Nokea
A client diagnosed with schizophrenia is constantly repeating what others say. The nurse would document these symptoms as which of the following?
- A. Loose associations
- B. Delusions
- C. Echolalia
- D. Neologism
Correct Answer: C
Rationale: Echolalia is repeating what others say. Loose associations are a sequence of ideas that are slightly connected. Delusions are false beliefs that cannot be changed by logical reasoning. Neologism is the inventing of new words.
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The nurse is relating medication classifications for Alzheimer type dementia to the pathophysiology of the disease process. Which neurotransmitter do most the medications on the market currently impact?
- A. Dopamine
- B. Acetylcholine
- C. Norepinephrine
- D. Epinephrine
Correct Answer: B
Rationale: Current drugs approved for treatment of dementia of the Alzheimer type include cholinesterase inhibitors, which increase acetylcholine by inhibiting cholinesterase, the enzyme that degrades it. When these drugs, tacrine (Cognex), donepezil (Aricept), or rivastigmine (Exelon), are administered in the early to middle stages of Alzheimer disease, some clients improve. Only memantine (Namenda) has a different mechanism of action.
A family brings a parent to the physician's office to discuss the parent's decline in cognitive status. The family states that the parent is forgetful and needs reminders to be able to live alone. Following assessment, which stage of Alzheimer disease does the nurse anticipate?
- A. Preclinical
- B. Post clinical
- C. Mild cognitive impairment
- D. Alzheimer dementia
Correct Answer: C
Rationale: The nurse is most correct to anticipate that the client will be diagnosed at the mild cognitive impairment stage of Alzheimer disease. At this stage, the client has noticeable memory problems, however, the memory loss is not serious enough to interfere with independent living.
The nurse is caring for a client who states: 'Can you tell this man sitting on the chair to leave my room. I am tired of him watching me.' The nurse notes that there is no one else in the room. The nurse would document the client's experience as which of the following?
- A. Delusion
- B. Dementia
- C. Hallucination
- D. Delirium
Correct Answer: C
Rationale: The nurse is correct to document the client's experience of a man in the room as a hallucination. Hallucinations are sensory experiences only the client perceives. They are auditory or visual in nature. A delusion is characterized by a disturbed thinking process. Dementia is the disturbance or decline in memory. Delirium is a sudden state of confusion.
The nurse is instructing the parents of a 21-year-old with schizophrenia who hears voices. Which response by the parent to the child validates that the parent understands the discharge teaching?
- A. The parent states 'Does the person speaking have a name?'
- B. The parent states 'The person speaking to you is bad, but you are good.'
- C. The parent states 'The voice is not real. We have talked about this before.'
- D. The parent states 'I do not hear the voices, but what are they telling you?'
Correct Answer: D
Rationale: The parent is most correct to state not hearing the voices but then asking the client to share what the voices are saying. By identifying the content of the hallucinations, the parent can determine the safety of the client or if others are in jeopardy. Also, the parent is correct to call the auditory hallucinations by the term 'the voices.'
Which medication classification is given to counteract extrapyramidal symptoms (EPS)?
- A. Antidepressants
- B. Antianxiety
- C. Anticholinergics
- D. Anticonvulsants
Correct Answer: C
Rationale: Anticholinergic drugs such as Artane and Cogentin are given to prevent or relieve EPS. Antidepressants, antianxiety, and anticonvulsant medications are not given to counteract EPS.