Schizophrenia

General Information

100

Condition consisting with difficulty with differentiating reality from fantasy (reality testing) as evidenced by delusions, hallucinations and disordered thinking

Psychosis

200

Which is NOT a symptom of schizophrenia? A. Delusions B. Organization C. Derealization D. Hallucinations

B. Organization Rationale: People with schizophrenia are disorganized in their speech and behaviors. Delusions, derealization, and hallucinations are all positive symptoms of schizophrenia.

300

What type of disorder is schizophrenia?

A psychotic disorder.

400

The first Antipsychotic drugs are known as Conventional (first-generation) Antipsychotics. Name two first generation anti-pscyhcotic drugs.

Haloperidol (Haldol) & Chlorpromazine (Thorazine)

500

Name the five sub-types of schizophrenia.

Catatonic Disorganized Paranoid Residual Schizoaffective

Fun Facts!

100

What is the cure for schizophrenia?

There is NO cure!! While there is no cure for schizophrenia, there are effective treatments. Medications, recovery-oriented psychosocial treatments and rehabilitation practices are increasingly helping people with schizophrenia to lead productive, successful and independent lives.

200

(10%, 25%, 50%, or 75%) of those affected by schizophrenia have a co-occurring substance abuse or chemical dependency diagnosis.

50% Substance abuse disorders occur in nearly 50% of persons with schizophrenia and are associated with treatment non- adherence , relapse, incarceration, homelessness, violence, suicide and a poorer prognosis.

300

If you had an identical twin, you would be (less/more) likely to develop schizophrenia.

MORE.

400

(1%, 10%, 20%, 50%) of the population (roughly 2.2 million Americans) will develop schizophrenia.

1%

500

Positive symptoms of schizophrenia consist of something that IS or IS NOT normally be present.

Positive symptoms of schizophrenia consist of the presence of something (such as hallucinations, delusions, paranoia, etc.) that is NOT normally present. Negative symptoms consist of something that SHOULD be present (such as interest in hygiene, motivation, etc.)

Signs & Symptoms

100

Involuntary tongue and lip movements, blinking, choreiform movements of limbs and trunks.

Tardive Dyskinesia

200

Limb and neck spasms, uncoordinated, jerky movements, difficulty speaking and swallowing, rigidity and muscle spasms

Dystonia

300

A jumble of words that is meaningless to the listener

Word Salad

400

False, fixed beliefs that cannot be corrected by reasoning.

Delusions

500

A false perception that the environment has changed.

Derealization

True or False

100

Schizophrenia has nothing to do with multiple or split personality.

TRUE — the term schizophrenia means split mind and is indicative of the disruption of thoughts and feelings that this disorder brings about.

200

Schizophrenia is caused by poor social conditions.

FALSE — Poor social conditions do not cause schizophrenia. It is a disorder that can affect anyone.

300

Some types of schizophrenia run in families.

TRUE — Schizophrenia is a syndrome (a group of symptoms) not a disease. This means that the symptoms may turn out to have several causes. In some cases it runs in families.

400

Schizophrenia is much more common in men than in women.

FALSE —Both men and women are almost equally affected by this disorder.

500

When you have schizophrenia, it is usually necessary to take medication in order to stay well.

TRUE — Like diabetes or heart conditions, people with schizophrenia need to take medication to stay well.

NCLEX Questions

100

During an interview, the client with schizophrenia is experiencing an anxiety attack. Which of these responses by the nurse would be most helpful for the client? A. “Calm down, there is nothing to be upset about.” B. “I will stay with you.” C. “If you don’t watch out, you will lose control again.” D. “Why are you acting in this manner?”

B. "I will stay with you" Rationale: Reassuring the client helps the client gain a sense that the nurse can be trusted and is there to offer support. The other responses are authoritarian or judgmental and are likely to increase anxiety.

200

A nurse is speaking with a client who has schizophrenia when he suddenly seems to stop focusing on the nurse’s questions and begins looking at the ceiling and talking to himself. Which of the following actions should the nurse take? A. Stop the interview at this point and resume later when the client is better able to concentrate. B. Ask the client, “Are you seeing something on the ceiling?” C. Tell the client, “You seem to be looking at something on the ceiling. I see something there, too.” D. Continue the interview without comment on the client’s behavior.

B. Ask the client, “Are you seeing something on the ceiling?” The appropriate action for the nurse to take is to ask the client directly about his hallucinations, but avoid treating hallucinations or delusions as if they were real. Stopping the interview until a later time may not be feasible since the client may experience hallucinations much of the time. Continuing the interview without commenting on this client’s hallucinations will not be an effective distraction.

300

A nurse is caring for a client on an inpatient mental health unit. The client reports hearing voices that are telling her to “kill your roommate.” Which of the following actions should the nurse take? A. Tell the client that she is imagining the voices. B. Initiate one-to-one observation of the client. C. Place the client in a restraint. D. Ask another client to sit with the client.

B. Initiate one-to-one observation of the client. The client is at risk for harming someone else or himself and therefore needs to be watched closely. Telling him he is imagining the voices is a non-therapeutic response. It is not appropriate to place this client in a vest restraint. Asking another client to sit with him places that client at risk for harm

400

The therapeutic team has identified the need to formulate strategies for a client’s inappropriate behavior and how to maintain a safe environment for the clients on the unit. Of the following intervention strategies, which strategy must be initiated immediately? A. Monitor the client’s behavior. B. Identify the client’s thought process that leads to this behavior. C. Help the client to identify why he demonstrates this behavior. D. Teach appropriate interpersonal skills to the client.

A. Monitor the client's behavior. Rationale: The unit must be maintained as a safe environment for the client and the other clients; therefore, the client should never have unsupervised time on the unit. The nurse never attempts to delve into why a client exhibits behavior. Teaching skills is not the priority at this early stage. Identifying thought processes would be part of the later implementation stage of the nursing process.

500

A client with schizophrenia has a highly impaired ability to focus on interactions with the team. The client has cognitive disturbances of distractibility, attention deficit, and difficulty in remembering recent events. The client also has a history of suicide attempts. The nurse is conducting an assessment interview. The client tells the nurse, “I do not have to talk to you.” The best response for the nurse would be: A. Anything you say about your feelings will be confidential but your thoughts about suicide will be reported to the team.” B. “It sounds like you are not concerned about your problems and why you are in the hospital.” C. “Don’t you trust me?” D. “I will only share your thoughts with your family.”

A. Anything you say about your feelings will be confidential but your thoughts about suicide will be reported to the team.” Rationale: Challenging the client will contribute to a sense of low self-worth. “Don’t you trust me?” and “It sounds like you are not concerned about your problems and why you are in the hospital.” are non-therapeutic and devalue the client’s self-perception. Being truthful with the client and reinforcing the need for prevention of harm to self or others clarifies what the client can expect from the team.