Chapter 49: Care of Patients with Thought and Personality Disorders

Chapter 49: Care of Patients with Thought and Personality Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is aware that it is estimated that approximately _____% of the United States population is affected with schizophrenia.

a.	1
b.	2
c.	3
d.	4

 

 

ANS:  A

Schizophrenia is the most common thought disorder. It is estimated that 1.1% of the general population is affected with schizophrenia, and in the United States this represents 2.4 million Americans.

 

DIF:    Cognitive Level: Comprehension     REF:   1102              OBJ:   1 (theory)

TOP:   Schizophrenia: Incidence                 KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Health Promotion and Maintenance

 

2. The nurse explains that depression is thought to be the result of a deficit of:

a.	norepinephrine.
b.	serotonin.
c.	acetylcholine.
d.	dopamine.

 

 

ANS:  B

Serotonin is a neurotransmitter of the central nervous system. It is important in sleep, pain perception, and emotional states. Lack of serotonin can lead to depression. Norepinephrine and acetylcholine are neurotransmitters of the autonomic nervous system. Norepinephrine plays an important role in the fight-or-flight reaction (constriction of the blood vessels, dilation of the pupils, increased heart rate, increased awareness and vigilance). Acetylcholine causes decreased heart rate and force of contraction and plays a role in the sleep-wake cycle. Dopamine is located mostly in the brainstem. It is thought to play a role in controlling complex movements, motivation, and cognition.

 

DIF:    Cognitive Level: Comprehension     REF:   1103              OBJ:   3 (theory)

TOP:   Depression: Etiology                       KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

3. The nurse documents a schizophrenic’s delusion of persecution when the patient says:

a.	“Did you know that I own this hospital and pay all these people to work for me?”
b.	“My doctor talked to all the other patients, but not to me. He doesn’t want me to get well.”
c.	“The president’s speech tonight is going to give me a coded message.”
d.	“I am going to wait in front of the hospital this morning for my limousine to pick me up and take me to my private jet.”

 

 

ANS:  B

Delusions can be either grandiose or persecutory. An individual who believes he owns the hospital or is planning to be picked up by a limousine or has a private jet is having delusions of grandeur. Individuals with delusions of persecution believe that they are being persecuted by agencies, by other people, or by supernatural beings. The patient who believes the president’s speech is coded is having an idea of reference.

 

DIF:    Cognitive Level: Application           REF:   1104              OBJ:   3 (theory)

TOP:   Delusions: Persecution                    KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Psychosocial Integrity

 

4. When the paranoid schizophrenic states that his whole family has conspired to have him put in the hospital and that the medical staff is part of the conspiracy, the nurse’s most therapeutic response would be:

a.	“I’m not like that. I want to help you.”
b.	“You know your family is concerned about you.”
c.	“I’m sorry you feel that way. I’ll be around if you want to talk about your feelings.”
d.	“The doctors are trying to help you feel better. They have your best interest in mind.”

 

 

ANS:  C

Arguing with the paranoid patient, or defending self or others, reinforces the paranoia. Passively offering self to the patient to approach you rather than the other way around is helpful to the nurse-patient relationship.

 

DIF:    Cognitive Level: Application           REF:   1109              OBJ:   3 (theory)

TOP:   Paranoia: Intervention                     KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Psychosocial Integrity