C HAPTER 12: S CHIZOPHRENIA S PECTRUM
D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. A nurse sits with a client diagnosed with schizophrenia. The client starts
to laugh uncontrollabl y, although the nurse has not said anything funny.
What is the nurse’s most therapeutic response?
a. “Why are you laughing?”
b. “Please share the joke with me.”
c. “I don’t think I said anything funny.”
d. “You’re laughing. Tell me what’s happening.”
ANS: D
The client is likel y laughing in response to inner stimuli, such as
hallucinations or fantasy. Focus on the hallucinatory clue (the cli ent’s
laughter) and then elicit the client’s observation. The incorrect options
are less useful in eliciting a response: no joke may be involved, “why”
questions are difficult to answer, and the client is probabl y not
focusing on what the nurse said in the first place.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
,2. The nurse assesses a client diagnosed with schizophrenia. Which
assessment finding would the nurse regard as a negative symptom of
schizophrenia?
a. Auditory hallucinations
b. Delusions of grandeur
c. Poor personal hygiene
d. Psychomotor agitation
ANS: C
Negative symptoms include apathy, anhedonia, poor social functioning,
and povert y of thought. Poor personal hygiene is an example of poor
social functioning. The distractors are positive symptoms of
schizophrenia. See relationship to audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Ps ychosocial Integrity
3. What assessment findings mark the prodromal stage of schizophrenia?
a. Withdrawal, misinterpreting, poor concentration, and preoccupation
with religion
b. Auditory hallucinations, ideas of reference, thought insertion, and
broadcasting
c. Stereot yped behavior, echopraxia, echolalia, and waxy flexibilit y
d. Loose associations, concrete thinking, and echolalia neologisms
ANS: A
, Withdrawal, misinterpreting, poor concentration, and preoccupation
with religion are prodromal symptoms, the symptoms that are present
before the development of florid symptoms. The incorrect options each
list the positive sym ptoms of schizophrenia that might be apparent
during the acute stage of the illness.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Psychosocial Integrity
4. A client diagnosed with schizophrenia says, “Contagious bacteria are
everywhere. When they get in your body, you will be locked up with other
infected people.” Which problem is evident?
a. Povert y of content
b. Concrete thinking
c. Neologisms
d. Paranoia
ANS: D
The client’s unrealistic fear of harm indicates paranoia. Neologisms are
invented words. Concrete thinking involves literal interpretation.
Povert y of content refers to an inadequate fund of in formation.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Psychosocial Integrity
D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. A nurse sits with a client diagnosed with schizophrenia. The client starts
to laugh uncontrollabl y, although the nurse has not said anything funny.
What is the nurse’s most therapeutic response?
a. “Why are you laughing?”
b. “Please share the joke with me.”
c. “I don’t think I said anything funny.”
d. “You’re laughing. Tell me what’s happening.”
ANS: D
The client is likel y laughing in response to inner stimuli, such as
hallucinations or fantasy. Focus on the hallucinatory clue (the cli ent’s
laughter) and then elicit the client’s observation. The incorrect options
are less useful in eliciting a response: no joke may be involved, “why”
questions are difficult to answer, and the client is probabl y not
focusing on what the nurse said in the first place.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
,2. The nurse assesses a client diagnosed with schizophrenia. Which
assessment finding would the nurse regard as a negative symptom of
schizophrenia?
a. Auditory hallucinations
b. Delusions of grandeur
c. Poor personal hygiene
d. Psychomotor agitation
ANS: C
Negative symptoms include apathy, anhedonia, poor social functioning,
and povert y of thought. Poor personal hygiene is an example of poor
social functioning. The distractors are positive symptoms of
schizophrenia. See relationship to audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Ps ychosocial Integrity
3. What assessment findings mark the prodromal stage of schizophrenia?
a. Withdrawal, misinterpreting, poor concentration, and preoccupation
with religion
b. Auditory hallucinations, ideas of reference, thought insertion, and
broadcasting
c. Stereot yped behavior, echopraxia, echolalia, and waxy flexibilit y
d. Loose associations, concrete thinking, and echolalia neologisms
ANS: A
, Withdrawal, misinterpreting, poor concentration, and preoccupation
with religion are prodromal symptoms, the symptoms that are present
before the development of florid symptoms. The incorrect options each
list the positive sym ptoms of schizophrenia that might be apparent
during the acute stage of the illness.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Psychosocial Integrity
4. A client diagnosed with schizophrenia says, “Contagious bacteria are
everywhere. When they get in your body, you will be locked up with other
infected people.” Which problem is evident?
a. Povert y of content
b. Concrete thinking
c. Neologisms
d. Paranoia
ANS: D
The client’s unrealistic fear of harm indicates paranoia. Neologisms are
invented words. Concrete thinking involves literal interpretation.
Povert y of content refers to an inadequate fund of in formation.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Psychosocial Integrity
