Chapter 17: Schizophrenia Spectrum Disorders

Chapter 17: Schizophrenia Spectrum Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A person has had difficulty keeping a job because of arguing with co-workers and accusing them of conspiracy. Today the person shouts, “They’re all plotting to destroy me. Isn’t that true?” Select the nurse’s most therapeutic response.

ANS:  B

Resist focusing on content; instead, focus on the feelings the patient is expressing. This strategy prevents arguing about the reality of delusional beliefs. Such arguments increase patient anxiety and the tenacity with which the patient holds to the delusion. The other options focus on content and provide opportunity for argument.

DIF:    Cognitive Level: Application           REF:   Pages: 314-316

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

2. A newly admitted patient diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment. The patient states, “I saw two doctors talking in the hall. They were plotting to kill me.” The nurse may correctly assess this behavior as:

ANS:  B

Ideas of reference are misinterpretations of the verbalizations or actions of others that give special personal meanings to these behaviors; for example, when seeing two people talking, the individual assumes they are talking about him or her. The other terms do not correspond with the scenario.

DIF:    Cognitive Level: Comprehension     REF:   Page: 306

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

3. A patient diagnosed with paranoid schizophrenia says, “My co-workers are out to get me. I also saw two doctors plotting to kill me.” How does this patient perceive the environment?

ANS:  B

The patient sees the world as hostile and dangerous. This assessment is important because the nurse can be more effective by using empathy to respond to the patient. Data are not present to support any of the other options.

DIF:    Cognitive Level: Comprehension     REF:   Page: 309|Page: 316

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

4. When a patient with paranoid schizophrenia was discharged 6 months ago, haloperidol (Haldol) was prescribed. The patient now says, “I stopped taking those pills. They made me feel like a robot.” What common side effects should the nurse validate with the patient?

ANS:  A

Typical antipsychotic drugs often produce sedation and extrapyramidal side effects such as stiffness and gait disturbance, effects the patient might describe as making him or her feel like a “robot.” The side effects mentioned in the other options are usually not associated with typical antipsychotic therapy or would not have the effect described by the patient.

DIF:    Cognitive Level: Application           REF:   Pages: 320-325

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