NURS 1102 Passpoint-psychotic disorders – Fairleigh Dickinson University | NURS1102 Passpoint-psychotic disorders

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-NURS 1102 Passpoint-psychotic disorders – Fairleigh Dickinson University A well-known client suffers a psychotic break and is admitted to the psychiatric unit. A large group of reporters with came... ras is camped out in the hospital parking lot. As a nurse walks to the employee parking after her shift, a reporter asks if she knows anything about the client's conditio Question 1   See full question A client with schizophrenia repeatedly uses profanity during an activity therapy session. Which response by the nurse is appropriate? You Selected: •  "Your behavior won't be tolerated. Go to your room immediately." Correct response: •  "Your cursing is interrupting the activity. Take time out in your room for 10 minutes."   Explanation:   Remediation: Question 2   See full question When conducting a mental status examination with a newly admitted client who has a diagnosis of paranoid schizophrenia, the client states, “I am being followed; it is not safe. They are monitoring my every move.” In which area of the mental status examination should the nurse document this information? You Selected: •  insight Correct response: •  thought content   Explanation: Question 1   See full question A client with delusional thinking who is overweight and tends to eat when stressed shows a lack of interest in eating at meal times. She states that she is unworthy of eating and that her children will die if she eats. Which nursing action is most appropriate for this client? You Selected: •  Paying special attention to the client's meal-related rituals and emotions Correct response: •  Restricting the client's access to food except at specified meal and snack times   Explanation:   Remediation: Question 2   See full question A client is about to be discharged with a prescription for the antipsychotic agent haloperidol, 10 mg by mouth twice per day. During a discharge teaching session, a nurse should provide which instruction to the client? You Selected: •  Apply a sunscreen before exposure to the sun. Correct response: •  Apply a sunscreen before exposure to the sun.   Explanation:   Remediation: Question 3   See full question A client has been receiving chlorpromazine, an antipsychotic, to treat his psychosis. Which findings should alert the nurse that the client is experiencing pseudoparkinsonism? You Selected: •  Tremors, shuffling gait, and masklike face Correct response: •  Tremors, shuffling gait, and masklike face   Explanation:   Remediation: Question 4   See full question Which response demonstrates that the parents of a child with newly diagnosed schizophrenia understand their child's diagnosis? You Selected: •  "We'll watch him swallow his daily pills and call the physician if he doesn't." Correct response: •  "We'll watch him swallow his daily pills and call the physician if he doesn't."   Explanation:   Remediation: Question 5   See full question During a home visit for a client diagnosed with paranoid schizophrenia discharged 1 week ago, the client’s mother tearfully states, “I can hardly sleep because I am so worried about my daughter. I am afraid to leave her alone in the house. What if something should happen while I am gone?” Which caregiver problem would be the most inclusive one for the nurse to incorporate into the client’s plan of care? You Selected: •  disturbed sleep pattern Correct response: •  caregiver role strain   Explanation:   Remediation: Question 6   See full question An outpatient client who has a history of paranoid schizophrenia and chronic alcohol dependency has been taking risperidone for several months. She reports that she stopped drinking 4 days ago. The client is very frightened by the tactile hallucinations of bugs crawling under her skin. Which factor should the nurse incorporate into the plan of care when explaining the tactile hallucinations? You Selected: •  alcohol withdrawal Correct response: •  alcohol withdrawal   Explanation:   Remediation: Question 7   See full question The client with a diagnosis of schizophrenia spends much of the morning in the bedroom but seeks out the nurse for brief interactions throughout the morning. Which goal should the nurse assist the client with achieving in the afternoon? The client will: You Selected: •  engage three of his peers in a card game. Correct response: •  help put a puzzle together.   Explanation:   Remediation: Question 8   See full question The client with a diagnosis of schizophrenia walks into group naked. The nurse should: You Selected: •  lead the client to his room and help him dress if he needs assistance. Correct response: •  lead the client to his room and help him dress if he needs assistance.   Explanation:   Remediation: Question 9   See full question One of the clients in group with a dual diagnosis of chronic schizophrenia and alcohol abuse states, “I am not going to take medicine every day.” Which response by the nurse would be mostappropriate? You Selected: •  “I hear you say that you do not like taking medication daily.” Correct response: •  “I hear you say that you do not like taking medication daily.”   Explanation:   Remediation: Question 10   See full question While planning the care for a client with paranoid delusions, which of the following will be the nurse’s initial goal for the client? You Selected: •  Establish trust with staff. Correct response: •  Establish trust with staff.   Explanation:   Remediation: Question 3   See full question One of the clients in group with a dual diagnosis of chronic schizophrenia and alcohol abuse states, “I am not going to take medicine every day.” Which response by the nurse would be mostappropriate? You Selected: •  “Let us discuss this tomorrow if we have time.” Correct response: •  “I hear you say that you do not like taking medication daily.”   Explanation:   Remediation: Question 4   See full question The client tells the nurse that she stopped taking olanzapine 2 weeks ago because she is better and wants “to make it on my own without this darned medicine.” What would be the nurse’s mosttherapeutic response? You Selected: •  “You have told me about other times like this when you stopped taking your medication and you got sick again. You should know better by now.” Correct response: •  ”I know you get tired of taking the medication, especially when you are doing well. Is there any special reason you decided to stop right now?”   Explanation:   Remediation: Question 5   See full question The guardian of a client diagnosed with schizophrenia indicates to the nurse a concern that the client is at risk for suicide. Which question to the client would the nurse utilize to determine the seriousness of the suicidal idealization? You Selected: •  “Are you planning on hurting yourself?” Correct response: Question 1   See full question A client who takes neuroleptic medication for treatment of chronic schizophrenia is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. Which life-threatening reaction do these findings suggest? You Selected: •  Neuroleptic malignant syndrome Correct response: •  Neuroleptic malignant syndrome   Explanation:   Remediation: Question 2   See full question A client with a diagnosis of borderline personality disorder is admitted to the psychiatric unit. The nurse expects the assessment to reveal: You Selected: •  coldness, detachment, and lack of tender feelings. Correct response: •  unpredictable behavior and intense interpersonal relationships.   Explanation: A client with borderline personality disorder displays a pervasive pattern of unpredictable behavior, mood, and self-image. His interpersonal relationships may be intense and unstable, and his behavior may be inappropriate and impulsive. Although the client's impaired ability to form relationships may affect his parenting skills, his inability to function as a responsible parent is more typical of antisocial personality disorder. Somatic symptoms characterize avoidant personality disorder. Coldness, detachment, and lack of tender feelings typify schizoid and schizotypal personality disorders.   Remediation: Question 3   See full question A client with a tentative diagnosis of psychosis is admitted to the psychiatric unit. A physician orders the phenothiazine thioridazine 50 mg by mouth three times per day. Phenothiazines differ from central nervous system (CNS) depressants in their sedative effects by producing: You Selected: •  more prolonged sedative effects, making the client more difficult to arouse. Correct response: •  a calming effect from which the client is easily aroused.   Explanation:   Remediation: Question 4   See full question A nurse is teaching a psychiatric client about his ordered drugs, chlorpromazine and benztropine. What evaluation would indicate a therapeutic response to these drugs? You Selected: •  The client expresses a decrease in anxiety. Correct response: •  The client is experiencing less psychosis and a decrease in extrapyramidal symptoms.   Explanation: Benztropine is an anticholinergic medication administered to reduce the extrapyramidal adverse effects of chlorpromazine and other antipsychotic medications. Benztropine doesn't reduce psychotic symptoms, relieve anxiety, or control nausea and vomiting. If the client displays akathisia or meaningless movements, this is not a therapeutic effect of the medication.   Remediation: Question 5   See full question The client with borderline personality disorder spends much time around the nurse's station, making numerous minor requests. The nurse interprets these behaviors as indicating which factor? You Selected: •  fears of abandonment and attention seeking Correct response: •  fears of abandonment and attention seeking   Explanation:   Remediation: Question 6   See full question A nurse is planning care for a regressed, chronically ill client diagnosed with schizophrenia. What is the most appropriate milieu? You Selected: •  nurturance and supportive interaction focusing on individual needs Correct response: •  nurturance and supportive interaction focusing on individual needs   Explanation:   Remediation: Question 1   See full question A client with schizophrenia is admitted to the psychiatric unit of a local hospital. During the next several days, the client is seen laughing, yelling, and talking to himself. This behavior is characteristic of: You Selected: •  hallucination. Correct response: •  hallucination.   Explanation:   Remediation: Question 2   See full question A well-known client suffers a psychotic break and is admitted to the psychiatric unit. A large group of reporters with cameras is camped out in the hospital parking lot. As a nurse walks to the employee parking after her shift, a reporter asks if she knows anything about the client's condition. What is the most appropriate response? You Selected: •  "All I can say is that the client is safe and stable." Correct response: •  "I can't answer your question."   Explanation: Question 3   See full question Which response demonstrates that the parents of a child with newly diagnosed schizophrenia understand their child's diagnosis? You Selected: •  "As long as we're understanding and supportive, he'll eventually be fine." Correct response: •  "We'll watch him swallow his daily pills and call the physician if he doesn't."   Explanation:   Remediation: Question 4   See full question A nurse is planning care for a regressed, chronically ill client diagnosed with schizophrenia. What is the most appropriate milieu? You Selected: •  nurturance and supportive interaction focusing on individual needs Correct response: •  nurturance and supportive interaction focusing on individual needs   Explanation:   Remediation: Question 5   See full question During a home visit, a client who is 75 years of age tells the community health nurse, “Lately I am getting forgetful about things. For one thing, I cannot remember names. Do you think I am getting Alzheimer’s disease?” Which response by the nurse is the most therapeutic? You Selected: •  “Most people your age have this problem. It is not Alzheimer’s disease.” Correct response: •  “Tell me more about your forgetfulness. It is not unusual for forgetfulness to occur.”   Explanation: A client with schizophrenia states, "I hear the voice of King Tut." Which response by the nurse is therapeutic? You Selected: •  "I don't hear the voice, but I know you hear what sounds like a voice." Correct response: •  "I don't hear the voice, but I know you hear what sounds like a voice."   Explanation:   Remediation: Question 2   See full question A client with a diagnosis of borderline personality disorder is admitted to the psychiatric unit. The nurse expects the assessment to reveal: You Selected: •  unpredictable behavior and intense interpersonal relationships. Correct response: •  unpredictable behavior and intense interpersonal relationships.   Explanation:   Remediation: Question 3   See full question A client begins clozapine therapy after several other antipsychotic agents fail to relieve her psychotic symptoms. The nurse instructs her to return for weekly white blood cell (WBC) counts to assess for which adverse reaction? You Selected: •  Granulocytopenia Correct response: •  Granulocytopenia   Explanation:   Remediation: Question 4   See full question While pacing in the hall, a client with schizophrenia runs to a nurse and asks, "Why are you poisoning me? I know you work for Central Thought Control! You can keep my thoughts. Give me back my soul!" How should the nurse respond during the early stage of the therapeutic process? You Selected: •  "I'm a nurse, and you're a client in the hospital. I'm not going to harm you." Correct response: •  "I'm a nurse, and you're a client in the hospital. I'm not going to harm you."   Explanation:   Remediation: Question 5   See full question A client diagnosed with borderline personality disorder has self-inflicted cuts on her arms. The nurse is assessing the client for the risk of suicide. What should the nurse ask the client first? You Selected: •  if she has a suicide plan Correct response: •  if she has a suicide plan   Explanation:   Remediation: Question 6   See full question A client diagnosed with schizophrenia is being switched to risperidone long-acting injection. He is told that he will remain on his oral dose of risperidone daily for approximately 1 month. The client says, "I did not have to take pills when I was on fluphenazine shots in the past." The nurse should tell the client: You Selected: •  "Risperidone long-acting injection initially takes a little longer to reach the ideal blood level." Correct response: •  "Risperidone long-acting injection initially takes a little longer to reach the ideal blood level."   Explanation:   Remediation: Question 7   See full question A client has been perceiving her roommate's stuffed animal as her own dog at home. The nurse determines that this misperception of reality (illusion) is improving when the client makes which statement? You Selected: •  "I wish Jan had not had my dog stuffed." Correct response: •  "Jan's stuffed dog looks somewhat like my dog, Trixie."   Explanation:   Remediation: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Question 3   See full question A man is brought to the hospital by his wife, who states that he has refused all meals for the past week and accused her of trying to poison him. During the initial interview, the client's speech, only partly comprehensible, reveals that his thoughts are controlled by delusions that he is possessed by the devil. A physician diagnoses paranoid schizophrenia. Schizophrenia is best described as a disorder characterized by: You Selected: •  preoccupation with persecutory delusions, anxiety, anger, and potential for violence. Correct response: •  preoccupation with persecutory delusions, anxiety, anger, and potential for violence.   Explanation:   Remediation: Question 4   See full question A nurse knows that a physician has ordered the liquid form of the drug chlorpromazine rather than the tablet form because the liquid: You Selected: •  has a more predictable onset of action. Correct response: •  has a more predictable onset of action.   Explanation:   Remediation: Question 5   See full question A client with schizophrenia believes his room is bugged by the Central Intelligence Agency (Canadian Security Intelligence Service) and that his roommate is a foreign spy. The client has never had a romantic relationship, has no contact with family members, and has not been employed in the past 14 years. Based on Erikson's theories, the nurse should recognize that this client is in which stage of psychosocial development? You Selected: •  Trust versus mistrust Correct response: •  Trust versus mistrust   Explanation: Question 6   See full question A client with chronic schizophrenia has received 10 mg of fluphenazine hydrochloride p.o qid. Now the client has a temperature of 102° F (38.9° C), a heart rate of 120 beats/minute, a respiratory rate of 20 breaths/minute, and a blood pressure of 210/140 mm Hg. Because the client is also confused and incontinent, the nurse suspects neuroleptic malignant syndrome. What steps should the nurse take? You Selected: •  Give the client his next dose of fluphenazine, call the physician, and monitor the client's vital signs. Correct response: •  Withhold the client's next dose of fluphenazine, call the physician, and monitor the client's vital signs.   Explanation:   Remediation: Question 7   See full question A client with schizophrenia who receives fluphenazine develops pseudoparkinsonism and akinesia. What drug should the nurse administer as ordered to minimize this client's extrapyramidal symptoms? You Selected: •  Benztropine Correct response: •  Benztropine   Explanation:   Remediation: Question 8   See full question A client with schizophrenia tells the nurse that he does not go out much because he does not have anywhere to go and he does not know anyone in the apartment where he is staying. Which action is most beneficial for the client at this time? You Selected: •  arranging for the client to attend day treatment at the clinic Correct response: •  arranging for the client to attend day treatment at the clinic   Explanation:   Remediation: Question 9   See full question The nurse recognizes the client in the emergency department from a picture in the local paper. The client has recently received a major scholarship for high academic achievement. The client tells the nurse that he hears voices that tell him he is worthless. He has tried to kill himself. What statement is the most appropriate for the nurse to use first when attempting to establish a therapeutic relationship? You Selected: •  "I am sorry this is happening to you." Correct response: •  "I am sorry this is happening to you."   Explanation:   Remediation: Question 10   See full question What should be charted by the nurse when the client has an involuntary commitment or formal admission status? You Selected: •  The client’s receipt of information about status and rights should be charted. Correct response: •  The client’s receipt of information about status and rights should be charted.   Explanation: Question 1   See full question During the initial interview, a client with schizophrenia suddenly turns to the empty chair beside him and whispers, "Now just leave. I told you to stay home. There isn't enough work here for both of us!" What is the nurse's best initial response? You Selected: •  "When people are under stress, they may see things or hear things that others don't. Is that what just happened?" Correct response: •  "When people are under stress, they may see things or hear things that others don't. Is that what just happened?"   Explanation:   Remediation: Question 2   See full question A nurse is aware that antipsychotic medications may cause: You Selected: •  lower seizure threshold. Correct response: •  lower seizure threshold.   Explanation: Question 3   See full question During a home visit for a client diagnosed with paranoid schizophrenia discharged 1 week ago, the client’s mother tearfully states, “I can hardly sleep because I am so worried about my daughter. I am afraid to leave her alone in the house. What if something should happen while I am gone?” Which caregiver problem would be the most inclusive one for the nurse to incorporate into the client’s plan of care? You Selected: •  caregiver role strain Correct response: •  caregiver role strain   Explanation:   Remediation: Question 4   See full question For the client with catatonic behaviors, which outcome would indicate a medication has been most effective in improving long-term behavior? You Selected: •  The client initiates simple activities without directions. Correct response: •  The client initiates simple activities without directions.   Explanation:   Remediation: Question 5   See full question A health care provider prescribes haloperidol p.o. 1 mg t.i.d. When assessing the client for extrapyramidal adverse effects, which nursing measures would be initiated? Select all that apply. You Selected: •  Observe for increased pacing and restlessness. •  Provide the client with sugar free hard candy. •  Closely monitor vital signs, especially temperature. Correct response: •  Closely monitor vital signs, especially temperature. •  Observe for increased pacing and restlessness. •  Provide the client with sugar free hard candy.   Explanation:   Remediation: Question 6   See full question A client is admitted to the psychiatric unit accompanied by her husband. She brings six suitcases and three shopping bags. She orders the nurse to carry her bags. Her husband states she has been purchasing items that they cannot afford and has not slept for 4 nights. Which additional information would be a priority for the nurse to seek from the client's husband? You Selected: •  their current financial status Correct response: •  the client's fluid and food intake   Explanation:   Remediation: Question 7   See full question A female client with paranoid schizophrenia has been hearing negative voices and “getting special messages from various sources.” Which intervention is most appropriate for the client's symptoms? You Selected: •  Reinforce appropriate dress and hygiene. Correct response: •  Monitor her reactions to television programs.   Explanation:   Remediation: Question 8   See full question A 20-year-old client with paranoid schizophrenia is in the fourth day of hospitalization. The client’s parents visit and state to the nurse, “What did we do wrong? What caused this awful thing to happen?” Which explanation by the nurse is most accurate and therapeutic? You Selected: •  “Let us talk about your family background. Schizophrenia is often genetic.” Correct response: •  ”You did not cause schizophrenia by doing something wrong. Schizophrenia is a brain disease.”   Explanation:   Remediation: Question 9   See full question A client diagnosed with schizophrenia is brought to the hospital from a group home where he became agitated, threw a chair at another client, and has been refusing medication for 8 weeks. The client exhibits a flat affect, is not caring for his hygiene, and has become increasingly withdrawn and asocial. The health care provider (HCP) prescribes treatment with risperidone to improve the client’s negative and positive symptoms of schizophrenia. When evaluating the drug’s effectiveness on the client’s negative symptoms, the nurse should expect improvement in which symptom? You Selected: •  agitation, delusions, hallucinations Correct response: •  apathy, affect, social isolation   Explanation:   Remediation: Question 10   See full question A client received haloperidol 12 hours previously. The client develops an oculogyric crisis and tongue protrusion. Which of the following is a nursing priority intervention? You Selected: •  Administering diazepam as ordered Correct response: •  Administering diphenhydramine as ordered Question 1   See full question A client with chronic schizophrenia receives 20 mg of fluphenazine decanoate by I.M. injection. Three days later, the client has muscle contractions that contort his neck. This client is exhibiting which extrapyramidal reaction? You Selected: •  Akinesia Correct response: •  Dystonia   Explanation:   Remediation: Question 2   See full question The wife of a client admitted for treatment of newly diagnosed paranoid schizophrenia visits 2 days after her husband’s admission and states to the nurse, “Why is he not eating? He is still talking about his food being poisoned.” Which appraisal by the nurse is most accurate? You Selected: •  Education about her husband's medications is needed. Correct response: •  Education about her husband's medications is needed.   Explanation:   Remediation: Question 3   See full question A new nurse is co-leading a family education group for those who have relatives with paranoid schizophrenia. Which statement by the new nurse indicates the need for further teaching about symptom management? You Selected: •  "The more we push the clients to spend time with friends, the more their voices decrease." Correct response: •  "The more we push the clients to spend time with friends, the more their voices decrease."   Explanation:   Remediation: Question 4   See full question The client with a diagnosis of schizophrenia is acutely psychotic and exhibits religious delusions and hallucinations, loose associations, and concrete thinking. When the nurse offers the client her medication, the client states, "I do not need that. God will heal me." The nurse should respond to the client by saying: You Selected: •  "This medicine will help clear your thoughts and decrease anxiety." Correct response: •  "God is important in your life, but the medicine will help you too."   Explanation:   Remediation: Question 5   See full question A client with bipolar disorder, manic phase, begins to swear at the nurse when reminded to limit telephone calls to 10 minutes. The nurse should respond by saying: You Selected: •  "Stop! Swearing is not appropriate behavior." Correct response: •  "Stop! Swearing is not appropriate behavior."   Explanation:   Remediation: Question 6   See full question The priority symptom to assess for in the client who is taking risperidone 1 mg, orally twice a day is: You Selected: •  insomnia. Correct response: •  orthostatic hypotension.   Explanation:   Remediation: Question 7   See full question The nurse assesses a client to be at risk for self-mutilation and implements a safety contract with the client. Which client behavior indicates that the contract is working? You Selected: •  The client notifies staff when anxiety is increasing. Correct response: •  The client notifies staff when anxiety is increasing.   Explanation:   Remediation: Question 8   See full question During a psychotic episode, a client with schizophrenia is unable to focus on interactions. The client has cognitive disturbances and poor attention, concentration, and memory. The client also has a history of suicide attempts. The client tells the nurse, "I do not want you to contact my family. I don’t even have to talk to you.” Which statement is the most appropriate nursing response? You Selected: •  "Anything you say about your feelings is confidential, but your care involves the whole team so we can all work together." Correct response: •  "Anything you say about your feelings is confidential, but your care involves the whole team so we can all work together."   Explanation:   Remediation: Question 9   See full question A client with schizophrenia states “I can’t stay here. I have to get away.” The nurse observes that the client is very agitated. What should be the nurse’s first action? You Selected: •  Approach the client in a calm, nonthreatening manner Correct response: •  Approach the client in a calm, nonthreatening manner   Explanation:   Remediation: Question 10   See full question The nurse is caring for a hospitalized client who has a disorder of the amygdala. Which of symptoms can the nurse anticipate that the client will have? You Selected: •  impulsive acts of aggression Correct response: •  impulsive acts of aggression [Show More]

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