Presenting illness (tony specifically)
Question: Where does the patient reside?
What is
Answer: B) Los Angeles
What is the main risk associated with clozapine use?
a) Weight gain
b) Agranulocytosis
c) Hypertension
d) Insomnia
What is
Answer: b) Agranulocytosis
Which of the following is a common symptom observed in schizophrenia?
a) Memory loss
b) Hallucinations
c) Muscle weakness
d) Being slay
What is
Answer: b) Hallucinations
Which ethical principle emphasizes the patient's right to self-determination and independence in decision-making?
a) Beneficence
b) Autonomy
c) Justice
d) Fidelity
What is
Answer: b) Autonomy
A 16-year-old-client diagnosed with paranoid schizophrenia experiences command hallucinations to harm others. The client's parents ask a nurse, "Where do the voices come from?" Which is the appropriate nursing reply?
A. "Your child has a chemical imbalance of the brain which leads to altered thoughts."
B. "Your child's hallucinations are caused by medication interactions."
C. "Your child has too little serotonin in the brain causing delusions and hallucinations."
D. "Your child's abnormal hormonal changes have precipitated auditory hallucinations."
What is
ANS: A
The nurse should explain that a chemical imbalance of the brain leads to altered thought processes. Hallucinations, or false sensory perceptions, may occur in all five senses. The client who hears voices is experiencing an auditory hallucination.
Question: What is the patient's past medical history regarding mental illness?
What is
Answer: B) History of paranoid delusions
What is a key nursing intervention to promote safety in a patient with schizophrenia?
a) Encourage isolation
b) Provide a chaotic environment
c) Remove potential weapons
d) Encourage aggressive behavior
What is
Answer: c) Remove potential weapons
What neurotransmitter dysfunction is associated with psychotic symptoms in schizophrenia?
What is
Answer: C) Dopamine dysfunction
What legal document allows patients to appoint someone to make healthcare decisions on their behalf if they become incapacitated?
a) Living will
b) Advanced directive
c) Power of attorney
d) Informed consent form
What is
Answer: c) Power of attorney
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
ANS: D
The most appropriate nursing intervention is to provide personal space to respect the client's boundaries. Providing personal space may serve to reduce anxiety and thus reduce the client's risk for violence.
Question: What symptom of schizophrenia is evidenced by the patient's belief in being involved in "world-saving missions" and fearing the destruction of the world?
What is
Answer: A) Delusions
Which pharmacological agent is considered first-line treatment for schizophrenia?
a) Benzodiazepines
b) Antidepressants
c) Mood stabilizers
d) Antipsychotic agents
What is
Answer: D) Antipsychotic agents
Which of the following conditions commonly co-occurs with schizophrenia?
a) Hypertension
b) Diabetes mellitus
c) Migraine headaches
d) Obsessive-compulsive disorder
What is
Answer: d) Obsessive-compulsive disorder
What is a primary focus of safety measures for patients with schizophrenia who are at risk of suicide?
a) Implementing comprehensive suicide prevention protocols, including regular assessments, safety checks, and crisis intervention strategies, to minimize the risk of self-harm.
b) Administering high doses of sedative medications to manage agitation and impulsivity, thereby reducing the likelihood of suicidal behavior.
c) Restricting patients' access to therapeutic activities and social interactions to prevent triggering suicidal thoughts or behaviors.
d) Placing patients in isolation to minimize external stressors and potential triggers for suicidal ideation or self-harm.
What is
Answer: a) Implementing comprehensive suicide prevention protocols, including regular assessments, safety checks, and crisis intervention strategies, to minimize the risk of self-harm.
Which nursing behavior will enhance the establishment of a trusting relationship with a client diagnosed with schizophrenia?
A. Establishing personal contact with family members.
B. Being reliable, honest, and consistent during interactions.
C. Sharing limited personal information.
D. Sitting close to the client to establish rapport.
What is
ANS: B
The nurse can enhance the establishment of a trusting relationship with a client diagnosed with schizophrenia by being reliable, honest, and consistent during interactions. The nurse should also convey acceptance of the client's needs and maintain a calm attitude when dealing with agitated behavior.
Question: What are the general symptoms reported by the patient?
What is
Answer: D) Difficulty sleeping and loss of appetite
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
ANS: 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.
Question: A client states, "I hear voices that tell me that I am evil." Which outcome related to these symptoms should the nurse expect this client to accomplish by discharge?
A. The client will verbalize the reason the voices make derogatory statements.
B. The client will not hear auditory hallucinations.
C. The client will identify events that increase anxiety and illicit hallucinations.
D. The client will positively integrate the voices into the client's personality structure.
What is
ANS: C
It is unrealistic to expect the client to completely stop hearing voices. Even when compliant with antipsychotic medications, clients may still hear voices. It would be realistic to expect the client to associate stressful events with an increase in auditory hallucinations. By this recognition the client can anticipate symptoms and initiate appropriate coping skills.
Question: In the case of a patient with schizophrenia, what is the role of the healthcare provider in ensuring informed consent?
a) Ensuring the patient fully understands their treatment options through clear and comprehensive information sharing
b) Explaining treatment options clearly, ensuring the patient understands without giving too much information all at once.
c) Collaborating with the patient to make decisions based on their preferences and medical expertise.
d) Involving the patient's family in decision-making while keeping the patient's desires central.
What is
Answer: A)
A) Ensuring the patient fully understands their treatment options through clear and comprehensive information sharing
Rationale: This option emphasizes the ethical principle of informed consent, ensuring that the patient has all the necessary information to make decisions about their treatment. Clear and comprehensive communication is crucial for respecting patient autonomy and promoting shared decision-making.
What makes this group so slay?
A. They're women
B. Great hair
C. đź‘€
D. They are running on no sleep <3
What is
All of the above
Question: What is the patient's social history regarding substance use?
What is
A client has been recently admitted to an inpatient psychiatric unit. Which intervention should the nurse plan to use to reduce the client's focus on delusional thinking?
A. Focus on feelings suggested by the delusion
B. Explore reasons why the client has the delusion
C. Address the delusion with logical explanations
D. Present evidence that supports the reality of the situation
What is
ANS:A
The nurse should focus on the client's feelings rather than attempt to change the client's delusional thinking by the use of evidence or logical explanations. Delusional thinking is usually fixed, and clients will continue to have the belief in spite of obvious proof that the belief is false or irrational.
Which brain regions commonly show reduction in gray matter volume in individuals with schizophrenia? [SATA]
a) Prefrontal
b) Medial
c) Cerebellum
d) Brain Stem
e.) Superior temporal
What is
Answer: A, B, E ) Prefrontal, medial, and superior temporal lobes
Question: A nurse prepares to administer a scheduled injection of haloperidol decanoate (Haldol depot) to an outpatient with schizophrenia. As the nurse swabs the site, the patient shouts, "Stop! I don't want to take that medicine anymore. I hate the side effects." Select the nurse's best action.
A. Assemble other staff for a show of force and proceed with the injection, using restraint if necessary.
B. Stop the medication administration procedure and say to the patient, "Tell me more about the side effects you've been having."
C. Proceed with the injection but explain to the patient that there are medications that will help reduce the unpleasant side effects.
D. Say to the patient, "Since I've already drawn the medication in the syringe, I'm required to give it, but let's talk to the doctor about delaying next month's dose."
What is
Answer: B
Patients with mental illness retain their civil rights unless there is clear, cogent, and convincing evidence of dangerousness. The patient in this situation presents no evidence of dangerousness. The nurse, as an advocate and educator, should seek more information about the patient's decision and not force the medication.
A client diagnosed with chronic schizophrenia presents in an emergency department (ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect the physician to recognize which condition and implement which treatment?
A. Neuroleptic malignant syndrome and treat by discontinuing antipsychotic medications
B. Agranulocytosis and treat by administration of clozapine (Clozaril)
C. Extrapyramidal symptoms and treat by administration of benztropine (Cogentin)
D. Tardive dyskinesia and treat by discontinuing antipsychotic medications
What is
ANS: D
The nurse should expect that an ED physician would diagnose the client with tardive dyskinesia and discontinue antipsychotic medications. Tardive dyskinesia is a condition of abnormal involuntary movements of the mouth, tongue, trunk, and extremities that can be an irreversible side effect of typical antipsychotic medications.