HESI CASE STUDY SCHIZOPHRENIA
SAM HARRIS EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
The nurse understands that an atypical antipsychotic like olanzapine (Zyprexa)
requires what period of time to reach a steady state?
2 weeks.
4 or more weeks.
1 week.
2 days. - ANSWER-1 week
The nurse is hopeful that Sam will respond favorably to the new antipsychotic. The
nurse recalls that another client with schizophrenia was treated with olanzapine
(Zyprexa) without a positive response. When that client failed to respond, several
other atypical antipsychotics were given to manage the client's symptoms. -
ANSWER-
Which medication with potentially life-threatening side effects should the nurse
expect the healthcare provider to prescribe for clients who do not respond to the use
of other antipsychotics?
Clozapine (Clozaril).
Haloperidol decanoate (Haldol decanoate).
Fluphenazine decanoate (Prolixin decanoate).
Perfenazine (Trilafon). - ANSWER-Clozapine
When a client has failed to respond to antipsychotic medications or long-acting
antipsychotics, clozapine (Clozaril) may be initiated. Clozaril is used for clients with
schizophrenia who have not responded to other antipsychotics. The potentially
serious side effect of agranulocytosis requires that WBC counts be done weekly or
every 2 weeks.
Speech and Thought Processes
After several weeks, Sam begins to demonstrate more initiative to attend daily
groups without prompting by the nurse. He awakens in the morning for the
community meeting but continues to answer questions only when asked. Answers to
questions are simple, one-word answers without any elaboration. - ANSWER-
Which speech process should the nurse document on the daily mental status exam
record?
Loose associations.
Tangential.
Monotone.
Poverty of speech. - ANSWER-Poverty of speech
, A client who demonstrates poverty of speech gives simple one- or two-word answers
to questions, even when the nurse asks an open-ended question.
When the nurse asks Sam to share one goal for the day in community meeting, he
states, "I'm going to take a shower and . . ." He pauses for several seconds and
begins talking again.
Which thought process does this exemplify? - ANSWER-Thought blocking
Thought blocking is the sudden stopping in the client's train of thought or in the
middle of a sentence.
Evaluation of Goal Achievement
The nurse further assesses Sam's mental status to determine if he still has thoughts
about FBI agents spying on him and hiding cameras in his apartment. The long-term
goal is that Sam will not experience delusional thoughts by discharge. - ANSWER-
Which intervention by the nurse will best assess if this goal has been met?
Observe sam for signs of talking to himself.
Talk to Sam for at least 20 minutes.
Ask Sam to describe how he feels.
Ask Sam to explain how the medication helps him. - ANSWER-Talk to Sam for at
least 20 minutes
The nurse should be able to talk to the client without observing the presence of
delusional thoughts.
Because Sam was violent with his father prior to admission, another long-term goal
is that the client will not verbalize the desire to harm himself or others.
Which statement will assist the nurse to assess if this goal has been met?
Do you have a history of violence?
Tell me about the relationship with your father.
How do you feel about your father now?
Do you think about hurting anyone now? - ANSWER-Do you think about hurting
anyone now?
Symptom Management Techniques
Sam talks to the nurse for nearly 30 minutes without mentioning FBI agents in his
apartment. When the nurse asks him about plans for discharge, Sam states that he
wants to return to his apartment. He denies having any thoughts of hurting himself or
others.
The treatment team meets to review Sam's discharge plan and his response to the
new atypical antipsychotic medication. The discharge plan is to dismiss the client in
1 week. A criterion for discharge is that Sam will attend a weekly wellness group. -
ANSWER-
SAM HARRIS EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
The nurse understands that an atypical antipsychotic like olanzapine (Zyprexa)
requires what period of time to reach a steady state?
2 weeks.
4 or more weeks.
1 week.
2 days. - ANSWER-1 week
The nurse is hopeful that Sam will respond favorably to the new antipsychotic. The
nurse recalls that another client with schizophrenia was treated with olanzapine
(Zyprexa) without a positive response. When that client failed to respond, several
other atypical antipsychotics were given to manage the client's symptoms. -
ANSWER-
Which medication with potentially life-threatening side effects should the nurse
expect the healthcare provider to prescribe for clients who do not respond to the use
of other antipsychotics?
Clozapine (Clozaril).
Haloperidol decanoate (Haldol decanoate).
Fluphenazine decanoate (Prolixin decanoate).
Perfenazine (Trilafon). - ANSWER-Clozapine
When a client has failed to respond to antipsychotic medications or long-acting
antipsychotics, clozapine (Clozaril) may be initiated. Clozaril is used for clients with
schizophrenia who have not responded to other antipsychotics. The potentially
serious side effect of agranulocytosis requires that WBC counts be done weekly or
every 2 weeks.
Speech and Thought Processes
After several weeks, Sam begins to demonstrate more initiative to attend daily
groups without prompting by the nurse. He awakens in the morning for the
community meeting but continues to answer questions only when asked. Answers to
questions are simple, one-word answers without any elaboration. - ANSWER-
Which speech process should the nurse document on the daily mental status exam
record?
Loose associations.
Tangential.
Monotone.
Poverty of speech. - ANSWER-Poverty of speech
, A client who demonstrates poverty of speech gives simple one- or two-word answers
to questions, even when the nurse asks an open-ended question.
When the nurse asks Sam to share one goal for the day in community meeting, he
states, "I'm going to take a shower and . . ." He pauses for several seconds and
begins talking again.
Which thought process does this exemplify? - ANSWER-Thought blocking
Thought blocking is the sudden stopping in the client's train of thought or in the
middle of a sentence.
Evaluation of Goal Achievement
The nurse further assesses Sam's mental status to determine if he still has thoughts
about FBI agents spying on him and hiding cameras in his apartment. The long-term
goal is that Sam will not experience delusional thoughts by discharge. - ANSWER-
Which intervention by the nurse will best assess if this goal has been met?
Observe sam for signs of talking to himself.
Talk to Sam for at least 20 minutes.
Ask Sam to describe how he feels.
Ask Sam to explain how the medication helps him. - ANSWER-Talk to Sam for at
least 20 minutes
The nurse should be able to talk to the client without observing the presence of
delusional thoughts.
Because Sam was violent with his father prior to admission, another long-term goal
is that the client will not verbalize the desire to harm himself or others.
Which statement will assist the nurse to assess if this goal has been met?
Do you have a history of violence?
Tell me about the relationship with your father.
How do you feel about your father now?
Do you think about hurting anyone now? - ANSWER-Do you think about hurting
anyone now?
Symptom Management Techniques
Sam talks to the nurse for nearly 30 minutes without mentioning FBI agents in his
apartment. When the nurse asks him about plans for discharge, Sam states that he
wants to return to his apartment. He denies having any thoughts of hurting himself or
others.
The treatment team meets to review Sam's discharge plan and his response to the
new atypical antipsychotic medication. The discharge plan is to dismiss the client in
1 week. A criterion for discharge is that Sam will attend a weekly wellness group. -
ANSWER-
