Mental Health/Psych Nursing - Boyd - Exam 2 - Chaps. 18-27

Mental Health/Psych Nursing - Boyd - Exam 2 - Chapters. 18-27 CH 22 SCHIZOPHRENIA AND PSYCHOSIS AnsWhat are the negative symptoms associated with schizophrenia? Select all that apply A. Anhedonia B. Hallucinations C. Ambivalence D. Delusions E. Avolition Ans- A,C,E A. Anhedonia C. Ambivalence E. Avolition Positive s/sx would be delusions and hallucinations. CH 22 The nurse is caring for a client in an inpatient mental health setting. The nurse notices that when the client is conversing with other clients, he repeats what they are saying word for word. The nurse interprets this finding and documents it as which of the following? A) Echopraxia B) Neologisms C) Tangentiality D) Echolalia Ans- D) Echolalia CH 22 Positive symptoms, specifically hallucination and delusions, are thought to be caused by hyperactivity of which neurotransmitter? A. Dopamine B. Norepinephrine C. Epinephrine D. Acetylcholine Ans- A. Dopamine Positive symptoms of schizophrenia, such as delusions and hallucinations, are thought to be caused by dopamine hyperactivity in the mesolimbic tract at the D2 receptor site in the striatal area, where memory and emotion are regulated. Hyperactivity of acetylcholine, norepinephrine, and epinephrine are not associated with schizophrenia. CH 22 Schizoaffective disorder has symptoms typical of both schizophrenia and which type of disorder? A. Mood disorder B. Anxiety disorder C. Eating disorder D.Substance use disorder Ans- A. Mood disorder CH 22 A client diagnosed with schizophrenia is having delusions that the client is being plotted against by the government. This would be documented as which type of delusion? A. Grandiose B. Somatic C. Nihilistic D. Persecutory Ans- D. Persecutory A persecutory delusion is a belief that one is being watched, ridiculed, harmed, or plotted against. The belief that one has exceptional powers, wealth, skill, influence, or destiny is a grandiose delusion. A nihilistic delusion is the belief that one is dead or a calamity is impending. A somatic delusion is a belief about abnormalities in bodily functions or structures. CH 22 When assessing a person with delusional disorder, which finding would the nurse expect to assess? A. few, if any, psychological deficits B. High level of intelligence C. altered personality D. Changes in mental status Ans- A. few, if any, psychological deficits Clients with delusional disorder show few, if any, psychological deficits. In these clients, average or marginally low intelligence is characteristic. Mental status is not generally affected. Thinking, orientation, affect, attention, memory, perception, and personality are generally intact. CH 22 A nurse assesses the health status of soldiers returning from Afghanistan. Screening will be a priority for signs and symptoms of which health problems? Select all that apply. a. Schizophrenia b. Eating disorder c. Traumatic brain injury d. Seasonal affective disorder e. Post-traumatic stress disorder Ans- C,E c. TBI e. PTSD A patient diagnosed with schizophrenia was hospitalized after arguing with co-workers and threatening to harm them. The patient is aloof, suspicious, and says, "Two staff members I saw talking were plotting to kill me." Based on data gathered at this point, which nursing diagnoses relate? Select all that apply. a. Risk for other-directed violence b. Disturbed thought processes c. Risk for loneliness d. Spiritual distress e. Social isolation Ans- A,B a. Risk for other-directed violence b. Disturbed thought processes Delusions of persecution and ideas of reference support the nursing diagnosis of disturbed thought processes. Risk for other-directed violence is substantiated by the patient's feeling endangered by persecutors. Fearful individuals may strike out at perceived persecutors or attempt self-harm to get away from persecutors. Data are not present to support the other diagnoses. A nurse at the mental health clinic plans a series of psychoeducational groups for persons newly diagnosed with schizophrenia. Which two topics take priority? a. "The importance of taking your medication correctly" b. "How to complete an application for employment" c. "How to dress when attending community events" d. "How to give and receive compliments" e. "Ways to quit smoking" Ans- A,E e. "Ways to quit smoking" a. "The importance of taking your medication correctly" Stabilization is maximized by adherence to the antipsychotic medication regimen. Because so many persons with schizophrenia smoke cigarettes, this topic relates directly to the patients' physiological well-being. The other topics are also important but are not priority topics. When developing the plan of care for a client diagnosed with delusional disorder, the nurse would anticipate treatment in which setting? A. Inpatient B. Partial hospitalization C. Residential treatment D. Outpatient Ans- D. Outpatient Clients with delusional disorder are treated most effectively in outpatient setting with supportive therapy. Inpatient residential treatment, and partial hospitalization, would not be appropriate for this client population. CH 22 A client has been prescribed clozapine for treatment of schizophrenia. The client must be taught to monitor which blood concentrations weekly while taking this drug? A. hemoglobin B. WBCs C. platelets D. hematocrit Ans- B. WBCs Agranulocytosis can develop with the use of all antipsychotic drugs but it is most likely to develop with clozapine use. Clients taking clozapine should have regular blood tests. White blood cell and granulocyte counts should be measured before treatment is initiated and at least weekly or twice weekly after treatment begins. CH 22 When investigating biologic theories related to schizophrenia, which neuroanatomic findings would be consistent with this mental health disorder? A. Enlarged hippocampus B. Smaller third ventricle C. enlarged lateral ventricle D. enlarged brain volume Ans- C. enlarged lateral ventricle The lateral and third ventricles are somewhat larger and total brain volume is somewhat smaller in persons with schizophrenia compared with those without schizophrenia. The thalamus and the medial temporal lobe structures, including the hippocampus, superior temporal, and prefrontal cortices, also tend to be smaller. CH 22 A client diagnosed with schizophrenia is an anticholinergic crisis. The nurse would expect which finding to be noted upon assessment? A. Hypothermia B. Bradycardia C. Facial flushing D. Incontinence Ans- C. Facial flushin