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.
Incorrect
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.
Incorrect
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.
Incorrect
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?
A. Call the therapist to request a medication change.
B. Encourage the use of learned relaxation techniques.
C. Request that the client be hospitalized until the crisis is over.
D. Wait before the anxiety worsens before intervening.
Incorrect
Correct Answer: B. Encourage the use of learned relaxation
techniques.
The client with schizophrenia can learn relaxation techniques, which
help reduce anxiety. The family can be supportive and helpful by
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.
Incorrect
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.
Incorrect
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.
Incorrect
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?
A. Call the therapist to request a medication change.
B. Encourage the use of learned relaxation techniques.
C. Request that the client be hospitalized until the crisis is over.
D. Wait before the anxiety worsens before intervening.
Incorrect
Correct Answer: B. Encourage the use of learned relaxation
techniques.
The client with schizophrenia can learn relaxation techniques, which
help reduce anxiety. The family can be supportive and helpful by
