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A family member of a client diagnosed with schizoaffective disorder asks a nurse what causes the disorder. Which response by the nurse would be most appropriate?
- A. Dysfunctional family dynamics has been identified as a strong link.
- B. Research has suggested that the cause is predominately genetic.
- C. Dopamine, a substance in the brain, appears to be underactive.
- D. Studies have indicated that birth order is strongly associated with this disorder.
Correct Answer: B
Rationale: Research indicates a strong genetic component (B) in schizoaffective disorder, with heritability estimates similar to schizophrenia. Family dynamics (A) are not a primary cause, dopamine is overactive (C) in psychosis, and birth order (D) lacks evidence as a cause.
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The nurse is caring for a client diagnosed with a delusional disorder. While assessing this client, which of the following would the nurse expect to find?
- A. History of chronic major depression
- B. Consistently disrupting behavior patterns
- C. Verbalization of bizarre delusions
- D. Living with one or more delusions for a period of time
Correct Answer: D
Rationale: Delusional disorder (D) is characterized by persistent, non-bizarre delusions lasting at least one month without prominent mood or psychotic symptoms. Depression (A) is not typical, disruptive behavior (B) is uncommon, and delusions are not bizarre (C) but plausible.
After assessing a client with schizophrenia, the nurse suspects that the client is experiencing an anticholinergic crisis. Which of the following would the nurse most likely have assessed? Select all that apply.
- A. Dilated reactive pupils
- B. Blurred vision
- C. Ataxia
- D. Coherent speech
- E. Facial pallor
- F. Disorientation
Correct Answer: B,C,F
Rationale: Anticholinergic crisis symptoms include blurred vision (B), ataxia (C), and disorientation (F) due to excessive anticholinergic effects (e.g., from medications). Dilated pupils (A) may occur but are less specific, coherent speech (D) is unlikely, and facial pallor (E) is not typical.
The nurse is caring for a client who has been taking clozapine (Clozaril) for 2 weeks. The client tells the nurse, My throat is sore, and I feel weak. The nurse assesses the client?s vital signs and finds that the client has a fever. The nurse notifies the physician, expecting an order to obtain which laboratory test?
- A. A white blood cell count
- B. Liver function studies
- C. Serum potassium level
- D. Serum sodium level
Correct Answer: A
Rationale: Clozapine (A) carries a risk of agranulocytosis, a potentially life-threatening drop in white blood cells, presenting with symptoms like sore throat, weakness, and fever. Monitoring white blood cell counts is critical. Liver function (B), potassium (C), and sodium (D) levels are less relevant to these symptoms.
A nurse is preparing an in-service program for a group of psychiatric-mental health nurses about schizophrenia. Which of the following would the nurse include as a major reason for relapse?
- A. Lack of family support
- B. Accessibility to community resources
- C. Non-adherence to prescribed medications
- D. Stigmatization of mental illness
Correct Answer: C
Rationale: Non-adherence to prescribed medications (C) is a primary cause of relapse in schizophrenia, as antipsychotics are critical for symptom control. Lack of family support (A) and stigmatization (D) contribute indirectly, while accessibility to resources (B) is a protective factor.
The nurse is assessing a newly admitted client diagnosed with schizoaffective disorder. The nurse assesses the client?s level of anxiety and reactions to stressful situations, obtaining this information for which reason?
- A. To help determine the client?s outcomes after treatment
- B. To help identify whether or not the client?s mental competency is intact
- C. To act as a predictor of the client?s risk for a suicide attempt
- D. To provide a basis for evaluating the client?s social skills
Correct Answer: C
Rationale: Assessing anxiety and stress reactions (C) in schizoaffective disorder helps predict suicide risk, as heightened anxiety can exacerbate mood and psychotic symptoms. Outcomes (A), competency (B), and social skills (D) are less directly tied to this assessment.