Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders

Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient diagnosed with schizophrenia has difficulty completing tasks and seems forgetful and disinterested in activities. A nurse can best select successful strategies by understanding that these behaviors are due to:

a.	a lack of self-esteem.
b.	manipulative tendencies.
c.	shyness and embarrassment.
d.	problems in cognitive functioning.

 

 

ANS:  D

The information processing of individuals with schizophrenia may be altered by brain deficits affecting memory and attention that then affect retention, ability to focus, and ability to make decisions.

 

DIF:    Cognitive Level: Comprehension     REF:   Text Page: 348

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

2. A patient diagnosed with schizophrenia is standing naked after showering and appears dazed and indecisive. The nursing intervention that will be most helpful to promote dressing would be:

a.	saying, “These are your clothes. Please get dressed.”
b.	saying, “These are your underpants. I’ll help you put them on.”
c.	asking, “Which of these two outfits would you like to wear now?”
d.	asking, “Is something the matter with your clothes that makes you not want to dress?”

 

 

ANS:  B

When cognitive functioning is disrupted, a self-care deficit may be severe. The nurse may need to dress the patient. Each step of the process of dressing should be undertaken singly, and a simple explanation as to what is expected should be given.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 348

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

3. During occupational therapy a patient diagnosed with schizophrenia sits staring at a piece of paper. Which response is most therapeutic at this time?

a.	“If you prefer to sit and stare for a time, it is acceptable for you to leave.”
b.	“You seem immobilized by anxiety. Is there anything I can do to help?”
c.	“Are you having trouble deciding where you want to glue that piece?”
d.	“Rub the glue stick on the back of the paper.”

 

 

ANS:  D

Patients with disrupted cognitive functioning have difficulty focusing on an activity in a sustained, concentrated fashion. They may need direction. Because multistage commands are often not understood, simple directions should be given one step at a time.

 

DIF:    Cognitive Level: Analysis                REF:   Text Pages: 348-349

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

4. A patient diagnosed with schizophrenia reveals to the nurse that voices have warned of danger and adds, “They’re so loud they frighten me. Do you hear them?” The nurse’s best initial response would be:

a.	“I know these voices are very real to you, but I don’t hear them.”
b.	“Don’t worry. You’re safe in the hospital. I won’t let anything happen to you.”
c.	“Tell me more about the voices. Are they men or women? How many are there?”
d.	“What do you do in order to keep yourself occupied so you don’t hear the voices?”

 

 

ANS:  A

When asked, the nurse should point out that he or she is not experiencing the same stimuli but should accept the reality of the hallucinations for the patient. Being able to communicate with the nurse at the time the hallucinations are occurring is helpful to the patient. Interactive discussion of hallucinations is a vital element in the development of reality-testing skills.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 366

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

5. What part of the brain is dysfunctional in persons with schizophrenia? Research has implicated the:

a.	medulla and cortex.
b.	cerebellum and cerebrum.
c.	hypothalamus and medulla.
d.	prefrontal and limbic cortices.

 

 

ANS:  D

The two most consistent neurobiological research findings in schizophrenia are imaging studies that show reduced brain volume and abnormal function, and neurochemical studies that show alterations of neurotransmitter systems affecting the prefrontal cortex and the limbic system.

 

DIF:    Cognitive Level: Comprehension     REF:   Text Page: 355

TOP:   Nursing Process: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation