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A group of nursing students is reviewing the various theories related to the etiology of schizophrenia. The students demonstrate understanding of the information when they identify which neurotransmitter as being responsible for hallucinations and delusions?
- A. Dopamine
- B. Serotonin
- C. Norepinephrine
- D. Gamma-amino butyric acid (GABA)
Correct Answer: A
Rationale: Dopamine (A) dysregulation, particularly excess in certain brain regions, is strongly linked to hallucinations and delusions in schizophrenia. Serotonin (B), norepinephrine (C), and GABA (D) play roles in other disorders or symptoms but are less directly associated with these psychotic features.
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When assessing a client with delusional disorder, the nurse would most likely expect to find impairment in which of the following? Select all that apply.
- A. Social functioning
- B. Marital functioning
- C. Intellectual functioning
- D. Occupational functioning
- E. Mental status functioning
Correct Answer: A,B,D
Rationale: Delusional disorder often impairs social (A), marital (B), and occupational functioning (D) due to the impact of delusions on relationships and work. Intellectual (C) and mental status functioning (E) typically remain intact, as the disorder is focal.
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.
The nurse is preparing to interview a client who has a delusional disorder. Which of the following would the nurse expect?
- A. Cognitive impairment
- B. Normal behavior
- C. Labile affect
- D. Evidence of motor symptoms
Correct Answer: B
Rationale: Clients with delusional disorder typically exhibit normal behavior (B) outside their specific delusions, with intact cognition and affect. Cognitive impairment (A), labile affect (C), and motor symptoms (D) are more characteristic of other psychotic disorders like schizophrenia.
A client hospitalized for treatment of schizophrenia has been receiving olanzapine (Zyprexa) for the past 2 months. The nurse would be especially alert for which of the following?
- A. Weight loss
- B. Hypertension
- C. Diarrhea
- D. Diabetes
Correct Answer: D
Rationale: Olanzapine (D) is associated with metabolic side effects, including an increased risk of diabetes due to weight gain and insulin resistance. Weight loss (A) is unlikely, hypertension (B) is less common, and diarrhea (C) is not a primary concern with olanzapine.
As part of an interdisciplinary team, a nurse is assisting in developing the plan of care for a client with a delusional disorder. Which of the following would the team be least likely to include in the plan?
- A. Insight-oriented therapy
- B. Psychoeducation
- C. Cognitive therapy
- D. Support therapy
Correct Answer: A
Rationale: Insight-oriented therapy (A) is least likely for delusional disorder, as clients often lack insight into their delusions, making this approach less effective. Psychoeducation (B), cognitive therapy (C), and support therapy (D) are more practical for managing symptoms and coping.