Chapter 13: Schizophrenia and Other Psychotic Disorders

Chapter 13: Schizophrenia and Other Psychotic Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A newly admitted patient has the diagnosis of catatonic schizophrenia. Which behavior observed in the patient supports that diagnosis?

a.	Uses a rhyming form of speech
b.	Refuses to eat any unwrapped foods
c.	Laughs when watching a sad movie
d.	Maintains an immobilized state for hours

 

ANS: D

Catatonic schizophrenia is characterized by extremes of psychomotor activity ranging from frenzied behavior to immobilization and may include echopraxia and posturing. Paranoid thinking is characteristic of paranoid schizophrenia. Inappropriate affect and clanging are seen in disorganized schizophrenia.

 

DIF:   Cognitive Level: Application        REF:  Page 274

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

 

2. What would be an appropriate short-term outcome for a patient diagnosed with residual schizophrenia who exhibits ambivalence?

a.	Decide their own daily schedule.
b.	Decide which unit groups they will attend.
c.	Choose which clinic staff member to work with.
d.	Choose between two outfits to wear each morning.

 

ANS: D

An early step would be to make choices about nonthreatening matters when presented with limited alternatives. The remaining options represent decisions that are too complicated for the patient to make initially.

 

DIF:   Cognitive Level: Application        REF:  Page 285

TOP:  Nursing Process: Outcome Identification

MSC: NCLEX: Psychosocial Integrity

 

3. What is the priority nursing diagnosis for a catatonic patient?

a.	Ineffective coping
b.	Impaired physical mobility
c.	Impaired social interaction
d.	Risk for deficient fluid volume

 

ANS: D

The highest priority for the patient is maintenance of basic physiologic needs, such as hydration. Mobility is of lesser physiological importance than fluid volume. The remaining options do not have priority over a physiological need.

 

DIF:   Cognitive Level: Application        REF:  Page 275        TOP:  Nursing Process: Diagnosis

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

 

4. Which nursing diagnosis is appropriate for a patient who insists being called “Your Highness” and demonstrates loosely associated thoughts?

a.	Risk for violence
b.	Defensive coping
c.	Impaired memory
d.	Disturbed thought processes

 

ANS: D

Delusions and loose associations suggest disturbed thought processes. The other options are not supported by data in the scenario.

 

DIF:   Cognitive Level: Application        REF:  Page 278        TOP:  Nursing Process: Diagnosis

MSC: NCLEX: Psychosocial Integrity

 

5. Which initial short-term outcome would be appropriate for a patient who was admitted expressing delusional thoughts?

a.	Accept that delusion is illogical.
b.	Distinguish external boundaries.
c.	Explain the basis for the delusions.
d.	Engage in reality-oriented conversation.

 

ANS: D

Delusions are not reality oriented; thus an appropriate outcome would be that patient will engage in reality-oriented conversation rather than discussing delusional beliefs. Delusions are fixed, false beliefs. Patients rarely accept anyone using logic to dispute them. Data are not present to suggest boundary disturbance. Explaining the delusion is not progress; it suggests the patient still holds to the belief.

 

DIF:   Cognitive Level: Application        REF:  Page 286

TOP:  Nursing Process: Outcome Identification

MSC: NCLEX: Psychosocial Integrity