Answer Options:
a. Extremes of motor activity, from excitement to stupor
b. Socially withdrawn and ineffective communication
c. Severe anxiety with ritualistic behavior
d. Highly suspicious, delusional behavior
Answer: B. Socially withdrawn and ineffective communication
Question: A nurse wants to find a description of diagnostic criteria for a person diagnosed with schizophrenia. Which resource should the nurse consult?
Answer Options:
a. U.S. Department of Health and Human Services
b. Journal of the American Psychiatric Association
c. North American Nursing Diagnosis Association International (NANDA-I)
d. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Answer: d. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Question: A patient diagnosed with schizophrenia has auditory hallucinations. The patient anxiously tells the nurse, “The voice is telling me to do things.” Select the nurse’s priority assessment question.
Answer Options:
a. “How long has the voice been directing your behavior?”
b. “Do the messages from the voice frighten you?”
c. “Do you recognize the voice speaking to you?”
d. “What is the voice telling you to do?”
Answer: d. “What is the voice telling you to do?”
Question: A child diagnosed with attention-deficit/hyperactivity disorder (ADHD) is going to begin medication therapy. The nurse should plan to teach the family about which classification of medications?
Answer Options:
a. Central nervous system stimulants and nonstimulants
b. Monamine oxidase inhibitors (MAOIs)
c. Antipsychotic medications
d. Anxiolytic medications
Answer: a. Central nervous system stimulants and nonstimulants
Question: The parent of a child diagnosed with schizophrenia tearfully asks a nurse, “What could I have done differently to prevent this illness?” Select the nurse’s most caring response.
Answer Options:
a. “Although schizophrenia is caused by impaired family relationships, try not to feel guilty. No one can predict how a child will respond to parental guidance.”
b. “Most of the damage is done, but there is still hope. Changing your parenting style can help your child learn to cope more effectively with the environment.”
c. “Schizophrenia is a biological illness with similarities to diabetes and heart disease. You are not to blame for your child’s illness.”
d. “Most mental illnesses result from genetic inheritance. Your genes are more at fault than your parenting.”
Answer: c. “Schizophrenia is a biological illness with similarities to diabetes and heart disease. You are not to blame for your child’s illness.”
Question: The parent of a child diagnosed with schizophrenia asks a nurse about the diagnosis of the prefrontal cortex. What should the nurse say is the function of the prefrontal cortex?
Answer Options:
a. Brainstem
b. Cerebellum
c. Temporal lobe
d. Prefrontal cortex
Answer: d. Prefrontal cortex
Question: A homeless patient diagnosed with severe and persistent mental illness became suspicious and delusional. The patient was given depot antipsychotic medication and housing was arranged at a local shelter. After 2 weeks, which statement by the patient indicates significant improvement?
Answer Options:
a. “I am feeling safe and comfortable here. Nobody bothers me.”
b. “They will not let me drink. They have many rules in the shelter.”
c. “Those guys are always watching me. I think someone stole my shoes.”
d. “That shot made my arm sore. I’m not going to take any more of them.”
Answer: a. “I am feeling safe and comfortable here. Nobody bothers me.”
Question: A veteran of military combat tells the nurse, “I saw a child get blown up over a year ago, and now I keep seeing bits of flesh everywhere. I see something red and the visions race back to my mind.” Which phenomenon associated with posttraumatic stress disorder (PTSD) is this veteran describing?
Answer Options:
a. Re-experiencing
b. Hyperarousal
c. Avoidance
d. Psychotic
Answer: A. Re-experiencing
Question: A patient begins therapy with a first-generation antipsychotic medication. What teaching should a nurse provide related to the drug’s strong dopamine receptor blocking effect?
Answer Options:
a. Chew sugarless gum.
b. Increase dietary fiber.
c. Arise slowly from bed.
d. Report muscle stiffness.
Answer: d. Report muscle stiffness.
Question: A patient diagnosed with schizophrenia demonstrates paranoid thinking. The patient angrily tells a nurse, “You are mean and nasty. No one trusts you or wants to be around you.” What is the likely motivation behind this behavior?
Answer Options:
a. Attempting to manipulate the nurse by using negative comments
b. The prelude to disorganization and catatonia in the near future
c. Jealousy of the nurse’s position of power in the relationship
d. Identifying another person’s shortcomings in order to preserve his or her own self-esteem
Answer: D. Identifying another person’s shortcomings in order to preserve his or her own self-esteem
Question: The relapse of a patient diagnosed with schizophrenia is related to medication nonadherence. The patient is hospitalized for 5 days, medication is restarted, and the patient’s thoughts are now more organized. The patient’s family members are upset and say, “It’s too soon for discharge. Hospitalization is needed for at least a month.” The nurse should implement what intervention?
Answer Options:
a. Call the psychiatrist to come explain the discharge rationale.
b. Explain that health insurance will not pay for a longer stay for the patient.
c. Notify security to handle the disturbance and escort the family off the unit.
d. Explain that the patient will continue to improve if medication is taken regularly.
Answer: d. Explain that the patient will continue to improve if medication is taken regularly.
Question: The parent of a child diagnosed with schizophrenia asks a nurse what is a PET scan. What is the nurse’s best response?
Answer Options:
a. “PET uses glucose to identify the metabolic activity in different brain areas.”
b. “It’s a special type of x-ray image that shows whether and where a brain injury has ever occurred.”
c. “PET is a scan that passes an electrical current through the brain and shows brain wave activity. PET can help diagnose seizures.”
d. “PET is a special scan that shows blood flow and activity in the brain.”
Answer: d. “PET is a special scan that shows blood flow and activity in the brain.”
Question: Priority teaching for a patient taking clozapine should include which instruction?
Answer Options:
a. Report sore throat and fever immediately.
b. Avoid foods high in polyunsaturated fat.
c. Use water-based lotions for rashes.
d. Avoid unprotected sex.
Answer: a. Report sore throat and fever immediately.
Question: A patient diagnosed with schizophrenia has taken a first-generation antipsychotic medication for a year. Hallucinations are less intrusive, but the patient continues to have apathy, poverty of thought, and social isolation. The nurse expects a change to which medication?
Answer Options:
a. Haloperidol
b. Olanzapine
c. Chlorpromazine
d. Diphenhydramine
Answer: b. Olanzapine
Question: The treatment team believes medication will help a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD). Which class of medications does the nurse expect will be prescribed?
Answer Options:
a. Benzodiazepines
b. Stimulants
c. Antipsychotics
d. Anxiolytics
Answer: b. Stimulants
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 Options:
a. Acute dystonic reaction
b. Tardive dyskinesia
c. Waxy flexibility
d. Akathisia
Answer: A. Acute dystonic reaction
Question: A nurse sits with a patient diagnosed with schizophrenia. The patient starts to laugh uncontrollably, although the nurse has not said anything funny. Select the nurse’s best response.
Answer Options:
a. “Why are you laughing?”
b. “Please share the joke with me.”
c. “I don’t think I said anything funny.”
d. “You are laughing. Tell me what’s happening.”
Answer: D. “You are laughing. Tell me what’s happening.”
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 Options:
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 uses Maslow’s hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority?
Answer Options:
a. Refuses to eat or bathe.
b. Reports feelings of alienation from family.
c. Is reluctant to participate in unit social activities.
d. Needs to be taught about medication action and side effects.
Answer: a. Refuses to eat or bathe.