EXAM 3 Chapter 16 Schizophrenia
Questions with Verified Answers
A client begins to exhibit hallucinations and delusions along with disorganized
speech after forgetting to take antipsychotic medication. The nurse suspects that the
client is at which point in the clinical course of the disorder?
Prodromal phase
Acute illness
Stabilization
Relapse - ANSWER-relapse
NOTE: Relapse involves a return of the symptoms, most often due to the client's
failure to follow the medication regimen.
A client with delusional disorder believes that the cook at the psychiatric hospital is
trying to poison the client. The nurse would record this type of delusion as what?
Erotomanic
Persecutory
Grandiose
Somatic - ANSWER-persecutory
NOTE: The central theme of persecutory delusions is the client's belief that he or she
is being conspired against, cheated on, spied on, followed, poisoned, drugged,
maliciously maligned, harassed, or obstructed in pursuit of long-term goals
The nurse is working with a client with schizophrenia who has cognitive deficits. It is
time for the client to get up and eat breakfast. Which statement by the nurse would
be most effective in helping the client prepare for breakfast?
"I'll expect you in the dining room in 20 minutes."
"First, wash your face and brush your teeth. Then put your clothes on."
"Stay right there and I'll get your clothes."
"Why don't you stay here and I'll get your tray for you." - ANSWER-first, wash your
face and brush your teeth. then put your clothes on
NOTE: The client needs clear direction, with tasks broken into small steps, to begin
to participate in the client's own self-care.
A client with schizophrenia is hearing voices that tell the client to kill the self. What
term is used to identify this type of false sensory perception?
Hallucination
Delusion
Flight of ideas
,Ideas of reference - ANSWER-hallucinations
A client with schizophrenia is prescribed an antipsychotic medication. Which
immediate side effects would the nurse include in the education plan for this
medication?
Risk for hypertension
Risk for hypoprolactinemia
The potential for weight loss
The potential for sedation - ANSWER-the potential for sedation
NOTE: Sedation with antipsychotic medication will likely happen immediately after
initiating the medication. The nurse should be sure to inform the client they he or she
will experience this side effect readily.
A client with a diagnosis of schizophrenia has been brought to the emergency
department by a worker from the group home where the client resides. The worker
states that the client has stopped taking medications and drank 2 to 3 gallons of
water over the past several hours. What assessments should the nurse who is caring
for this client prioritize?
Neurological assessment and monitoring of electrolyte levels
Monitoring for evidence of hallucinations or delusions
Blood glucose levels and body weight
Assessing for allergic reactions, dry mouth, and lethargy - ANSWER-neurological
assessment and monitoring for electrolyte levels
NOTE: Hyponatremia, electrolyte imbalances, and seizures may result from
polydipsia. Consequently, close monitoring of the client's electrolytes and
neurological status assessment are prioritized at this stage.
A student nurse has been assigned to provide care for an inpatient psychiatric-
mental health client who has a diagnosis of schizophrenia. The student nurse is
apprehensive about interacting with the client. The client's detailed explanations of
the client's delusions accompanied by unpredictable movements have prompted fear
in the student. How should this nursing student interpret such feelings?
Despite their unusual behavior, clients with schizophrenia do not pose a safety risk
to care providers.
Being afraid of a client who has schizophrenia is a result of stereotyping.
It is natural to feel fear when a client exhibits unpredictable behavior, and this can
cause the student to be reasonably cautious.
These feelings are best disclosed to the client, and doing so can foster the openness
that promotes a therapeutic relationship. - ANSWER-it is a natural to feel fear when
a client exhibits unpredictable behavior, and this can cause the student to be
reasonably cautious
A client with a diagnosis of schizophrenia has a history of auditory and visual
hallucinations. Which intervention is most likely to minimize the client's
hallucinations?
, Ensuring that the client does not sleep more than 7 hours in any 24-hour period
Clustering the client's medications at 0800 hours
Providing a vivid, bright environment that provides distractions from hallucinations
Provide frequent contact and communication with the client - ANSWER-provide
frequent contact and communication with the client
A client with schizoaffective disorder (SAD) is prescribed clozapine. The nurse
understands that in addition to the drug's antipsychotic effects, it is also effective in
which area?
Limiting the risk for extrapyramidal adverse effects
Reducing the risk for suicide
Eliminating the need for additional medications
Requiring no physiological monitoring - ANSWER-reducing the risk for suicide
NOTE: Clozapine, reported effective for SAD by several authorities, can reduce
hospitalizations and risk for suicide.
A nurse is assessing a client who is reporting the sensation of "bugs crawling under
the skin" and intense itching and burning. The client states, "I know bugs have
invaded my body." There is no evidence to support the client's report. The nurse
interprets this as which type of delusion?
Nihilistic
Grandiose
Somatic
Persecutory - ANSWER-somatic
NOTE: Somatic delusions involve bodily functions or sensations, such as insects
having infested the skin. The client vividly describes crawling, itching, burning,
swarming, and jumping on the skin surface or below the skin. The client maintains
the conviction that he or she is infested with parasites in the absence of objective
evidence to the contrary.
A client has been taking neuroleptic medications for many years as a treatment for
schizophrenia. The client is exhibiting tongue protrusion, facial grimacing, and
excessive blinking. These manifestations are characteristic of which side effect?
Tardive dyskinesia
Dystonia
Neuroleptic malignant syndrome
Akathisia - ANSWER-tardive dyskinesia
NOTE: Unusual movements of the tongue, neck, and arms suggest tardive
dyskinesia, an adverse reaction to neuroleptic medication. Dystonia is characterized
by cramps and rigidity of the tongue, face, neck, and back muscles. Neuroleptic
malignant syndrome causes rigidity, fever, hypertension, and diaphoresis. Akathisia
causes restlessness, anxiety, and jitteriness
Questions with Verified Answers
A client begins to exhibit hallucinations and delusions along with disorganized
speech after forgetting to take antipsychotic medication. The nurse suspects that the
client is at which point in the clinical course of the disorder?
Prodromal phase
Acute illness
Stabilization
Relapse - ANSWER-relapse
NOTE: Relapse involves a return of the symptoms, most often due to the client's
failure to follow the medication regimen.
A client with delusional disorder believes that the cook at the psychiatric hospital is
trying to poison the client. The nurse would record this type of delusion as what?
Erotomanic
Persecutory
Grandiose
Somatic - ANSWER-persecutory
NOTE: The central theme of persecutory delusions is the client's belief that he or she
is being conspired against, cheated on, spied on, followed, poisoned, drugged,
maliciously maligned, harassed, or obstructed in pursuit of long-term goals
The nurse is working with a client with schizophrenia who has cognitive deficits. It is
time for the client to get up and eat breakfast. Which statement by the nurse would
be most effective in helping the client prepare for breakfast?
"I'll expect you in the dining room in 20 minutes."
"First, wash your face and brush your teeth. Then put your clothes on."
"Stay right there and I'll get your clothes."
"Why don't you stay here and I'll get your tray for you." - ANSWER-first, wash your
face and brush your teeth. then put your clothes on
NOTE: The client needs clear direction, with tasks broken into small steps, to begin
to participate in the client's own self-care.
A client with schizophrenia is hearing voices that tell the client to kill the self. What
term is used to identify this type of false sensory perception?
Hallucination
Delusion
Flight of ideas
,Ideas of reference - ANSWER-hallucinations
A client with schizophrenia is prescribed an antipsychotic medication. Which
immediate side effects would the nurse include in the education plan for this
medication?
Risk for hypertension
Risk for hypoprolactinemia
The potential for weight loss
The potential for sedation - ANSWER-the potential for sedation
NOTE: Sedation with antipsychotic medication will likely happen immediately after
initiating the medication. The nurse should be sure to inform the client they he or she
will experience this side effect readily.
A client with a diagnosis of schizophrenia has been brought to the emergency
department by a worker from the group home where the client resides. The worker
states that the client has stopped taking medications and drank 2 to 3 gallons of
water over the past several hours. What assessments should the nurse who is caring
for this client prioritize?
Neurological assessment and monitoring of electrolyte levels
Monitoring for evidence of hallucinations or delusions
Blood glucose levels and body weight
Assessing for allergic reactions, dry mouth, and lethargy - ANSWER-neurological
assessment and monitoring for electrolyte levels
NOTE: Hyponatremia, electrolyte imbalances, and seizures may result from
polydipsia. Consequently, close monitoring of the client's electrolytes and
neurological status assessment are prioritized at this stage.
A student nurse has been assigned to provide care for an inpatient psychiatric-
mental health client who has a diagnosis of schizophrenia. The student nurse is
apprehensive about interacting with the client. The client's detailed explanations of
the client's delusions accompanied by unpredictable movements have prompted fear
in the student. How should this nursing student interpret such feelings?
Despite their unusual behavior, clients with schizophrenia do not pose a safety risk
to care providers.
Being afraid of a client who has schizophrenia is a result of stereotyping.
It is natural to feel fear when a client exhibits unpredictable behavior, and this can
cause the student to be reasonably cautious.
These feelings are best disclosed to the client, and doing so can foster the openness
that promotes a therapeutic relationship. - ANSWER-it is a natural to feel fear when
a client exhibits unpredictable behavior, and this can cause the student to be
reasonably cautious
A client with a diagnosis of schizophrenia has a history of auditory and visual
hallucinations. Which intervention is most likely to minimize the client's
hallucinations?
, Ensuring that the client does not sleep more than 7 hours in any 24-hour period
Clustering the client's medications at 0800 hours
Providing a vivid, bright environment that provides distractions from hallucinations
Provide frequent contact and communication with the client - ANSWER-provide
frequent contact and communication with the client
A client with schizoaffective disorder (SAD) is prescribed clozapine. The nurse
understands that in addition to the drug's antipsychotic effects, it is also effective in
which area?
Limiting the risk for extrapyramidal adverse effects
Reducing the risk for suicide
Eliminating the need for additional medications
Requiring no physiological monitoring - ANSWER-reducing the risk for suicide
NOTE: Clozapine, reported effective for SAD by several authorities, can reduce
hospitalizations and risk for suicide.
A nurse is assessing a client who is reporting the sensation of "bugs crawling under
the skin" and intense itching and burning. The client states, "I know bugs have
invaded my body." There is no evidence to support the client's report. The nurse
interprets this as which type of delusion?
Nihilistic
Grandiose
Somatic
Persecutory - ANSWER-somatic
NOTE: Somatic delusions involve bodily functions or sensations, such as insects
having infested the skin. The client vividly describes crawling, itching, burning,
swarming, and jumping on the skin surface or below the skin. The client maintains
the conviction that he or she is infested with parasites in the absence of objective
evidence to the contrary.
A client has been taking neuroleptic medications for many years as a treatment for
schizophrenia. The client is exhibiting tongue protrusion, facial grimacing, and
excessive blinking. These manifestations are characteristic of which side effect?
Tardive dyskinesia
Dystonia
Neuroleptic malignant syndrome
Akathisia - ANSWER-tardive dyskinesia
NOTE: Unusual movements of the tongue, neck, and arms suggest tardive
dyskinesia, an adverse reaction to neuroleptic medication. Dystonia is characterized
by cramps and rigidity of the tongue, face, neck, and back muscles. Neuroleptic
malignant syndrome causes rigidity, fever, hypertension, and diaphoresis. Akathisia
causes restlessness, anxiety, and jitteriness
