Nokea
A client who has schizophrenia is having a conversation with the nurse suddenly stops talking in the middle of a sentence. The client is experiencing which type of thought disruption?
- A. Thought withdrawal
- B. Thought insertion
- C. Thought blocking
- D. Thought broadcasting
Correct Answer: C
Rationale: Sudden cessation of speech indicates thought blocking, unlike thought withdrawal (belief others take thoughts), insertion (belief others place thoughts), or broadcasting (belief others hear thoughts).
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The nurse is working with a client with schizophrenia, disorganized type. It is time for the client to get up and eat breakfast. Which of the following statements by the nurse would be most effective in helping the client prepare for breakfast?
- A. I'll expect you in the dining room in 20 minutes.
- B. It's time to put your dress on now.
- C. Stay right there and I'll get your clothes for you.
- D. Why don't you stay here and I'll get your tray for you.
Correct Answer: B
Rationale: Clear, simple directions like dressing support self-care in disorganized schizophrenia, unlike authoritarian demands or doing tasks for the client.
All of the following are included in the plan of care for a client with schizophrenia. Which nursing intervention should the nurse perform first when caring for this client?
- A. Observe for signs of fear or agitation
- B. Maintain reality through frequent contact
- C. Encourage to participate in the treatment milieu
- D. Assess community support systems
Correct Answer: A
Rationale: Observing for fear or agitation prioritizes safety, addressing potential escalation before other interventions like reality orientation or social participation.
A client who has suspicion has been placed in a room with a roommate. The night nurse reports that this client has been awake for the past 3 nights. The likely explanation for his wakefulness is which of the following?
- A. He is fearful of what his roommate might do to him while he sleeps.
- B. He is a light sleeper and unaccustomed to a roommate.
- C. He is watching for an opportunity to escape.
- D. He is worrying about his family problems.
Correct Answer: A
Rationale: Suspicion in schizophrenia often causes fear of harm from others, like a roommate, making it the most likely reason for wakefulness over other explanations.
All of the following are nursing diagnoses identified for a client with schizophrenia. The student nurse correctly anticipates which diagnosis will resolve when the client's negative symptoms improve?
- A. Impaired verbal communication
- B. Risk for other-directed violence
- C. Disturbed thought processes
- D. Social isolation
Correct Answer: D
Rationale: Social isolation, a negative symptom, improves with negative symptom reduction, unlike impaired communication, violence risk, or thought processes, which are positive symptom-related.
A client with schizophrenia is admitted to the inpatient unit. He does not speak when spoken to but has been observed talking to himself on occasion. What would be the priority objective at this time?
- A. The client will begin talking with other clients
- B. The client will express his feelings freely
- C. The client will increase his socialization with others
- D. The client will increase his reality orientation
Correct Answer: D
Rationale: Increasing reality orientation is the priority to ground the client before addressing socialization or emotional expression, given his current withdrawn state.