Schizophrenia
Name at least 4 symptoms of infection related to agranulocytosis that a provider could be concerned with in regard to a client on the antipsychotic clozapine?
sore throat, fever, malaise, unusual bleeding, easy bruising, persistent nausea and vomiting, severe headache, rapid heart rate, difficulty urinating, muscle twitching, tremors, darkly colored urine, excessive urination, excessive thirst, excessive hunger, weakness, pale stools, yellow skin or eyes, muscular incoordination, or skin rash
T or F: When initially talking to a MH client, it is a PRIORITY to identify the client's perception of their mental health status.
True. Assessment is the priority action when using the nursing process approach to client care. Identifying the client's perception of their mental health status provides important information about the client's psychosocial history.
T or F: When thinking about MH clients, it is important to be self aware, self assess, and be willing to interact with MH clients.
True. The nurse should be willing to engage in meaningful relationships with people who have mental illnesses and addictions.
A sudden event that overwhelms usual coping mechanisms and disturbs homeostasis is called this.
What is a crisis? Rationale: A crisis occurs when normal coping fails and external support is required.
Clients with this disorder are at high risk for self‑harm and suicidal behaviors, requiring close monitoring.
What is Borderline Personality Disorder?
Rationale: Impulsivity and chronic feelings of emptiness place these clients at high risk for suicide and self‑injury. Close monitoring, safety planning, and suicide precautions are essential nursing interventions.
What is the definition of a delusion?
Delusions are fixed, false beliefs that are irrational and that the individual maintains are true despite evidence to the contrary
For a client on antipsychotics, what is the most likely reason a nurse would administer benztropine as a PRN?
Benztropine is an anticholinergic medication used for symptoms of EPS (extrapyramidal symptoms), characterized by abnormal involuntary movements.
A client is indicating that they would like care from a different nurse / CNA. What would be a therapeutic response?
"I can review the assignments and try to arrange for a different nurse to care for you."
In this therapeutic response, the nurse demonstrates empathy by endeavoring to meet the client's request for a different caregiver.
What are two factors that strongly predict likelihood of violent incidents, or risk for aggression/violence?
Past history of violence, client diagnosis, and current behaviors are key considerations in assessing this.
This disorder is characterized by detachment from social relationships and a preference for solitary activities.
What is Schizoid Personality Disorder?
Rationale: Schizoid Personality Disorder is characterized by social withdrawal and preference for solitary activities. Clients often lack interest in forming close relationships, even with family.
T or F: Hallucinations occur when there is not enough serotonin in the brain.
False: Hallucinations are positive symptoms of schizophrenia related to increased production or release of dopamine at nerve terminals.
Of note: An excess of serotonin has been hypothesized to be responsible for both positive and negative symptoms of schizophrenia (including hallucinations), and the effectiveness of medications like clozapine lends support to this idea.
A student overwhelmed after a new baby and job change is experiencing this type of crisis.
What is an anticipated life transition crisis? Rationale: Predictable life changes can overwhelm coping abilities.
Give an example of the therapeutic communication technique of "exploring."
Tell me more about....
What are at least 3 reasons a woman may return to a battering partner?
Clients in severely abusive relationships may be paralyzed into inaction by a combination of physical threats and a sense of powerlessness.
Victims have been known to stay with an abusive partner for some of the following reasons: fear of losing custody of children, financial dependence, fear of retaliation, lack of a support network, cultural or religious reasons, and/or dissociation related to post-traumatic stress disorder (PTSD)
Despite desiring close relationships, these clients avoid them due to fear of criticism or disapproval.
What is Avoidant Personality Disorder?
Rationale: Unlike Schizoid Personality Disorder, Avoidant clients want close relationships but avoid them due to fear of criticism or disapproval. This paradox is central to their diagnosis.
T or F: It is appropriate to promote the use of music to compete with the client's auditory hallucinations.
True: Competing reality-based stimulation such as the use of music or television during auditory hallucinations can assist in limiting the effect the hallucinations have on the client's stress level.
T or F: If a client is dysregulated and angry (throwing items), an appropriate intervention by nursing staff might be to explore why they are upset.
False. Exploring the source of anger may be more appropriate once the client has resolved the current emotion or is in a therapeutic group setting. It is hard to resolve these emotions when a person is "in the red"
Is "giving reassurance" a therapeutic or non-therapeutic communication technique?
Giving reassurance is a nontherapeutic communication technique. Giving reassurance indicates to the client that there is no cause for anxiety, thereby devaluing the client’s feelings.
Tell me about trauma informed care
Trauma‑informed care (TIC) in nursing means providing care that recognizes the widespread impact of trauma, avoids re‑traumatization, and empowers patients through safety, trust, and collaboration. It’s not about treating trauma directly, but about shaping every interaction with awareness that past trauma may influence how patients experience healthcare
This disorder is marked by odd beliefs, magical thinking, and eccentric behavior.
Answer: What is Schizotypal Personality Disorder?
Rationale: Schizotypal Personality Disorder involves eccentric thinking patterns, such as superstition, telepathy, or magical beliefs. These are not as severe as psychosis but impair social functioning.
What is the definition of schizoaffective disorder?
Schizoaffective disorder includes symptoms of schizophrenic behaviors, with strong symptoms also associated with mood disorders (depression or mania). The client may appear depressed, with psychomotor retardation and suicidal ideation, or symptoms may include euphoria, grandiosity, and hyperactivity. The decisive factor in the diagnosis of schizoaffective disorder is the presence of hallucinations and/or delusions that occur for at least 2 weeks in the absence of a major mood episode. Prominent mood disorder symptoms must be evident for a majority of the time.
What are the definitions for anosognosia and avolition? You must get both correct to get the points.
anosognosia is lack of insight. Some individuals lack awareness of there being any illness or disorder even when symptoms appear obvious to others.
avolition is a lack of motivation. Impairment in the ability to initiate goal-directed activity.
Both are negative symptoms of schizophrenia
A nurse is caring for a client who states, "I plan to commit suicide." What should the nurse identify as the priority?
The priority assessment is to determine how lethal the method is, how available the method is, and how detailed the plan is (and place on appropriate precautions)
There are several clients in the dayroom watching TV. There is a client pacing the milieu and pushing chairs around while yelling and appearing to escalate. He is making threatening statements. What do you do first?
Offer other activities to the other clients to move them safely - courtyard open, coffee and cocoa in the kitchen, gym open. This removes the audience, keeps others safe.
What are at least 3 nursing considerations / interventions when working with clients diagnosed with PTSD?
Establish trust and safety (calm, non-threatening)
Therapeutic communication (empathy, active listening, nonjudgmental)
Monitor for risk behaviors (substance abuse, self-destructive habits, isolation)