Varcarolis: Chapter 12 - Schizophrenia
and Schizophrenia Spectrum
Disorders
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.
a. "Everyone here is trying to help you. No one wants to harm you."
b. "Feeling that people want to destroy you must be very frightening."
c. "That is not true. People here are trying to help you if you will let them."
d. "Staff members are health care professionals who are qualified to help you." -
ANSWER-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.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 205-206 | Page 213-215 (Box 12-4)
A newly admitted patient diagnosed with 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:
a. echolalia.
b. an idea of reference.
c. a delusion of infidelity.
d. an auditory hallucination. - ANSWER-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.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 206 (Table 12-1) TOP: Nursing Process: Assessment
,MSC: Client Needs: Psychosocial Integrity
3. A patient diagnosed with 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?
a. Disorganized
b. Dangerous
c. Supportive
d. Bizarre - ANSWER-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.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 210 (Table 12-3) | Page 213 (Box 12-4)
4. When a patient diagnosed with 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 are common side effects the nurse should
validate with the patient?
a. Sedation and muscle stiffness
b. Sweating, nausea, and diarrhea
c. Mild fever, sore throat, and skin rash
d. Headache, watery eyes, and runny nose - ANSWER-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.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 215-216 (Table 12-4) TOP: Nursing Process: Assessment
MSC: Client Needs: Physiological Integrity
5. Which hallucination necessitates the nurse to implement safety measures? The
patient says,
a. "I hear angels playing harps."
, b. "The voices say everyone is trying to kill me."
c. "My dead father tells me I am a good person."
d."The voices talk only at night when I'm trying to sleep." - ANSWER-ANS: B
The correct response indicates the patient is experiencing paranoia. Paranoia often
leads to fearfulness, and the patient may attempt to strike out at others to protect self.
The distracters are comforting hallucinations or do not indicate paranoia.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Page 207 | Page 212-213 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
6. A patient's care plan includes monitoring for auditory hallucinations. Which
assessment findings suggest the patient may be hallucinating?
a. Detachment and overconfidence
b. Darting eyes, tilted head, mumbling to self
c. Euphoric mood, hyperactivity, distractibility
d. Foot tapping and repeatedly writing the same phrase - ANSWER-ANS: B
Clues to hallucinations include eyes looking around the room as though to find the
speaker, tilting the head to one side as though listening intently, and grimacing,
mumbling, or talking aloud as though responding conversationally to someone.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 206-207 | Page 212-213 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
7. A health care provider considers which antipsychotic medication to prescribe for a
patient diagnosed with schizophrenia who has auditory hallucinations and poor social
function. The patient is also overweight and hypertensive. Which drug should the nurse
advocate?
a. Clozapine (Clozaril)
b. Ziprasidone (Geodon)
c. Olanzapine (Zyprexa)
d. Aripiprazole (Abilify) - ANSWER-ANS: D
and Schizophrenia Spectrum
Disorders
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.
a. "Everyone here is trying to help you. No one wants to harm you."
b. "Feeling that people want to destroy you must be very frightening."
c. "That is not true. People here are trying to help you if you will let them."
d. "Staff members are health care professionals who are qualified to help you." -
ANSWER-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.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 205-206 | Page 213-215 (Box 12-4)
A newly admitted patient diagnosed with 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:
a. echolalia.
b. an idea of reference.
c. a delusion of infidelity.
d. an auditory hallucination. - ANSWER-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.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 206 (Table 12-1) TOP: Nursing Process: Assessment
,MSC: Client Needs: Psychosocial Integrity
3. A patient diagnosed with 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?
a. Disorganized
b. Dangerous
c. Supportive
d. Bizarre - ANSWER-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.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 210 (Table 12-3) | Page 213 (Box 12-4)
4. When a patient diagnosed with 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 are common side effects the nurse should
validate with the patient?
a. Sedation and muscle stiffness
b. Sweating, nausea, and diarrhea
c. Mild fever, sore throat, and skin rash
d. Headache, watery eyes, and runny nose - ANSWER-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.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 215-216 (Table 12-4) TOP: Nursing Process: Assessment
MSC: Client Needs: Physiological Integrity
5. Which hallucination necessitates the nurse to implement safety measures? The
patient says,
a. "I hear angels playing harps."
, b. "The voices say everyone is trying to kill me."
c. "My dead father tells me I am a good person."
d."The voices talk only at night when I'm trying to sleep." - ANSWER-ANS: B
The correct response indicates the patient is experiencing paranoia. Paranoia often
leads to fearfulness, and the patient may attempt to strike out at others to protect self.
The distracters are comforting hallucinations or do not indicate paranoia.
PTS: 1 DIF: Cognitive Level: Analyze (Analysis)
REF: Page 207 | Page 212-213 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
6. A patient's care plan includes monitoring for auditory hallucinations. Which
assessment findings suggest the patient may be hallucinating?
a. Detachment and overconfidence
b. Darting eyes, tilted head, mumbling to self
c. Euphoric mood, hyperactivity, distractibility
d. Foot tapping and repeatedly writing the same phrase - ANSWER-ANS: B
Clues to hallucinations include eyes looking around the room as though to find the
speaker, tilting the head to one side as though listening intently, and grimacing,
mumbling, or talking aloud as though responding conversationally to someone.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 206-207 | Page 212-213 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
7. A health care provider considers which antipsychotic medication to prescribe for a
patient diagnosed with schizophrenia who has auditory hallucinations and poor social
function. The patient is also overweight and hypertensive. Which drug should the nurse
advocate?
a. Clozapine (Clozaril)
b. Ziprasidone (Geodon)
c. Olanzapine (Zyprexa)
d. Aripiprazole (Abilify) - ANSWER-ANS: D
