General
A patient is admitted with a diagnosis of brief
psychotic disorder, with catatonic features. Which symptoms are associated with the catatonic specifier?
A. Strong ego boundaries and abstract thinking
B. Ataxia and akinesia
C. Stupor, muscle rigidity, and negativism
D. Substance abuse and cachexia
What is Stupor, muscle rigidity, and negativism?
Correct Answer: C
§Symptoms associated with the catatonic specifier include stupor and muscle rigidity or excessive, purposeless motor activity.
§Waxy flexibility, negativism, echolalia, and echopraxia are also common behaviors.
A severe mental condition in which there is disorganization of the personality, deterioration in social functioning, and loss of contact with, or distortion of, reality is known as?
What is psychosis?
Your patient is acting shy and withdrawn. What phase of schizophrenia are they most likely in?
What is Phase I- Premorbid Phase?
This type of disorder often times has a sudden onset of symptoms, may or may not be preceded by a severe psychosocial stressor and lasts less than one month.
What is a Brief Psychotic Disorder?
A client who has been taking chlorpromazine (Thorazine) for several months presents in the emergency department with EPS of restlessness, drooling, and tremors. What medication will the nurse expect the physician to order?
A. Paroxetine (Paxil)
B. Carbamazepine (Tegretol)
C. Benztropine (Cogentin)
D. Lorazepam (Ativan)
What is Benztropine (Cogentin)?
Correct Answer: C
§Benztropine is an anticholinergic medication that blocks cholinergic activity in the central nervous system, which is responsible for EPS.
§Anticholinergics are the drugs of choice to treat extrapyramidal symptoms associated with antipsychotic medications.
The patient hears the word “match.” The patient replies, “A match. I like matches. They are the light of the world. God will light the world. Let your light so shine.” Which communication pattern does the nurse identify?
A. Word salad
B. Clang association
C. Loose association
D. Ideas of reference
What is Loose association?
Correct Answer: C
§Loose association is characterized by communication in which ideas shift from one unrelated topic to another.
§The situation in the question represents this communication pattern.
This disorder causes disturbances in thought processes, perception and affect...
What is Schizophrenia?
During this phase of schizophrenia the patient often has delusions, hallucinations, and disorganized speech and behavior.
What is stage III-Active Psychotic Phase?
The presence of prominent hallucinations and delusions that are judged to be directly attributable to substance intoxication or withdrawal is associated with which disorder?
What is a Substance-induced psychotic disorder?
This type of treatment is an evidence-based program of case management that takes a team approach in providing comprehensive, community-based psychiatric treatment, rehabilitation, and support to persons with serious and persistent mental illness, such as schizophrenia. What is the treatment?
What is Program of assertive community treatment (ACT)?
A patient diagnosed with schizophrenia experiences identity confusion and communicates with the nurse using echolalia. What is the patient attempting to do by using this form of speech?
A. Identify with the person speaking
B. Imitate the nurse’s movements
C. Alleviate alogia
D. Alleviate avolition
What is Identify with the person speaking?
Correct Answer: A
§Echolalia is a parrot-like repetition of overheard words or fragments of speech.
§It is an attempt by the client to identify with the person who is speaking.
What is a deterioration of social and occupational functioning?
A return to full premorbid functioning is what?
What is Not Common?
Factors associated with a positive prognosis include:
Good premorbid functioning
Later age at onset
Female gender
Abrupt onset precipitated by a stressful event
Associated mood disturbance
Brief duration of active-phase symptoms
Minimal residual symptoms
Absence of structural brain abnormalities
Normal neurological functioning
Family history of mood disorder
No family history of schizophrenia
Metabolic disorders (e.g., hepatic encephalopathy, diabetic ketoacidosis, hypo- and hyperthyroidism, hypo- and hyperadrenalism, hypercalcemia, and vitamin B12 deficiency), Neurological conditions (e.g., epilepsy, tumors, cerebrovascular disease, head trauma, and encephalitis) are related to this type of disorder...
What is a Catatonic disorder due to another medical condition?
Your patient is discharged and joins a mental health clubhouse for further support and assistance with integration into society after their acute episode. What treatment model is being used?
What is a Recovery Model?
A concept of healing and transformation enabling a person with mental illness to live a meaningful life in the community while striving to achieve his or her full potential.
Research provides support for recovery as an obtainable objective for individuals with schizophrenia.
To deal with a client's hallucinations therapeutically, which nursing intervention should be implemented?
A. Reinforce the perceptual distortions until the patient develops new defenses.
B. Provide an unstructured environment.
C. Avoid making connections between anxiety-producing situations and hallucinations.
D. Distract the patient’s attention.
What is Distract the patient’s attention?
Correct Answer: D
The nurse should first empathize with the patient by focusing on feelings generated by the hallucination, present objective reality, and then distract or redirect the client to reality-based activities.
Symptoms for schizophrenia generally appear in late _____ to early _____ although they may occur in _____ or ______-____ life.
What are adolescence, adulthood, middle, late-adult?
During this phase significant deterioration is seen in function, and many become socially withdrawn and may show some OCD behavior as well.
What is Phase II-Prodromal Phase?
Same symptoms as schizophrenia with the exception that the duration of the disorder has been at least 1 month but less than 6 months. What is this disorder?
What is Schizophreniform disorder?
Blockage of the ____ ____ is thought to be responsible for controlling positive symptoms of schizophrenia.
What are dopamine receptors?
A patient, diagnosed with paranoid schizophrenia, states, “My roommate is plotting to have others kill me.” Which is the appropriate nursing response?
A. “I find that hard to believe.”
B. “What would make you think such a thing?”
C. “I know your roommate. He would do no such thing.”
D. “I can see why you feel that way.”
What is “I find that hard to believe.”?
Correct Answer: A
§This patient is experiencing a persecutory delusion. This nursing response is an example of “voicing doubt,” which expresses uncertainty as to the reality of the patient’s perceptions.
§This is an appropriate therapeutic communication technique in dealing with patients who are experiencing delusional thinking.
Psychosis can occur with or without what?
What is Organic Impairment?
During this phase of schizophrenia, active psychotic phase symptoms are either absent or no longer prominent. Often times a flat affect and impairment in role function is common. What phase is this?
What is Phase IV- Residual Phase?
Schizophrenic symptoms accompanied by a strong element of symptomatology associated with either mania or depression. What is this disorder?
What is Schizoaffective disorder?
Besides the obvious health risks of chronic lung diseases and cancers, smoking decreases the effectiveness of what for mental health patients?
What are psychotropic medications?