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When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:
- A. Medications provided are ineffective.
- B. Nurses are trying to control their minds.
- C. The medications will make them sick.
- D. They are not actually ill.
Correct Answer: D
Rationale: The correct answer is D: They are not actually ill. Anosognosia is a symptom of schizophrenia where patients lack awareness of their illness. This leads them to deny their condition and refuse treatment. Choice A is incorrect as it assumes patients are aware of the medication's effectiveness. Choice B is incorrect as it introduces a paranoid belief not related to anosognosia. Choice C is incorrect as it focuses on physical side effects, not denial of illness.
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To provide effective care for the patient diagnosed with schizophrenia, the nurse should frequently assess for which associated condition? Select all that apply.
- A. Alcohol use disorder
- B. Major depressive disorder
- C. Stomach cancer
- D. Polydipsia
Correct Answer: A
Rationale: The correct answer is A: Alcohol use disorder. Patients with schizophrenia are at higher risk for co-occurring substance use disorders, including alcohol use disorder. Assessing for alcohol use is crucial as it can worsen symptoms and interfere with treatment. Major depressive disorder (B) is a common comorbidity but is not specific to schizophrenia. Stomach cancer (C) is not directly associated with schizophrenia. Polydipsia (D), excessive thirst, can be seen in schizophrenia due to medication side effects but is not a primary associated condition.
Which student behavior is consistent with therapeutic communication?
- A. Offering your opinion when asked to convey support.
- B. Summarizing the essence of the patient’s comments in your own words.
- C. Interrupting periods of silence before they become awkward for the patient.
- D. Telling the patient he did well when you approve of his statements or actions.
Correct Answer: B
Rationale: The correct answer is B: Summarizing the essence of the patient's comments in your own words. This behavior is consistent with therapeutic communication as it shows active listening and understanding of the patient's feelings and thoughts. By summarizing, the healthcare provider demonstrates empathy and helps clarify any misunderstandings.
A: Offering your opinion when asked to convey support may not always align with therapeutic communication, as it can shift the focus from the patient to the provider's perspective.
C: Interrupting periods of silence before they become awkward for the patient can disrupt the patient's thought process and hinder open communication.
D: Telling the patient he did well when you approve of his statements or actions may come across as judgmental and can limit the patient's ability to express themselves fully.
April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Time-out does not appear to be an effective tool for April to engage in self-reflection. April’s mother admits to putting her in time-out up to 20 times a day. The nurse recognizes that:
- A. Time-out is an important part of April’s baseline discipline.
- B. Time-out is no longer an effective therapeutic measure.
- C. April enjoys time-out, and acts out to get some alone time.
- D. Time-out will need to be replaced with seclusion and restraint.
Correct Answer: B
Rationale: The correct answer is B: Time-out is no longer an effective therapeutic measure. In this scenario, April's escalating behavior and the ineffectiveness of time-out suggest that it is not addressing the underlying issues causing her behavior. Continuous use of time-out can lead to it losing its effectiveness and may not promote self-reflection. April's behavior worsening despite frequent use of time-out indicates the need for a different approach to address her needs.
Choices A, C, and D are incorrect because they do not address the situation at hand. Choice A assumes time-out is still effective despite evidence to the contrary. Choice C assumes April enjoys time-out, which is not supported by the information given. Choice D suggests a drastic and inappropriate measure of seclusion and restraint, which should only be used as a last resort in emergency situations.
A client tells the RN that he has an IQ of 400+ and is a genius and an inventor. He also reports that he is married to a female movie star and thinks that his brother wants a sexual relationship with her. What is the priority nursing problem for admission to the psychiatric unit?
- A. Ineffective sexual patterns.
- B. Impaired environmental interpretation.
- C. Disturbed sensory perception.
- D. Compromised family coping.
Correct Answer: C
Rationale: The correct answer is C: Disturbed sensory perception. The client's delusions and false beliefs indicate a break from reality, which is a hallmark symptom of disturbed sensory perception. This poses a risk to the client's safety and well-being. Ineffective sexual patterns (choice A) and compromised family coping (choice D) may be secondary to the primary issue of distorted perceptions. Impaired environmental interpretation (choice B) is less relevant as the client's issues are more internal. Overall, addressing the disturbed sensory perception is the priority to ensure the client's safety and initiate appropriate treatment.
Which nursing intervention is particularly well chosen for addressing a population at high risk for developing schizophrenia?
- A. Screening a group of males between the ages of 15 and 25 for early symptoms.
- B. Forming a support group for females aged 25 to 35 who are diagnosed with substance use issues.
- C. Providing a group for patients between the ages of 45 and 55 with information on coping skills that have proven to be effective.
- D. Educating the parents of a group of developmentally delayed 5- to 6-year-olds on the importance of early intervention.
Correct Answer: A
Rationale: The correct answer is A. Screening a group of males between the ages of 15 and 25 for early symptoms is well chosen for addressing a population at high risk for developing schizophrenia because schizophrenia commonly first appears in late adolescence to early adulthood. By screening this specific age group, healthcare providers can identify early symptoms, provide early intervention, and potentially prevent or delay the onset of schizophrenia. This proactive approach aligns with evidence-based practices in mental health care.
Summary of why the other choices are incorrect:
B: Forming a support group for females aged 25 to 35 with substance use issues is not directly addressing the high-risk population for developing schizophrenia.
C: Providing coping skills information to patients between 45 and 55 is not targeting the age group most at risk for developing schizophrenia.
D: Educating parents of developmentally delayed children on early intervention is important but not specific to addressing the high-risk group for schizophrenia.