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Chapter 7 Schizophrenia Spectrum and Other Psychotic Disorders | Kaplan and Sadock

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Chapter 7 Schizophrenia Spectrum and Other Psychotic Disorders

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Chapter 7: Schizophrenia Spectrum and Other Psychotic Disorders

MULTIPLE CHOICE

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




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,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.

MSC: NCLEX: Psychosocial Integrity

3. What is the priority nursing diagnosis for a catatonic patient?

a. Ineffective coping

b. Impaired physical mobility

c. Impaired social interaction

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.

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort




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, 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.

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
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




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