CHAPTER 17 SCHIZOPHRENIA (PSYCH
- EXAM 4) CORRECT ANSWERS
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
c. Self-actualization
d. Safety and security - ANSWER-ANS: B
Physiologic needs must be met to preserve life. A patient who is catatonic may need
to be fed by hand or tube, toileted, and given range-of-motion exercises to preserve
physiologic integrity. The assessment findings do not suggest safety concerns.
Higher level needs (psychosocial and self-actualization) are of lesser concern.
A patient diagnosed with schizophrenia has catatonia. The patient is stuporous,
demonstrates little spontaneous movement, and has waxy flexibility. The patient's
activities of daily living are severely compromised. An appropriate outcome is that
the patient will:
a. demonstrate increased interest in the environment by the end of week 1.
b. perform self-care activities with coaching by the end of day 3.
c. gradually take the initiative for self-care by the end of week 2.
d. voluntarily accept tube feeding by day 2. - ANSWER-ANS: B
, Outcomes related to self-care deficit nursing diagnoses should deal with increasing
the patient's ability to perform self-care tasks independently, such as feeding,
bathing, dressing, and toileting. Performing the tasks with coaching by the nursing
staff denotes improvement over the complete inability to perform the tasks. The
incorrect options are not directly related to self-care activities; they are difficult to
measure and are unrelated to maintaining nutrition.
A nurse observes a patient who is diagnosed with schizophrenia. The patient is
standing immobile, facing the wall with one arm extended in a salute. The patient
remains immobile in this position for 15 minutes, moving only when the nurse gently
lowers the arm. What is the name of this phenomenon?
a. Echolalia
b. Waxy flexibility
c. Depersonalization
d. Thought withdrawal - ANSWER-ANS: B
Waxy flexibility is the ability to hold distorted postures for extended periods, as
though the patient were molded in wax. Echolalia is a speech pattern.
Depersonalization refers to a feeling state. Thought withdrawal refers to an alteration
in thinking.
Which patient diagnosed with schizophrenia would be expected to have the lowest
level of overall functioning?
a. 39 years old; paranoid ideation since age 35 years
b. 32 years old; isolated episodes of catatonia since age 24 years; stable for 3 years
c. 19 years old; diagnosed with schizophreniform disorder 6 months ago
d. 40 years old; frequent relapses since age 18; often does not take medication as
prescribed - ANSWER-ANS: D
The 40-year-old patient who has been diagnosed with schizophrenia since 18 years
of age could logically be expected to have the lowest overall level of functioning
secondary to deterioration associated with frequent relapses. The 39-year-old patient
who has had paranoid ideation since 35 years of age could be expected to have a
higher level because schizophrenia of short duration may be less impairing than
other types. The patient who has had episodes of catatonia since the age of 24
years has been stable for more than 3 years, suggesting a higher functional ability.
The 19-year-old patient diagnosed with schizophreniform disorder has been ill for
only 6 months, and disability is likely to be minimal.
A patient with delusions of persecution about being poisoned has refused all hospital
meals for 3 days. Which intervention is most likely to be acceptable to the patient?
a. Allow the patient to have supervised access to food vending machines
- EXAM 4) CORRECT ANSWERS
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
c. Self-actualization
d. Safety and security - ANSWER-ANS: B
Physiologic needs must be met to preserve life. A patient who is catatonic may need
to be fed by hand or tube, toileted, and given range-of-motion exercises to preserve
physiologic integrity. The assessment findings do not suggest safety concerns.
Higher level needs (psychosocial and self-actualization) are of lesser concern.
A patient diagnosed with schizophrenia has catatonia. The patient is stuporous,
demonstrates little spontaneous movement, and has waxy flexibility. The patient's
activities of daily living are severely compromised. An appropriate outcome is that
the patient will:
a. demonstrate increased interest in the environment by the end of week 1.
b. perform self-care activities with coaching by the end of day 3.
c. gradually take the initiative for self-care by the end of week 2.
d. voluntarily accept tube feeding by day 2. - ANSWER-ANS: B
, Outcomes related to self-care deficit nursing diagnoses should deal with increasing
the patient's ability to perform self-care tasks independently, such as feeding,
bathing, dressing, and toileting. Performing the tasks with coaching by the nursing
staff denotes improvement over the complete inability to perform the tasks. The
incorrect options are not directly related to self-care activities; they are difficult to
measure and are unrelated to maintaining nutrition.
A nurse observes a patient who is diagnosed with schizophrenia. The patient is
standing immobile, facing the wall with one arm extended in a salute. The patient
remains immobile in this position for 15 minutes, moving only when the nurse gently
lowers the arm. What is the name of this phenomenon?
a. Echolalia
b. Waxy flexibility
c. Depersonalization
d. Thought withdrawal - ANSWER-ANS: B
Waxy flexibility is the ability to hold distorted postures for extended periods, as
though the patient were molded in wax. Echolalia is a speech pattern.
Depersonalization refers to a feeling state. Thought withdrawal refers to an alteration
in thinking.
Which patient diagnosed with schizophrenia would be expected to have the lowest
level of overall functioning?
a. 39 years old; paranoid ideation since age 35 years
b. 32 years old; isolated episodes of catatonia since age 24 years; stable for 3 years
c. 19 years old; diagnosed with schizophreniform disorder 6 months ago
d. 40 years old; frequent relapses since age 18; often does not take medication as
prescribed - ANSWER-ANS: D
The 40-year-old patient who has been diagnosed with schizophrenia since 18 years
of age could logically be expected to have the lowest overall level of functioning
secondary to deterioration associated with frequent relapses. The 39-year-old patient
who has had paranoid ideation since 35 years of age could be expected to have a
higher level because schizophrenia of short duration may be less impairing than
other types. The patient who has had episodes of catatonia since the age of 24
years has been stable for more than 3 years, suggesting a higher functional ability.
The 19-year-old patient diagnosed with schizophreniform disorder has been ill for
only 6 months, and disability is likely to be minimal.
A patient with delusions of persecution about being poisoned has refused all hospital
meals for 3 days. Which intervention is most likely to be acceptable to the patient?
a. Allow the patient to have supervised access to food vending machines
