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A client with schizophrenia is attending a follow-up appointment at the community mental health clinic. The client reports to the nurse, 'I stopped taking the antipsychotic medication because I can't get a hard-on with my girlfriend anymore.' Which of the following should the nurse recommend to enhance the client's well-being?
- A. It sounds like that is a problem for you. Don't you still find her to be sexy enough?
- B. Sexual dysfunction is a temporary side effect and should get better once your body is used to the medication.
- C. You should avoid having sex with your girlfriend anyway. Do you really want her to get pregnant?
- D. It is important for you to take an antipsychotic medication. You may need a different type that will be less likely to affect your sexual functioning. I would like to call your physician about this.
Correct Answer: D
Rationale: Suggesting a medication change addresses sexual dysfunction, a common side effect, promoting adherence and well-being, unlike dismissive or inappropriate responses.
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A client with schizophrenia is reluctant to take his prescribed oral medication. The most therapeutic response by the nurse to this refusal is,
- A. I can see that you're uncomfortable now, so we can wait until tomorrow.
- B. If you refuse these pills, you'll have to get an injection.
- C. What is it about the medicine that you don't like?
- D. You know you have to take this medicine for your own good.
Correct Answer: C
Rationale: Exploring reasons for medication refusal addresses barriers to compliance, fostering collaboration, unlike threats, delays, or non-therapeutic insistence.
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.
The client with schizophrenia makes the following statement. 'I just don't know how to count. The sky turned to fire. I have a ball in my head.' The nurse documents this entire statement as an example of
- A. Flight of ideas
- B. Ideas of reference
- C. Delusional thinking
- D. Associative looseness
Correct Answer: D
Rationale: The fragmented, poorly related thoughts demonstrate associative looseness, not flight of ideas (rapid but connected thoughts), ideas of reference, or solely delusional thinking.
The most commonly supported neuroanatomic theory of schizophrenia suggests which etiology?
- A. Excessive amounts of dopamine and serotonin in the brain
- B. Ineffective ability of the brain to use dopamine and serotonin
- C. Insufficient amounts of dopamine in the brain
- D. Decreased brain tissue in the frontal and temporal regions of the brain
Correct Answer: D
Rationale: Decreased brain tissue in frontal and temporal regions is the primary neuroanatomic theory for schizophrenia etiology, unlike neurochemical theories involving dopamine or serotonin.
The parents of a young adult male who has schizophrenia ask how they can recognize when their son is beginning to relapse. The nurse teaches the family to look for which of the following?
- A. Excessive sleeping
- B. Fatigue
- C. Irritability
- D. Increased inhibition
- E. Negativity
Correct Answer: B,C,E
Rationale: Fatigue, irritability, and negativity are early relapse signs, unlike excessive sleeping or increased inhibition, which are less specific to schizophrenia relapse.