Chapter 17 Schizophrenia (Psych -
Exam 4) Correct Answers
When a patient diagnosed with schizophrenia was discharged 6 months ago,
haloperidol (Haldol) was prescribed. The patient now says, "I stopped taking those
pills. They made me feel like a robot." What common side effects should the nurse
validate with the patient?
a. Sedation and muscle stiffness
b. Sweating, nausea, and diarrhea
c. Mild fever, sore throat, and skin rash
d. Headache, watery eyes, and runny nose - ANSWER-ANS: A
Typical antipsychotic drugs often produce sedation and extrapyramidal side effects
such as stiffness and gait disturbance, effects the patient might describe as making
him or her feel like a "robot." The side effects mentioned in the other options are
usually not associated with typical antipsychotic therapy or would not have the effect
described by the patient.
A nurse works with a patient diagnosed with schizophrenia regarding the importance
of medication management. The patient repeatedly says, "I don't like taking pills."
Which treatment strategy should the nurse discuss with the health care provider?
a. Use of a long-acting antipsychotic injections
b. Addition of a benzodiazepine, such as lorazepam (Ativan)
c. Adjunctive use of an antidepressant, such as amitriptyline (Elavil)
d. Inpatient hospitalization because of the high risk for exacerbation of symptoms -
ANSWER-ANS: A
Medications such as fluphenazine decanoate and haloperidol decanoate are long-
acting forms of antipsychotic medications. They are administered by depot injection
every 2 to 4 weeks, thus reducing daily opportunities for nonadherence. The
incorrect options do not address the patient's dislike of taking pills.
A patient's care plan includes monitoring for auditory hallucinations. Which
assessment findings suggest the patient may be hallucinating?
a. Aloofness, haughtiness, suspicion
b. Darting eyes, tilted head, mumbling to self
c. Elevated mood, hyperactivity, distractibility
, d. Performing rituals, avoiding open places - ANSWER-ANS: B
Clues to hallucinations include looking around the room as though to find the
speaker; tilting the head to one side as though intently listening; and grimacing,
mumbling, or talking aloud as though responding conversationally to someone.
A health care provider considers which antipsychotic medication to prescribe for a
patient diagnosed with schizophrenia who has auditory hallucinations and poor
social functioning. The patient is also overweight and has hypertension. Which drug
should the nurse advocate?
a. clozapine (Clozaril)
b. ziprasidone (Geodon)
c. olanzapine (Zyprexa)
d. aripiprazole (Abilify) - ANSWER-ANS: D
Aripiprazole is an atypical antipsychotic medication that is effective against both
positive and negative symptoms of schizophrenia. It causes little or no weight gain
and no increase in glucose, high- or low-density lipoprotein cholesterol levels, or
triglycerides, making it a reasonable choice for a patient with obesity or heart
disease. Clozapine may produce agranulocytosis, making it a poor choice as a first-
line agent. Ziprasidone may prolong the QT interval, making it a poor choice for a
patient with cardiac disease. Olanzapine fosters weight gain.
A patient diagnosed with schizophrenia tells the nurse, "I eat skiller. Tend to end.
Easter. It blows away. Get it?" Select the nurse's best response.
a. "Nothing you are saying is clear."
b. "Your thoughts are very disconnected."
c. "Try to organize your thoughts, and then tell me again."
d. "I am having difficulty understanding what you are saying." - ANSWER-ANS: D
When a patient's speech is loosely associated, confused, and disorganized,
pretending to understand is useless. The nurse should tell the patient that he or she
is having difficulty understanding what the patient is saying. If a theme is discernible,
ask the patient to talk about the theme. The incorrect options tend to place blame for
the poor communication with the patient. The correct response places the difficulty
with the nurse rather than being accusatory.
A patient diagnosed with schizophrenia has catatonia. The patient has little
spontaneous movement and waxy flexibility. Which patient needs are of priority
importance?
a. Psychosocial
b. Physiologic
Exam 4) Correct Answers
When a patient diagnosed with schizophrenia was discharged 6 months ago,
haloperidol (Haldol) was prescribed. The patient now says, "I stopped taking those
pills. They made me feel like a robot." What common side effects should the nurse
validate with the patient?
a. Sedation and muscle stiffness
b. Sweating, nausea, and diarrhea
c. Mild fever, sore throat, and skin rash
d. Headache, watery eyes, and runny nose - ANSWER-ANS: A
Typical antipsychotic drugs often produce sedation and extrapyramidal side effects
such as stiffness and gait disturbance, effects the patient might describe as making
him or her feel like a "robot." The side effects mentioned in the other options are
usually not associated with typical antipsychotic therapy or would not have the effect
described by the patient.
A nurse works with a patient diagnosed with schizophrenia regarding the importance
of medication management. The patient repeatedly says, "I don't like taking pills."
Which treatment strategy should the nurse discuss with the health care provider?
a. Use of a long-acting antipsychotic injections
b. Addition of a benzodiazepine, such as lorazepam (Ativan)
c. Adjunctive use of an antidepressant, such as amitriptyline (Elavil)
d. Inpatient hospitalization because of the high risk for exacerbation of symptoms -
ANSWER-ANS: A
Medications such as fluphenazine decanoate and haloperidol decanoate are long-
acting forms of antipsychotic medications. They are administered by depot injection
every 2 to 4 weeks, thus reducing daily opportunities for nonadherence. The
incorrect options do not address the patient's dislike of taking pills.
A patient's care plan includes monitoring for auditory hallucinations. Which
assessment findings suggest the patient may be hallucinating?
a. Aloofness, haughtiness, suspicion
b. Darting eyes, tilted head, mumbling to self
c. Elevated mood, hyperactivity, distractibility
, d. Performing rituals, avoiding open places - ANSWER-ANS: B
Clues to hallucinations include looking around the room as though to find the
speaker; tilting the head to one side as though intently listening; and grimacing,
mumbling, or talking aloud as though responding conversationally to someone.
A health care provider considers which antipsychotic medication to prescribe for a
patient diagnosed with schizophrenia who has auditory hallucinations and poor
social functioning. The patient is also overweight and has hypertension. Which drug
should the nurse advocate?
a. clozapine (Clozaril)
b. ziprasidone (Geodon)
c. olanzapine (Zyprexa)
d. aripiprazole (Abilify) - ANSWER-ANS: D
Aripiprazole is an atypical antipsychotic medication that is effective against both
positive and negative symptoms of schizophrenia. It causes little or no weight gain
and no increase in glucose, high- or low-density lipoprotein cholesterol levels, or
triglycerides, making it a reasonable choice for a patient with obesity or heart
disease. Clozapine may produce agranulocytosis, making it a poor choice as a first-
line agent. Ziprasidone may prolong the QT interval, making it a poor choice for a
patient with cardiac disease. Olanzapine fosters weight gain.
A patient diagnosed with schizophrenia tells the nurse, "I eat skiller. Tend to end.
Easter. It blows away. Get it?" Select the nurse's best response.
a. "Nothing you are saying is clear."
b. "Your thoughts are very disconnected."
c. "Try to organize your thoughts, and then tell me again."
d. "I am having difficulty understanding what you are saying." - ANSWER-ANS: D
When a patient's speech is loosely associated, confused, and disorganized,
pretending to understand is useless. The nurse should tell the patient that he or she
is having difficulty understanding what the patient is saying. If a theme is discernible,
ask the patient to talk about the theme. The incorrect options tend to place blame for
the poor communication with the patient. The correct response places the difficulty
with the nurse rather than being accusatory.
A patient diagnosed with schizophrenia has catatonia. The patient has little
spontaneous movement and waxy flexibility. Which patient needs are of priority
importance?
a. Psychosocial
b. Physiologic
