Question: A patient diagnosed with schizophrenia says, “My coworkers are out to get me. I also saw two doctors plotting to overdose me.” What term identifies how this patient is perceiving the environment?
Answer Choices: a. Disorganized b. Unpredictable c. Dangerous d. Bizarre
Answer: c. Dangerous
Question: When a patient diagnosed with schizophrenia was discharged 6 months ago, haloperidol was prescribed. The patient now says, “I stopped taking those pills. I didn’t like how it made me feel.” What likely side effects did the patient experience?
Answer Choices: a. Sedation and muscle stiffness b. Sweating, nausea, and diarrhea c. Mild fever, sore throat, and skin rash d. Headache, watery eyes, and runny nose
Answer: a. Sedation and muscle stiffness
Question: 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?
Answer Choices: a. Use of long-acting antipsychotic injections b. Addition of a benzodiazepine, such as lorazepam c. Adjunctive use of an antidepressant, such as amitriptyline d. Inpatient hospitalization because of the high risk for exacerbation of symptoms
Answer: a. Use of long-acting antipsychotic injections
Question: A patient’s care plan includes monitoring for auditory hallucinations. Which assessment findings suggest the patient may be hallucinating?
Answer Choices: a. Aloofness, haughtiness, suspicion b. Darting eyes, tilted head, mumbling to self c. Elevated mood, hyperactivity, distractibility d. Performing rituals, avoiding open places
Answer: b. Darting eyes, tilted head, mumbling to self
Question: 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. Which drug should the nurse advocate?
Answer Choices: a. Clozapine b. Ziprasidone c. Olanzapine d. Aripiprazole
Answer: d. Aripiprazole
Question: 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.
Answer Choices: a. “Nothing you are saying is clear.” b. “Your thoughts are very disconnected.” c. “Try to organize your thoughts, and then tell me again.” d. “I am having difficulty understanding what you are saying.”
Answer: d. “I am having difficulty understanding what you are saying.”
Question: A patient diagnosed with schizophrenia is demonstrating catatonia. The patient has little spontaneous movement and waxy flexibility. Which patient needs are of priority importance?
Answer Choices: a. Psychosocial b. Physiological c. Self-actualization d. Safety and security
Answer: b. Physiological
Question: A patient diagnosed with schizophrenia 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:
Answer Choices: a. Demonstrate increased interest in the environment by the end of week 1 b. Perform self-care activities with coaching by the end of day 3 c. Gradually take the initiative for self-care by the end of week 2 d. Voluntarily accept tube feeding by day 2
Answer: b. Perform self-care activities with coaching by the end of day 3
Question: A nurse observes a patient 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?
Answer Choices: a. Echolalia b. Waxy flexibility c. Depersonalization d. Thought withdrawal
Answer: b. Waxy flexibility
Question: Which patient diagnosed with schizophrenia would be expected to have the lowest level of overall functioning?
Answer Choices: a. 39 years old; paranoid ideation since age 35 years b. 32 years old; isolated episodes of catatonia since age 24 years; stable for 3 years c. 19 years old; diagnosed with schizophreniform disorder 6 months ago d. 40 years old; frequent relapses since age 18; often does not take medication as prescribed
Answer: d. 40 years old; frequent relapses since age 18; often does not take medication as prescribed
Question: A patient presenting 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?
Answer Choices: a. Allow the patient to have supervised access to food vending machines. b. Allow the patient to telephone a local restaurant to deliver meals. c. Offer to taste each portion on the tray for the patient. d. Begin tube feedings or total parenteral nutrition.
Answer: a. Allow the patient to have supervised access to food vending machines.
Question: 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.
Answer Choices: a. 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. b. Arrange to spend 1 hour each day with the patient; focus on asking questions about what the patient is thinking or experiencing; avoid silences. c. 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. d. Visit every other day; remind the patient of the nurse’s identity; encourage the patient to talk while the nurse works on reports.
Answer: a. 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.
Question: Patients diagnosed with schizophrenia who are suspicious and withdrawn generally present with what additional characteristic?
Answer Choices: a. Universally fear sexual involvement with therapists. b. Are socially disabled by the positive symptoms of schizophrenia. c. Exhibit a high degree of hostility as evidenced by rejecting behavior. d. Avoid relationships because they become anxious with emotional closeness.
Answer: d. Avoid relationships because they become anxious with emotional closeness.
Question: 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.
Answer Choices: a. “Do you hear the voices often?” b. “Do you have a plan for getting away from the voices?” c. “I will stay with you. Focus on what we are talking about, not the voices.” d. “Forget about the voices. Ask some other patients to sit and talk with you.”
Answer: c. “I will stay with you. Focus on what we are talking about, not the voices.”
Question: A patient diagnosed with schizophrenia has taken fluphenazine 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?
Answer Choices: a. Neuroleptic malignant syndrome b. Hepatocellular effects c. Pseudoparkinsonism
Answer: c. Pseudoparkinsonism
Question: A patient diagnosed with schizophrenia is acutely disturbed and violent. After several doses of haloperidol, 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 effect is the patient demonstrating?
Answer Choices: a. Acute dystonic reaction b. Tardive dyskinesia c. Waxy flexibility d. Akathisia
Answer: a. Acute dystonic reaction
Question: An acutely violent patient diagnosed with schizophrenia receives several doses of haloperidol. 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?
Answer Choices: a. Administer diphenhydramine 50 mg IM from the PRN medication administration record. b. Reassure the patient that the symptoms will subside. Practice relaxation exercises with the patient. c. Give trihexyphenidyl 5 mg orally at the next regularly scheduled medication administration time. d. Administer atropine sulfate 2 mg subcutaneously from the PRN medication administration record.
Answer: a. Administer diphenhydramine 50 mg IM from the PRN medication administration record.