Psychotic disorders
What is the definition of Schizoaffective Disorder?
Presents with symptoms and signs of both schizophrenia and depressive or bipolar disorder.
Identify three signs and symptoms of PTSD?
Intrusive memories, flashbacks; Flashbacks; Nightmares; Isolation/avoiding event
A paranoid client presents with bizarre behaviors, neologisms, and thought insertion. Which nursing action should be prioritized to maintain this client’s safety?
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.
When people ask the psychiatric nurse about mental illnesses, one of the best explanations is:
Sharing the neurobiological-genetic model.
A client with bipolar disorder who became hyperactive after discontinuing lithium has not eaten or slept for 3 days. Which of the following nursing diagnoses would be of priority importance?
Risk for injury
Identify the three of the five negative symptoms found in schizophrenia?
Affect flat, Alogia, Anergia, Anhedonia, Avolition
Which factors differentiate the diagnosis of PTSD from the diagnosis of adjustment disorder (AD)?
PTSD results from exposure to an extreme traumatic event, whereas AD results from exposure to “normal” daily events.
A nurse is assessing a client diagnosed with schizophrenia spectrum disorder. The nurse asks the client, “Do you receive special messages from certain sources, such as the television or radio?” The nurse is assessing which potential symptom of this disorder?
Delusions of reference
The priority nursing interventions for the period immediately after electroconvulsive therapy treatment focus on:
Supporting physiological stability.
A client with bipolar disorder who had a relapse after discontinuing lithium has orders for chlorpromazine (Thorazine) four times daily and twice-daily lithium. The nurse’s planning will be aided if he understands that use of the phenothiazine will:
Bring hyperactivity under rapid control.
What is the reason that Shelia is on sodium valproate (Depakote) 500 mg every morning and 1000 mg. at bedtime?
To stabilize her moods and help with sleep.
What realistic goal should be included in George's plan of care?
The client will not require lorazepam (Ativan) to obtain adequate sleep by discharge.
A client diagnosed with schizophrenia spectrum disorder states, “Can’t you hear him? It’s the devil. He’s telling me I’m going to hell.” What is the most appropriate nursing response?
“The voices must sound scary, but the devil is not talking to you. This is part of your illness.”
What is an appropriate nursing intervention for an agitated, depressed client who paces the corridor hour after hour?
Provide a simple monotonous task. (a form of distraction)
A nursing diagnosis relevant for both the client with depression and the client with acute mania is:
Sleep pattern disturbance.
Talk about the implications for using paliperidone XL (Invega XL)?
New generation antipsychotic, treat the schizophrenia.
George suffers with PTSD. Dr. Anwar is considering adding paliperidone (Invega). Which symptoms should you identify that would warrant the need for this medication?
Flashbacks of killing the enemy
A client diagnosed with schizophrenia spectrum disorder tells a nurse about voices commanding him to kill the president. Which is the priority nursing diagnosis for this client?
Risk for violence: directed toward others
A disheveled, severely depressed client with psychomotor retardation has not showered for several days. The nurse should:
Firmly and neutrally assist the client to shower.
During periods of laughter, talkativeness, and banter, a client with manic behavior is noted to abruptly become irritable. Such changes in mood should be assessed as:
Lability. The mood of the manic client is often unstable. Rapid mood shifts are called mood lability.
Identify three defense mechanisms Shelia uses to decrease her anxiety?
Projection, Compensation, Intellectualization
George's daughter asks the nurse why her father was diagnosed with PTSD and others in unit in Vietnam were not. What information should you offer?
Responses are affected by how an individual handled previous trauma. Protectiveness of family and friends can help an individual. Control over the possibility of recurrence can affect the response to trauma. The time in which the trauma occurred can affect the individual’s response.
A nurse prepares to assess a client for tardive dyskinesia. What assessment tool will the nurse use?
Abnormal Involuntary Movement Scale (AIMS)
A depressed client tells the nurse “The bad things that happen are always my fault.” To assist the client to reframe this overgeneralization, the nurse should respond:
“Let’s look at one bad thing that happened to see if another explanation exists.”
A male client displaying acute mania has disrobed in the hall three times in 2 hours. The nurse should:
Arrange for one-on-one supervision. A client who repeatedly disrobes despite verbal limit setting needs more structure. One-on-one supervision may provide the necessary structure.