lOMoAR cPSD| 14985576
Chapter 10. Integrative Management of Psychotic Symptoms
1. A newly admitted patient has the diagnosis of catatonic schizophrenia. Which behavior
observed in the patient supports that diagnosis?
a. Uses a rhyming form of speech
b. Refuses to eat any unwrapped foods c. Laughs when watching a sad movie
d. Maintains an immobilized state for hours
ANS: D
Catatonic schizophrenia is characterized by extremes of psychomotor activity ranging from
frenzied behavior to immobilization and may include echopraxia and posturing. Paranoid
thinking is characteristic of paranoid schizophrenia. Inappropriate affect and clanging are
seen in disorganized schizophrenia.
2. What would be an appropriate short-term outcome for a patient diagnosed with residual
schizophrenia who exhibits ambivalence?
a. Decide their own daily schedule.
b. Decide which unit groups they will attend.
c. Choose which clinic staff member to work with.
d. Choose between two outfits to wear each morning. ANS: D
An early step would be to make choices about nonthreatening matters when presented with
limited alternatives. The remaining options represent decisions that are too complicated for
the patient to make initially.
3. What is the priority nursing diagnosis for a catatonic patient?
a. Ineffective coping
b. Impaired physical mobility c. Impaired social interaction
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d. Risk for deficient fluid volume
ANS: D
The highest priority for the patient is maintenance of basic physiologic needs, such as
hydration. Mobility is of lesser physiological importance than fluid volume. The remaining
options do not have priority over a physiological need.
4. Which nursing diagnosis is appropriate for a patient who insists being called Your
Highness and demonstrates loosely associated thoughts?
a. Risk for violence b. Defensive coping c. Impaired memory
d. Disturbed thought processes
ANS: D
Delusions and loose associations suggest disturbed thought processes. The other options are
not supported by data in the scenario.
5. Which initial short-term outcome would be appropriate for a patient who was admitted
expressing delusional thoughts?
a. Accept that delusion is illogical. b. Distinguish external boundaries.
c. Explain the basis for the delusions.
d. Engage in reality-oriented conversation. ANS: D
Delusions are not reality oriented; thus an appropriate outcome would be that patient will
engage
in reality-oriented conversation rather than discussing delusional beliefs. Delusions are fixed,
false beliefs. Patients rarely accept anyone using logic to dispute them. Data are not present to
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suggest boundary disturbance. Explaining the delusion is not progress; it suggests the patient
still holds to the belief.
6. Which of the following interventions should the nurse plan to use to reduce patient focus
on delusional thinking?
a. Confronting the delusion
b. Refuting the delusion with logic
c. Exploring reasons the patient has the delusion d. Focusing on feelings suggested by the
delusion
ANS: D
Focusing on feelings suggested by the delusion will help meet patient needs and help the
patient stay based in reality. This technique fosters rapport and trust while discouraging the
belief without challenging or refuting it.
7. Which assessment observation supports a patients diagnosis of disorganized
schizophrenia?
a. Reports suicidal ideations
b. Last relapse was 6 years ago
c. Consistent inappropriate laughing
d. Believes that the government is out to get me
ANS: C
The presence of disorganization and inappropriate affect identifies this disorder as
disorganized schizophrenia. The symptoms of residual schizophrenia have long periods of
remission. Schizoaffective disorder presents with severe mood disorders along with
symptoms of schizophrenia. Paranoid schizophrenia is characterized by persecutory or
grandiose delusions.
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Chapter 10. Integrative Management of Psychotic Symptoms
1. A newly admitted patient has the diagnosis of catatonic schizophrenia. Which behavior
observed in the patient supports that diagnosis?
a. Uses a rhyming form of speech
b. Refuses to eat any unwrapped foods c. Laughs when watching a sad movie
d. Maintains an immobilized state for hours
ANS: D
Catatonic schizophrenia is characterized by extremes of psychomotor activity ranging from
frenzied behavior to immobilization and may include echopraxia and posturing. Paranoid
thinking is characteristic of paranoid schizophrenia. Inappropriate affect and clanging are
seen in disorganized schizophrenia.
2. What would be an appropriate short-term outcome for a patient diagnosed with residual
schizophrenia who exhibits ambivalence?
a. Decide their own daily schedule.
b. Decide which unit groups they will attend.
c. Choose which clinic staff member to work with.
d. Choose between two outfits to wear each morning. ANS: D
An early step would be to make choices about nonthreatening matters when presented with
limited alternatives. The remaining options represent decisions that are too complicated for
the patient to make initially.
3. What is the priority nursing diagnosis for a catatonic patient?
a. Ineffective coping
b. Impaired physical mobility c. Impaired social interaction
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d. Risk for deficient fluid volume
ANS: D
The highest priority for the patient is maintenance of basic physiologic needs, such as
hydration. Mobility is of lesser physiological importance than fluid volume. The remaining
options do not have priority over a physiological need.
4. Which nursing diagnosis is appropriate for a patient who insists being called Your
Highness and demonstrates loosely associated thoughts?
a. Risk for violence b. Defensive coping c. Impaired memory
d. Disturbed thought processes
ANS: D
Delusions and loose associations suggest disturbed thought processes. The other options are
not supported by data in the scenario.
5. Which initial short-term outcome would be appropriate for a patient who was admitted
expressing delusional thoughts?
a. Accept that delusion is illogical. b. Distinguish external boundaries.
c. Explain the basis for the delusions.
d. Engage in reality-oriented conversation. ANS: D
Delusions are not reality oriented; thus an appropriate outcome would be that patient will
engage
in reality-oriented conversation rather than discussing delusional beliefs. Delusions are fixed,
false beliefs. Patients rarely accept anyone using logic to dispute them. Data are not present to
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y ut
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suggest boundary disturbance. Explaining the delusion is not progress; it suggests the patient
still holds to the belief.
6. Which of the following interventions should the nurse plan to use to reduce patient focus
on delusional thinking?
a. Confronting the delusion
b. Refuting the delusion with logic
c. Exploring reasons the patient has the delusion d. Focusing on feelings suggested by the
delusion
ANS: D
Focusing on feelings suggested by the delusion will help meet patient needs and help the
patient stay based in reality. This technique fosters rapport and trust while discouraging the
belief without challenging or refuting it.
7. Which assessment observation supports a patients diagnosis of disorganized
schizophrenia?
a. Reports suicidal ideations
b. Last relapse was 6 years ago
c. Consistent inappropriate laughing
d. Believes that the government is out to get me
ANS: C
The presence of disorganization and inappropriate affect identifies this disorder as
disorganized schizophrenia. The symptoms of residual schizophrenia have long periods of
remission. Schizoaffective disorder presents with severe mood disorders along with
symptoms of schizophrenia. Paranoid schizophrenia is characterized by persecutory or
grandiose delusions.
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