SCHIZOPHRENIA NCLEX PRACTICE
QUIZ: 65 QUESTIONS
1. Question
Nurse Dorothy is evaluating care of a client with schizophrenia;
the nurse should keep which point in mind?
o A. Frequent reassessment is needed and is based
on the client's response to treatment.
o B. The family does not need to be included in the care
because the client is an adult.
o C. The client is too ill to learn about his illness.
o D. Relapse is not an issue for a client with
schizophrenia.
Correct Answer: A. Frequent reassessment is needed and
is based on the client’s response to treatment.
Because the client responds to treatment in different ways, the
nurse must constantly evaluate the client and his potential. A
premorbid adjustment must also be considered. Assess if
incoherence in speech is chronic or if it is more sudden, as in an
exacerbation of symptoms. Establishing a baseline facilitates the
establishment of realistic goals, the foundation for planning
effective care.
Option B: Most clients with such conditions go home,
so the family should be involved. Inform the client’s
family in clear, simple terms about
psychopharmacologic therapy: dose, duration,
indication, side effects, and toxic effects. Written
information should be given to the client and family
members as well. Understanding of the disease and
the treatment of the disease encourages greater
family support and client adherence.
Option C: The client can learn about the illness if the
information is provided gradually. Use simple,
concrete, and literal explanations. Minimizes
, misunderstanding and/or incorporating those
misunderstandings into delusional systems. Use
therapeutic techniques (clarifying feelings when
speech and thoughts are disorganized) to try to
understand the client’s concerns. Even if the words
are hard to understand, try getting to the feelings
behind them.
Option D: Relapse is common in schizophrenia.
Educating patients on the importance of modifying risk
factors such as increasing exercise, healthier diets,
and smoking cessation will decrease their risk of
cardiovascular problems and reduce the mortality
rate. Moreover, cognitive behavioral therapy has been
shown to improve patient compliance and decrease
future hospital admissions.
2. 2. Question
Gio told his nurse that the FBI is monitoring and recording his
every movement and that microphones have been placed in the
unit walls. Which action would be the most therapeutic
response?
A. Confront the delusional material directly by telling Gio
that this simply is not so.
B. Tell Gio that this must seem frightening to him
but that you believe he is safe here.
C. Tell Gio to wait and talk about these beliefs in his
one-on-one counseling sessions.
D. Isolate Gio when he begins to talk about these
beliefs.
Correct Answer: B. Tell Gio that this must seem
frightening to him but that you believe he is safe here.
The nurse must realize that these perceptions are very real to the
client. Acknowledging the client’s feelings provides support;
explaining how the nurse sees the situation in a different way
provides reality orientation. Recognize the client’s delusions as
the client’s perception of the environment. Recognizing the
, client’s perception can help you understand the feelings he or
she is experiencing.
Option A: Confronting the delusional material directly
will not work with this client and may diminish trust.
Attempt to understand the significance of these beliefs
to the client at the time of their presentation.
Important clues to underlying fears and issues can be
found in the client’s seemingly illogical fantasies.
Option C: Telling the client to wait and talk about
these beliefs in his one-on-one counseling session will
reinforce the delusion. Initially do not argue with the
client’s beliefs or try to convince the client that the
delusions are false and unreal. Arguing will only
increase a client’s defensive position, thereby
reinforcing false beliefs. This will result in the client
feeling even more isolated and misunderstood.
Option D: Isolation will increase anxiety. Distraction
with a radio or activities would be a better approach.
Interact with clients on the basis of things in the
environment. Try to distract the client from their
delusions by engaging in reality-based activities (e.g.,
card games, simple arts and crafts projects, etc).
When thinking is focused on reality-based activities,
the client is free of delusional thinking during that
time. Helps focus attention externally.
3. 3. Question
Which of the following client behaviors documented in Gio’s chart
would validate the nursing diagnosis of Risk for other-directed
violence?
A. Gio's description of being endowed with superpowers.
B. Frequent angry outburst noted toward peers
and staff.
C. Refusal to eat cafeteria food.
D. Refusal to join in group activities.
, Correct Answer: B. Frequent angry outburst noted toward
peers and staff
Anger is an important factor that indicates the potential for acting
out. Because the client is angry with both peers and staff, any
acting out would probably be directed toward others. Frequently
assess client’s behavior for signs of increased agitation and
hyperactivity. Early detection and intervention of escalating
mania will prevent the possibility of harm to self or others, and
decrease the need for seclusions.
Option A: The client’s description of being endowed
with superpowers indicates he is having delusions.
Attempt to understand the significance of these beliefs
to the client at the time of their presentation.
Important clues to underlying fears and issues can be
found in the client’s seemingly illogical fantasies.
Recognize the client’s delusions as the client’s
perception of the environment.
Option C: His refusal to eat cafeteria food indicates
that he may have delusional beliefs, but not
necessarily a risk for violence. Do not touch the client;
use gestures carefully. Suspicious clients might
misinterpret touch as either aggressive or sexual in
nature and might interpret it as a threatening gesture.
People who are psychotic need a lot of personal space.
Option D: Refusal to join in group activities indicates
discomfort with a group, however, no threat of
violence is apparent. Structure times each day to
include planned times for brief interactions and
activities with the client on one-on-one basis. Helps
the client to develop a sense of safety in a non-
threatening environment. Provide opportunities for the
client to learn adaptive social skills in a non-
threatening environment. Initial social skills training
could include basic social behaviors (e.g., appropriate
distance, maintain good eye contact, calm
manner/behavior, moderate voice tone).
4. 4. Question
Nurse Winona educates the family about symptom management
for when the schizophrenic client becomes upset or anxious.
Which of the following would Nurse Winona state be helpful?
QUIZ: 65 QUESTIONS
1. Question
Nurse Dorothy is evaluating care of a client with schizophrenia;
the nurse should keep which point in mind?
o A. Frequent reassessment is needed and is based
on the client's response to treatment.
o B. The family does not need to be included in the care
because the client is an adult.
o C. The client is too ill to learn about his illness.
o D. Relapse is not an issue for a client with
schizophrenia.
Correct Answer: A. Frequent reassessment is needed and
is based on the client’s response to treatment.
Because the client responds to treatment in different ways, the
nurse must constantly evaluate the client and his potential. A
premorbid adjustment must also be considered. Assess if
incoherence in speech is chronic or if it is more sudden, as in an
exacerbation of symptoms. Establishing a baseline facilitates the
establishment of realistic goals, the foundation for planning
effective care.
Option B: Most clients with such conditions go home,
so the family should be involved. Inform the client’s
family in clear, simple terms about
psychopharmacologic therapy: dose, duration,
indication, side effects, and toxic effects. Written
information should be given to the client and family
members as well. Understanding of the disease and
the treatment of the disease encourages greater
family support and client adherence.
Option C: The client can learn about the illness if the
information is provided gradually. Use simple,
concrete, and literal explanations. Minimizes
, misunderstanding and/or incorporating those
misunderstandings into delusional systems. Use
therapeutic techniques (clarifying feelings when
speech and thoughts are disorganized) to try to
understand the client’s concerns. Even if the words
are hard to understand, try getting to the feelings
behind them.
Option D: Relapse is common in schizophrenia.
Educating patients on the importance of modifying risk
factors such as increasing exercise, healthier diets,
and smoking cessation will decrease their risk of
cardiovascular problems and reduce the mortality
rate. Moreover, cognitive behavioral therapy has been
shown to improve patient compliance and decrease
future hospital admissions.
2. 2. Question
Gio told his nurse that the FBI is monitoring and recording his
every movement and that microphones have been placed in the
unit walls. Which action would be the most therapeutic
response?
A. Confront the delusional material directly by telling Gio
that this simply is not so.
B. Tell Gio that this must seem frightening to him
but that you believe he is safe here.
C. Tell Gio to wait and talk about these beliefs in his
one-on-one counseling sessions.
D. Isolate Gio when he begins to talk about these
beliefs.
Correct Answer: B. Tell Gio that this must seem
frightening to him but that you believe he is safe here.
The nurse must realize that these perceptions are very real to the
client. Acknowledging the client’s feelings provides support;
explaining how the nurse sees the situation in a different way
provides reality orientation. Recognize the client’s delusions as
the client’s perception of the environment. Recognizing the
, client’s perception can help you understand the feelings he or
she is experiencing.
Option A: Confronting the delusional material directly
will not work with this client and may diminish trust.
Attempt to understand the significance of these beliefs
to the client at the time of their presentation.
Important clues to underlying fears and issues can be
found in the client’s seemingly illogical fantasies.
Option C: Telling the client to wait and talk about
these beliefs in his one-on-one counseling session will
reinforce the delusion. Initially do not argue with the
client’s beliefs or try to convince the client that the
delusions are false and unreal. Arguing will only
increase a client’s defensive position, thereby
reinforcing false beliefs. This will result in the client
feeling even more isolated and misunderstood.
Option D: Isolation will increase anxiety. Distraction
with a radio or activities would be a better approach.
Interact with clients on the basis of things in the
environment. Try to distract the client from their
delusions by engaging in reality-based activities (e.g.,
card games, simple arts and crafts projects, etc).
When thinking is focused on reality-based activities,
the client is free of delusional thinking during that
time. Helps focus attention externally.
3. 3. Question
Which of the following client behaviors documented in Gio’s chart
would validate the nursing diagnosis of Risk for other-directed
violence?
A. Gio's description of being endowed with superpowers.
B. Frequent angry outburst noted toward peers
and staff.
C. Refusal to eat cafeteria food.
D. Refusal to join in group activities.
, Correct Answer: B. Frequent angry outburst noted toward
peers and staff
Anger is an important factor that indicates the potential for acting
out. Because the client is angry with both peers and staff, any
acting out would probably be directed toward others. Frequently
assess client’s behavior for signs of increased agitation and
hyperactivity. Early detection and intervention of escalating
mania will prevent the possibility of harm to self or others, and
decrease the need for seclusions.
Option A: The client’s description of being endowed
with superpowers indicates he is having delusions.
Attempt to understand the significance of these beliefs
to the client at the time of their presentation.
Important clues to underlying fears and issues can be
found in the client’s seemingly illogical fantasies.
Recognize the client’s delusions as the client’s
perception of the environment.
Option C: His refusal to eat cafeteria food indicates
that he may have delusional beliefs, but not
necessarily a risk for violence. Do not touch the client;
use gestures carefully. Suspicious clients might
misinterpret touch as either aggressive or sexual in
nature and might interpret it as a threatening gesture.
People who are psychotic need a lot of personal space.
Option D: Refusal to join in group activities indicates
discomfort with a group, however, no threat of
violence is apparent. Structure times each day to
include planned times for brief interactions and
activities with the client on one-on-one basis. Helps
the client to develop a sense of safety in a non-
threatening environment. Provide opportunities for the
client to learn adaptive social skills in a non-
threatening environment. Initial social skills training
could include basic social behaviors (e.g., appropriate
distance, maintain good eye contact, calm
manner/behavior, moderate voice tone).
4. 4. Question
Nurse Winona educates the family about symptom management
for when the schizophrenic client becomes upset or anxious.
Which of the following would Nurse Winona state be helpful?
