Chapter 20: The Schizophrenias

Chapter 20: The Schizophrenias

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1)   A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales. Today, he argued with several office mates and threatened to kill one of them. The police were called, and he was brought to the mental health center for evaluation. He has had previous admissions to the unit for stabilization of symptoms of paranoid schizophrenia. When the nurse meets him, he points at staff in the nursing station and states loudly “They’re all plotting to destroy me. Isn’t that true?” An appropriate response for the nurse would be

ANS:   C

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

DIF:    Cognitive Level: Application             REF:    Text Page: 401

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

2)   A newly admitted client diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment. He states that he saw two doctors talking in the hall and knows they were plotting to kill him. The nurse may correctly assess this behavior as

ANS:   A

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

DIF:    Cognitive Level: Application             REF:    Text Page: 392

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

3)   A newly admitted client diagnosed with paranoid schizophrenia believes co-workers are “out to get” him and has stated he thinks two doctors on the unit are plotting to kill him. How does the client perceive the environment?

ANS:   B

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

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 392

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

4)   Family members of a client newly diagnosed with paranoid schizophrenia state that they do not understand what caused the client’s illness. The nurse’s response should be predicated on the

ANS:   A

Compelling evidence exists that schizophrenia is a neurological disorder probably related to neurochemical abnormalities, neuroanatomical disruption of brain circuits, and genetic vulnerability. Options B, C, and D: Stress, family disruption, and developmental influences may contribute but are not considered single etiologies.

DIF:    Cognitive Level: Application             REF:    Text Page: 386, Text Page: 387

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