apter 15: Schizophrenia Spectrum and Other Psychotic Disorders Halter: Varcarolis’s Canadian Psychiatric Mental Health Nursing, 2nd Edition

Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders Halter: Varcarolis’s Canadian Psychiatric Mental Health Nursing, 2nd Edition MULTIPLE CHOICE 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 providers who are qualified to help you.” 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. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 2. 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 behaviour as which of the following? a. Echolalia b. An idea of reference c. A delusion of infidelity d. An auditory hallucination ANS: B Ideas of reference are misinterpretations of the verbalizations or actions of others that give special personal meanings to these behaviours; 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. DIF: Cognitive Level: Understand (C