Positive Symptoms
What are false sensory imputs with no external stimuli?
What is Hallucinations.
When assessing a patient diagnosed with schizophrenia, which of the following will the healthcare provider identify as a negative symptom?
A. Disorganized Speech
B. Anhedonia
C. Hallucinations
D. Delusions
What is B. Anhedonia.
What EPS symptom causes muscle cramps of the head and neck?
What is Acute Dystonia.
Which nursing intervention would be most appropriate when caring for an acutely agitated client diagnosed with paranoid schizophrenia?
A. Provide neon lights and soft music.
B. Maintain continual eye contact throughout the interview.
C. Use therapeutic touch to increase trust and rapport.
D. Provide personal space to respect the client's boundaries.
What is answer D.
A nurse is giving instructions to a client taking risperidone (Risperdal). The nurse advise the client to which of the following?
A. Take it on an empty stomach.
B. Change positions slowly.
C. Get a daily source of sunlight.
D. Discontinue medication once the symptoms go away.
What is answer B. Change positions slowly because Risperdal causes orthostatic hypotension.
A pediatric mental health patient says to the nurse, "It snowed last night because I wished very, very hard that it would." The nurse knows that the patient is exhibiting which of the following positive symptoms?
What is Magical Thinking?
Nurse Arya assesses for evidence of positive symptoms of schizophrenia in a newly admitted client. Which of the following symptoms are considered positive evidence? Select all that apply.
A. Anhedonia
B. Delusions
C. Flat Affect
D. Hallucinations
What is B and D. Delusions and Hallucinations.
What is stiffening of muscular activity in the face, body, arms and legs? May have a shuffling gait.
What is pseudoparkinsonism.
The healthcare provider is caring for a patient in an inpatient mental health unit. The patient tells the healthcare provider, “Here come the monkeys. They are on the ceiling.” Which of the following responses is most appropriate in this situation?
A. "Really? How many monkeys do you see?"
B. "Did you say you see monkeys on the ceiling?"
C. " I don't see any monkeys on the ceiling."
D. " Please tell me more about the monkeys"
What is answer C. I don't see any monkeys.
A client with schizophrenia has been started on medication therapy with clozapine (Clozaril). A nurse assesses the results of which laboratory study to monitor for adverse effect related to this medication?
A. White blood cell count
B. Platelet Count
C. Liver function tests
D. Random blood sugar
What is answer A. White blood cell count.
It can cause agranulocytosis.
A paranoid client presents with bizarre behaviors, neologisms, and thought insertion. Which nursing action should be prioritized to maintain this client's safety?
A. Assess for medication noncompliance
B. Note escalating behaviors and intervene immediately
C. Interpret attempts at communication
D. Assess triggers for bizarre, inappropriate behaviors.
What is answer B. The nurse should note escalating behaviors and intervene immediately to maintain this client's safety. Early intervention may prevent an aggressive response and keep the client and others safe.
What negative symptom is defined as:
A lack of desire or motivation to accomplish goals?
What is avolition.
What EPS symptom results in internal restlessness and external restless pacing or fidgeting?
What is Akathisia.
A nurse is caring for a client on an acute mental health unit. The client reports hearing voices that are telling her to "kill your doctor." Which of the following is the priority action for the nurse to take?
A. Use therapeutic communication to discuss the hallucination with the client.
B. Initiate one-to-one observation of the client.
C. Focus the client on reality.
D. Notify the provider of the client's statement.
What is answer B. Initiate 1 to 1 observation to ensure safety for the client and others.
A nurse is caring for a hospitalized client with schizophrenia that has been taking clozapine (Clozaril) for several months. Which of the following indicates that the medication is working correctly?
A. He no longer has a memory of psychotic behavior.
B. He is drowsier, so is less bothered by hallucinations
C. He no longer hears voices.
D. He is more uncomfortable around others.
What is answer C. He no longer hears voices.
Mr. S states, "Look at the snakes on the ceiling." You see some cracks in the plaster. Mr. S is experiencing a (an):
1. Hallucination
2. Illusion
3. Delusion
4. Flashback
What is number 2, an illusion.
Illusion- False perceptions of REAL stimuli
What is a negative symptom of Schizophrenia where the patient has a diminished ability to experience pleasure?
What is anhedonia.
A nurse notes that a client with schizophrenia and receiving an antipsychotic medication is having uncontrolled movement of the lips and tongue. The nurse determines that the client is experiencing?
A. Hypertensive Crisis
B. Parkinsonism
C. Tardive Dyskinesia
D. Neuroleptic Malignant Syndrome
What is C. Tardive Dyskinesia,
Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely agitated in the dayroom while other clients are watching television. He begins cursing and throwing furniture. Nurse Oliver first action is to:
A. Check the MAR to see if there is an order for medication for agitation given IM.
B. Place the client in full leather restraints.
C. Call the attending physician and report the behavior.
D. Remove all other clients from the dayroom.
What is D. Remove all clients from the dayroom.
A patient is prescribed haloperidol (Haldol) for the management of schizophrenia. Before administering the medication to the patient, the healthcare provider observes facial grimacing and tongue thrusting. Which of the following interventions should the healthcare provider perform first?
A. Send a blood sample to the lab to measure the haloperidol level
B. Hold the medication and continue to assess the patient
C. Perform a mental status exam and document the findings
D. Administer the prescribed benztropine (Cogentin)
What is answer B. Hold the medication and continue to assess the patient. What is the patient displaying symptoms of?
Parents ask a nurse how they should reply when their child, diagnosed with paranoid schizophrenia, tells them that voices command him to harm others. Which is the appropriate nursing reply?
A. "Tell him to stop discussing the voices."
B. "Ignore what he is saying, while attempting to discover the underlying cause."
C. "Focus on the feelings generated by the hallucinations and present reality."
D. "Present objective evidence that the voices are not real."
What is answer C.
A. Chlorpromazine
B. Thiothixene (Navene)
C. Risperidone (Risperdal)
D. Haloperidol (Haldol)
What is answer C. Risperidone (risperdal).
It is a atypical antipsychotic that can be used for NEGATIVE symptoms of schizophrenia.
What medication class is used to help manage EPS?
Which class of antipyschotics is more likely to produce EPS?
What is Anticholinergics.
What is TYPICAL (older generation) antipsychotics.
Brian, an 18 year old with Schizophrenia, has a negative attitude, is delusional, hears voices, and is withdrawing from others. A nursing intervention that is appropriate for promoting activity for Brian is:
A. Tell him "the voices" told you he should participate in the weekly party.
B. Remind him that he does not want to get worse by sitting alone.
C. Tell him he must join the party; it is part of his care plan.
D. Invite him to join the party.
Which is NOT an ATYPICAL antipsychotic?
1. Asenapine
2. Olanzapine
3. Haloperidol
4. Risperidone
What is answer 3. Haloperidol. Haloperidol is one of the older antipsychotics (TYPICAL).