Chapter 12 Schizophrenia and Schizophrenia Spectrum Disorders

Chapter 12 Schizophrenia and Schizophrenia Spectrum Disorders Which of the following symptoms would alert a health care provider to a possible diagnosis of schizophrenia in a young adult male? A. Excessive sleeping with disturbing dreams B. Hearing voices telling him to hurt his roommate C. Withdrawal from college because of failing grades D. Chaotic and dysfunctional relationships with his family and peers ans: C People diagnosed with schizophrenia all have at least one psychotic symptom, such as hallucinations, delusional thinking, or disorganized speech. Excessive sleeping, failing grades, and chaotic and dysfunctional relationships do not describe schizophrenia but could be caused by a number of problems. A patient diagnosed with disorganized schizophrenia would have greatest difficulty when the nurse A. Interacts with a neutral attitude B. Uses concrete language C. Gives multistep directions D. Provides nutritional supplements ans: C The thought processes of the patient with disorganized schizophrenia are severely disordered, and severe perceptual problems are present, making it extremely difficult for the patient to understand what others are saying. All communication should be simple and concrete and may need to be repeated several times. A nurse is educating a patient's family about schizophrenia. What is the most appropriate advice the nurse can give to the patient's family? Select all that apply. A. The nurse should advise them to keep in touch with support groups. B. The nurse should avoid mentioning the side effects of the drugs prescribed. C. The nurse should advise them to keep the patient in an isolated room. D. The nurse should advise them to adhere to the treatment plan. E. The nurse should advise them to immediately stop the medication if the patient's symptoms are relieved. ans: A, D The nurse should advise the family of the patient to join support groups such as National Alliance on Mental Illness and other local support groups. These groups would help to provide optimal patient care as well as support to the family. Adherence to the treatment plan would result in positive outcomes for the patient. The patient's family must be educated about the possible side effects of the prescribed drugs. This would help in effective monitoring and reducing panic in the patient and family members. The patient should be encouraged to interact with others. Keeping the patient isolated can make the patient either aggressive or withdrawn. The medications should not be stopped immediately after the symptoms are relieved as it could cause relapse of the schizophrenic symptoms. Gradually decreasing the dosage of the drug would be useful to prevent a relapse. A patient's dose of haloperidol (Haldol) was increased earlier today. The patient now is experiencing laryngeal dystonia. What is the nurse's priority action? A. Document the finding B. Maintain a patent airway C. Offer oral fluids to the patient D. Engage the patient in an alternative activity ans: B Laryngeal dystonia is associated with an acute dystonic reaction and may impair the integrity of the patient's airway. The nurse will document the events after they are managed. Oral fluids could be aspirated. Immediate nursing action is indicated; it would be inappropriate to try to engage the patient in an alternate activity. A nurse works with a patient in the acute phase of schizophrenia. Which assessment findings increase the risk of aggression and violence? Select all that apply. A. Paranoia B. Flat affect C. Poor hygiene D. Delusional thinking E. Command hallucinations ans: A, D, E A small percentage of patients with schizophrenia, especially during the acute phase, may exhibit a risk for physical violence, typically in response to hallucinations (especially command hallucinations), delusions, paranoia, and impaired judgment or impulse control. Poor hygiene and a flat affect are negative symptoms that usually are not associated with aggression or violence.