Schizophrenia Spectrum Disorders And Other Psychotic Disorders

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Practicing the Science and Art of Psychiatric Nursing
Mental Health and Mental Illness
Theories and Therapies
Biological Basis for Understanding Psychopharmacology
Settings for Psychiatric Care
Legal and Ethical Basis for Practice
Nursing Process and QSEN: The Foundation for Safe and Effective Care
Communication Skills: Medium for All Nursing Practice
Therapeutic Relationships and the Clinical Interview
Trauma and Stress-Related Disorders
Anxiety, Anxiety Disorders, and Obsessive-Compulsive and Related Disorders
Somatic Symptom Disorders and Dissociative Disorders
Personality Disorders
Eating Disorders
Mood Disorders: Depression
Bipolar Spectrum Disorders
Schizophrenia Spectrum Disorders and Other Psychotic Disorders
Neurocognitive Disorders
Substance-Related and Addictive Disorders
Crisis and Mass Disaster
Child, Partner, and Elder Violence
Sexual Violence
Suicidal Thoughts and Behavior
Anger, Aggression, and Violence
Care for the Dying and Those Who Grieve
Children and Adolescents
Adults
Older Adults

All Questions

Question 1

Free

Multiple Choice

A person diagnosed with schizophrenia has had difficulty keeping a job because of arguing with coworkers and accusing them of conspiracy. Today the person shouts, "They're all plotting to destroy me." Select the nurse's most therapeutic response.

Choose correct answer/s

"Everyone here is trying to help you. No one wants to harm you."

"Feeling that people want to destroy you must be very frightening."

"That is not true. People here are trying to help if you will let them."

"Staff members are health care professionals who are qualified to help you."

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Question 2

Free

Multiple Choice

A newly admitted patient diagnosed with schizophrenia is hypervigilant and constantly scans the environment. The patient states, "I saw two doctors talking in the hall. They were plotting to kill me." The nurse may correctly assess this behavior as:

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echolalia.

an idea of reference.

a delusion of infidelity.

an auditory hallucination.

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Question 3

Free

Multiple Choice

A patient diagnosed with schizophrenia says, "My coworkers are out to get me. I also saw two doctors plotting to overdose me." How does this patient perceive the environment?

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Disorganized

Unpredictable

Dangerous

Bizarre

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Question 4

Free

Multiple Choice

When a patient diagnosed with schizophrenia was discharged 6 months ago, haloperidol (Haldol) was prescribed. The patient now says, "I stopped taking those pills. They made me feel like a robot." What likely side effects did the patient experience?

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Sedation and muscle stiffness

Sweating, nausea, and diarrhea

Mild fever, sore throat, and skin rash

Headache, watery eyes, and runny nose

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Question 5

Free

Multiple Choice

A nurse works with a patient diagnosed with schizophrenia regarding the importance of medication management. The patient repeatedly says, "I don't like taking pills." Which treatment strategy should the nurse discuss with the patient and health care provider?

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Use of long-acting antipsychotic injections

Addition of a benzodiazepine, such as lorazepam (Ativan)

Adjunctive use of an antidepressant, such as amitriptyline (Elavil)

Inpatient hospitalization because of the high risk for exacerbation of symptoms

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Question 6

Multiple Choice

A patient's care plan includes monitoring for auditory hallucinations. Which assessment findings suggest the patient may be hallucinating?

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Aloofness, haughtiness, suspicion

Darting eyes, tilted head, mumbling to self

Elevated mood, hyperactivity, distractibility

Performing rituals, avoiding open places

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Question 7

Multiple Choice

A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social functioning. The patient is also overweight and has hypertension. Which drug should the nurse advocate?

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Clozapine (Clozaril)

Ziprasidone (Geodon)

Olanzapine (Zyprexa)

Aripiprazole (Abilify)

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Question 8

Multiple Choice

A patient diagnosed with schizophrenia tells the nurse, "I eat skiller. Tend to end. Easter. It blows away. Get it?" Select the nurse's best response.

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"Nothing you are saying is clear."

"Your thoughts are very disconnected."

"Try to organize your thoughts, and then tell me again."

"I am having difficulty understanding what you are saying."

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Question 9

Multiple Choice

A patient diagnosed with schizophrenia has catatonia. The patient has little spontaneous movement and waxy flexibility. Which patient needs are of priority importance?

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Psychosocial

Physiologic

Self-actualization

Safety and security

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Question 10

Multiple Choice

A patient diagnosed with schizophrenia has catatonia. The patient is stuporous, demonstrates little spontaneous movement, and has waxy flexibility. The patient's activities of daily living are severely compromised. An appropriate outcome is that the patient will:

Choose correct answer/s

demonstrate increased interest in the environment by the end of week 1.

perform self-care activities with coaching by the end of day 3.

gradually take the initiative for self-care by the end of week 2.

voluntarily accept tube feeding by day 2.

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Question 11

Multiple Choice

A nurse observes a patient who is diagnosed with schizophrenia. The patient is standing immobile, facing the wall with one arm extended in a salute. The patient remains immobile in this position for 15 minutes, moving only when the nurse gently lowers the arm. What is the name of this phenomenon?

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Echolalia

Waxy flexibility

Depersonalization

Thought withdrawal

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Question 12

Multiple Choice

Which patient diagnosed with schizophrenia would be expected to have the lowest level of overall functioning?

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39 years old; paranoid ideation since age 35 years

32 years old; isolated episodes of catatonia since age 24 years; stable for 3 years

19 years old; diagnosed with schizophreniform disorder 6 months ago

40 years old; frequent relapses since age 18; often does not take medication as prescribed

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Question 13

Multiple Choice

A patient with delusions of persecution about being poisoned has refused all hospital meals for 3 days. Which intervention is most likely to be acceptable to the patient?

Choose correct answer/s

Allow the patient to have supervised access to food vending machines

Allow the patient to telephone a local restaurant to deliver meals

Offer to taste each portion on the tray for the patient

Begin tube feedings or total parenteral nutrition

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Question 14

Multiple Choice

A community mental health nurse wants to establish a relationship with a very withdrawn patient diagnosed with schizophrenia. The patient lives at home with a supportive family. Select the nurse's best plan.

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Visit daily for 4 days, then visit every other day for 1 week; stay with the patient for 20 minutes; accept silence; state when the nurse will return.

Arrange to spend 1 hour each day with the patient; focus on asking questions about what the patient is thinking or experiencing; avoid silences.

Visit twice daily; sit beside the patient with a hand on the patient's arm; leave if the patient does not respond within 10 minutes.

Visit every other day; remind the patient of the nurse's identity; encourage the patient to talk while the nurse works on reports.

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Question 15

Multiple Choice

Patients diagnosed with schizophrenia who are suspicious and withdrawn:

Choose correct answer/s

universally fear sexual involvement with therapists.

are socially disabled by the positive symptoms of schizophrenia.

exhibit a high degree of hostility as evidenced by rejecting behavior.

avoid relationships because they become anxious with emotional closeness.

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Question 16

Multiple Choice

A newly admitted patient diagnosed with schizophrenia says, "The voices are bothering me. They yell and tell me I'm bad. I have got to get away from them." Select the nurse's most helpful reply.

Choose correct answer/s

"Do you hear the voices often?"

"Do you have a plan for getting away from the voices?"

"I will stay with you. Focus on what we are talking about, not the voices."

"Forget about the voices. Ask some other patients to sit and talk with you."

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Question 17

Multiple Choice

A patient diagnosed with schizophrenia has taken fluphenazine (Prolixin) 5 mg orally twice daily for 3 weeks. The nurse now assesses a shuffling, propulsive gait; a masklike face; and drooling. Which term applies to these symptoms?

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Neuroleptic malignant syndrome

Hepatocellular effects

Pseudoparkinsonism

Akathisia

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Question 18

Multiple Choice

A patient diagnosed with schizophrenia is acutely disturbed and violent. After several doses of haloperidol (Haldol), the patient is calm. Two hours later the nurse sees the patient's head rotated to one side in a stiff position; the lower jaw is thrust forward, and the patient is drooling. Which problem is most likely?

Choose correct answer/s

Acute dystonic reaction

Tardive dyskinesia

Waxy flexibility

Akathisia

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Question 19

Multiple Choice

An acutely violent patient diagnosed with schizophrenia receives several doses of haloperidol (Haldol). Two hours later the nurse notices the patient's head rotated to one side in a stiffly fixed position; the lower jaw is thrust forward, and the patient is drooling. Which intervention by the nurse is indicated?

Choose correct answer/s

Administer diphenhydramine (Benadryl) 50 mg IM from the PRN medication administration record.

Reassure the patient that the symptoms will subside. Practice relaxation exercises with the patient.

Give trihexyphenidyl (Artane) 5 mg orally at the next regularly scheduled medication administration time.

Administer atropine sulfate 2 mg subcutaneously from the PRN medication administration record.

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Question 20

Multiple Choice

A patient has taken trifluoperazine (Stelazine) 30 mg/day orally for 3 years. The clinic nurse notes that the patient grimaces and constantly smacks both lips. The patient's neck and shoulders twist in a slow, snakelike motion. Which problem would the nurse suspect?

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Agranulocytosis

Tardive dyskinesia

Tourette syndrome

Anticholinergic effects

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