients diagnosed with SIPD experience delusions, whereas clients diagnosed with BPD do not.
B) Clients diagnosed with BPD experience hallucinations, whereas clients diagnosed with SIPD do not.
C) Catatonic features may be associated with SIPD, whereas BPD has no catatonic features.
D) Catatonic features may be associated with BPD, whereas SIPD has no catatonic features.

Question 16

A nurse is caring for a client who is experiencing a flat affect, paranoid delusions, anhedonia, anergia, neologisms, and echolalia. Which statement correctly differentiates the client's positive and negative symptoms of schizophrenia?

A) Paranoid delusions, anhedonia, and anergia are positive symptoms of schizophrenia.
B) Paranoid delusions, neologisms, and echolalia are positive symptoms of schizophrenia.
C) Paranoid delusions, anergia, and echolalia are negative symptoms of schizophrenia.
D) Paranoid delusions, flat affect, and anhedonia are negative symptoms of schizophrenia.

Question 17

A paranoid client diagnosed with schizophrenia spectrum disorder states, "My psychiatrist is out to get me. I'm sad that the voice is telling me to stop him." What symptom is the client exhibiting, and what is the nurse's legal responsibility related to this symptom?

A) Magical thinking; administer an antipsychotic medication.
B) Persecutory delusions; orient the client to reality.
C) Command hallucinations; warn the psychiatrist.
D) Altered thought processes; call an emergency treatment team meeting.

Question 18

Parents ask a nurse how they should reply when their child, diagnosed with schizophrenia spectrum disorder, tells them that voices command him to harm others. Which is the appropriate nursing response?

A) "Tell him to stop discussing the voices."
B) "Ignore what he is saying, while attempting to discover the underlying cause."
C) "Focus on the feelings generated by the hallucinations and present reality."
D) "Present objective evidence that the voices are not real."

Question 19

Which of the following components should a nurse recognize as an integral part of a rehabilitative program when planning care for clients diagnosed with schizophrenia spectrum disorder?

A) Group therapy
B) Medication management
C) Deterrent therapy
D) Supportive family therapy
E) Social skills training

Question 20

A nurse is assessing a client diagnosed with schizophrenia spectrum disorder. The nurse asks the client, "Do you receive special messages from certain sources, such as the television or radio?" The nurse is assessing which potential symptom of this disorder?

A) Thought insertion
B) Paranoid delusions
C) Magical thinking
D) Delusions of reference

Question 21

___________________________ are false sensory perceptions not associated with real external stimuli and may involve any of the five senses.