Nokea
A client with schizophrenia has returned to the clinic because of an increase in symptoms. The client reports he stopped taking his meds because he did not like the side effects. The nurse educates the client about managing uncomfortable side effects. Which of the following is included in the teaching plan?
- A. Suck on hard candy as desired
- B. Spend at least 30 minutes outside in the sun daily
- C. Use stool softeners as needed
- D. Decrease the amount of daily fluid intake
- E. Maintain a balanced calorie-controlled diet
Correct Answer: A,C,E
Rationale: Managing side effects like dry mouth (candy), constipation (stool softeners), and weight gain (diet) supports adherence, unlike increased sun exposure or reduced fluid intake.
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The client with schizophrenia believes the student nurses are there to spy on the clients. The client is suffering from which of the following symptoms?
- A. Hallucinations
- B. Delusions
- C. Anhedonia
- D. Ideas of reference
Correct Answer: B
Rationale: Believing nurses are spying indicates delusions, fixed false beliefs, distinct from hallucinations (false perceptions), anhedonia (lack of pleasure), or ideas of reference (external events with personal meaning).
A client asks the nurse upon discharge, 'What should I do if I forget to take my medicine?' The nurse should explain to the client which of the following?
- A. Just double the dose next time it is scheduled.
- B. Skip that dose and resume your regular with the next dose.
- C. Don't miss doses, or you will not maintain therapeutic drug levels.
- D. If you remember within 3 to 4 hours later than it is due, take it then. If you remember more than 4 hours after it was due, do not take that dose.
Correct Answer: D
Rationale: Taking a missed dose within 3-4 hours maintains therapeutic levels, but skipping it if later avoids disruption, unlike doubling doses or vague warnings.
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.
During the nursing assessment, a client describes constantly hearing voices mumbling in the background. The client denies that the voices are telling him to do anything harmful. The nurse documents that the client is experiencing which of the following?
- A. Command hallucinations
- B. Auditory hallucinations
- C. Olfactory hallucinations
- D. Gustatory hallucinations
Correct Answer: B
Rationale: Hearing non-command voices indicates auditory hallucinations, the most common type in schizophrenia, distinct from command, olfactory, or gustatory hallucinations.
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.