SCHIZOPHRENIA NCLEX PRACTICE QUIZ: 65 QUESTIONS

SCHIZOPHRENIA NCLEX PRACTICE QUIZ: 65 QUESTIONS1. 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. 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. o 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. o 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. o 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? o A. Confront the delusional material directly by telling Gio that this simply is not so. o B. Tell Gio that this must seem frightening to him but that you believe he is safe here. o C. Tell Gio to wait and talk about these beliefs in his one-on-one counseling sessions. o D. Isolate Gio when he begins to talk about these beliefs. 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. o 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. o 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. o 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? o A. Gio's description of being endowed with superpowers. o B. Frequent angry outburst noted toward peers and staff. o C. Refusal to eat cafeteria food. o D. Refusal to join in group activities. 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.