Schizophrenia Case Study (Sam Harris) Guaranteed Success
Question 1: Important Nursing Intervention
Correct Answer: A) Establish rapport and trust.
- Rationale: In a situation where a client exhibits guarded and suspicious behavior, it is crucial to build a
therapeutic relationship. Establishing rapport and trust helps create a safe environment wherein the
client may eventually feel more comfortable expressing concerns or engaging with the nurse.
Incorrect Answers:
- B) Assess for hallucinations: While it may be relevant to assess for hallucinations, the primary focus
should be on establishing trust first, as suspicion can hinder communication and assessment.
- C) Maintain adequate social space: While this remains important in behavioral scenarios, it is not the
primary intervention when addressing guardedness. Establishing a rapport can create a more open
space socially.
- D) Plan to give a PRN antipsychotic: Medications may be necessary but would not be the first step in
response to suspicious behavior; building trust is essential before considering pharmacologic
approaches.
Question 2: Accurate Assessment
Correct Answer: B) Delusions.
- Rationale: Delusions refer to fixed, false beliefs that are not grounded in reality, such as believing
healthcare providers are FBI agents. It’s important to recognize that delusions must be addressed with
care and should not be confronted with logic, as this could further alienate the client.
Incorrect Answers:
- A) Hallucinations: Hallucinations involve sensory experiences that are not present. The scenario
describes delusional beliefs rather than sensory misperceptions.
- C) Confabulation: This involves the fabrication of memories, often seen in dementia, which does not
apply here as there is no mention of memory issues.
- D) Thought broadcasting: This term refers to the belief that one's thoughts are being transmitted to
others; the scenario primarily revolves around delusions, not broadcasting of thoughts.
,Question 3: Characteristic Behavior of a Thought Disorder
Correct Answer: A) Blunted affect.
- Rationale: Blunted affect is indeed characteristic of thought disorders, especially negative symptoms
seen in schizophrenia. It refers to a reduced emotional expression, which can be indicative of underlying
cognitive deficits.
Incorrect Answers:
- B) Irritability: Irritability is more attributed to mood disorders and is not specifically a hallmark of
thought disorders.
- C) Lability of Mood: While it can appear in various mental health disorders, it’s not specific to thought
disorders.
- D) Preoccupation with guilty feelings: This suggests a mood aspect that is not characteristic of thought
disorders and is more aligned with mood disorders, such as depression or anxiety.
Question 4: Differentiating Schizophrenia from Psychosis
Correct Answer: D) Negative symptoms.
- Rationale: Negative symptoms, such as lack of motivation, social withdrawal, or poor personal hygiene,
are key indicators that help distinguish schizophrenia from other forms of psychosis. They provide
insight into a person’s emotional and behavioral state in terms of deficits.
Incorrect Answers:
- A) Disorganized speech: Both schizophrenia and various forms of psychosis can exhibit disorganized
speech patterns, so this does not help differentiate.
- B) Disorganized behavior: Similar to disorganized speech, this behavior is present in both conditions.
- C) Auditory hallucinations: While they occur in both conditions, hallucinations alone do not serve to
differentiate schizophrenia specifically.
5. Which finding depicts negative symptoms of schizophrenia?
, A) Difficulty sitting still.
B) Rapid and disorganized speech.
C) Flat affect and social inattentiveness.
D) Delusional statements. ✔️A) Difficulty sitting still. INCORRECT: Difficulty sitting still is not a negative
symptom and may be related to akathisia, an extrapyramidal side effect.
B) Rapid and disorganized speech. INCORRECT: Rapid and disorganized speech is not a negative
symptom. Rapid speech is characteristic of flight of ideas.
C) Flat affect and social inattentiveness. CORRECT: Flat affect and social inattentiveness, or 'spaciness',
are examples of negative symptoms characteristic of schizophrenia.
D) Delusional statements. INCORRECT: Delusional statements are not a negative symptom of
schizophrenia.
6. Which nursing problem has priority?
A) Ineffective community coping.
B) Disturbed thought processes.
C) Sensory-perceptual disturbance.
D) Ineffective denial. ✔️A) Ineffective community coping. INCORRECT: Ineffective community coping
would be a nursing problem prior to admission, but it is not a priority problem for the nursing care plan
after admission.
Question 1: Important Nursing Intervention
Correct Answer: A) Establish rapport and trust.
- Rationale: In a situation where a client exhibits guarded and suspicious behavior, it is crucial to build a
therapeutic relationship. Establishing rapport and trust helps create a safe environment wherein the
client may eventually feel more comfortable expressing concerns or engaging with the nurse.
Incorrect Answers:
- B) Assess for hallucinations: While it may be relevant to assess for hallucinations, the primary focus
should be on establishing trust first, as suspicion can hinder communication and assessment.
- C) Maintain adequate social space: While this remains important in behavioral scenarios, it is not the
primary intervention when addressing guardedness. Establishing a rapport can create a more open
space socially.
- D) Plan to give a PRN antipsychotic: Medications may be necessary but would not be the first step in
response to suspicious behavior; building trust is essential before considering pharmacologic
approaches.
Question 2: Accurate Assessment
Correct Answer: B) Delusions.
- Rationale: Delusions refer to fixed, false beliefs that are not grounded in reality, such as believing
healthcare providers are FBI agents. It’s important to recognize that delusions must be addressed with
care and should not be confronted with logic, as this could further alienate the client.
Incorrect Answers:
- A) Hallucinations: Hallucinations involve sensory experiences that are not present. The scenario
describes delusional beliefs rather than sensory misperceptions.
- C) Confabulation: This involves the fabrication of memories, often seen in dementia, which does not
apply here as there is no mention of memory issues.
- D) Thought broadcasting: This term refers to the belief that one's thoughts are being transmitted to
others; the scenario primarily revolves around delusions, not broadcasting of thoughts.
,Question 3: Characteristic Behavior of a Thought Disorder
Correct Answer: A) Blunted affect.
- Rationale: Blunted affect is indeed characteristic of thought disorders, especially negative symptoms
seen in schizophrenia. It refers to a reduced emotional expression, which can be indicative of underlying
cognitive deficits.
Incorrect Answers:
- B) Irritability: Irritability is more attributed to mood disorders and is not specifically a hallmark of
thought disorders.
- C) Lability of Mood: While it can appear in various mental health disorders, it’s not specific to thought
disorders.
- D) Preoccupation with guilty feelings: This suggests a mood aspect that is not characteristic of thought
disorders and is more aligned with mood disorders, such as depression or anxiety.
Question 4: Differentiating Schizophrenia from Psychosis
Correct Answer: D) Negative symptoms.
- Rationale: Negative symptoms, such as lack of motivation, social withdrawal, or poor personal hygiene,
are key indicators that help distinguish schizophrenia from other forms of psychosis. They provide
insight into a person’s emotional and behavioral state in terms of deficits.
Incorrect Answers:
- A) Disorganized speech: Both schizophrenia and various forms of psychosis can exhibit disorganized
speech patterns, so this does not help differentiate.
- B) Disorganized behavior: Similar to disorganized speech, this behavior is present in both conditions.
- C) Auditory hallucinations: While they occur in both conditions, hallucinations alone do not serve to
differentiate schizophrenia specifically.
5. Which finding depicts negative symptoms of schizophrenia?
, A) Difficulty sitting still.
B) Rapid and disorganized speech.
C) Flat affect and social inattentiveness.
D) Delusional statements. ✔️A) Difficulty sitting still. INCORRECT: Difficulty sitting still is not a negative
symptom and may be related to akathisia, an extrapyramidal side effect.
B) Rapid and disorganized speech. INCORRECT: Rapid and disorganized speech is not a negative
symptom. Rapid speech is characteristic of flight of ideas.
C) Flat affect and social inattentiveness. CORRECT: Flat affect and social inattentiveness, or 'spaciness',
are examples of negative symptoms characteristic of schizophrenia.
D) Delusional statements. INCORRECT: Delusional statements are not a negative symptom of
schizophrenia.
6. Which nursing problem has priority?
A) Ineffective community coping.
B) Disturbed thought processes.
C) Sensory-perceptual disturbance.
D) Ineffective denial. ✔️A) Ineffective community coping. INCORRECT: Ineffective community coping
would be a nursing problem prior to admission, but it is not a priority problem for the nursing care plan
after admission.
