Nokea
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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A client is being released from the inpatient psychiatric unit with a diagnosis of schizophrenia and treatment with antipsychotic medications. After teaching the client and family about managing the disorder, the nurse determines that the teaching was effective when they state which of the following should be reported immediately?
- A. Elevated temperature
- B. Tremor
- C. Decreased blood pressure
- D. Weight gain
Correct Answer: A
Rationale: Elevated temperature (A) could indicate a serious side effect like neuroleptic malignant syndrome or infection (e.g., agranulocytosis with clozapine), requiring immediate reporting. Tremor (B), decreased blood pressure (C), and weight gain (D) are less urgent, though they warrant monitoring.
A group of nursing students is reviewing information about other psychotic disorders. The students demonstrate understanding of this information when they identify which disorder as involving an inducer?
- A. Brief psychotic disorder
- B. Schizophreniform disorder
- C. Shared psychotic disorder
- D. Psychotic disorder attributable to a substance
Correct Answer: C
Rationale: Shared psychotic disorder (C), or folie à deux, involves an inducer who transmits delusional beliefs to another person. Brief psychotic disorder (A) is time-limited, schizophreniform disorder (B) mimics schizophrenia, and substance-induced psychosis (D) is caused by substances, not an inducer.
After teaching a class on antipsychotic agents, the instructor determines that the teaching was successful when the class identifies which of the following as an example of a second-generation antipsychotic agent?
- A. Fluphenazine (Prolixin)
- B. Thiothixene (Navane)
- C. Quetiapine (Seroquel)
- D. Chlorpromazine (Thorazine)
Correct Answer: C
Rationale: Quetiapine (C) is a second-generation (atypical) antipsychotic, effective for schizophrenia with fewer extrapyramidal side effects. Fluphenazine (A), thiothixene (B), and chlorpromazine (D) are first-generation (typical) antipsychotics, associated with higher side effect risks.
A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer?
- A. Diphenhydramine (Benadryl)
- B. Propranolol (Inderal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: A
Rationale: Diphenhydramine (A), an antihistamine with anticholinergic properties, is commonly used to treat acute dystonic reactions caused by antipsychotics, relieving muscle spasms. Propranolol (B) treats akathisia, while risperidone (C) and aripiprazole (D) are antipsychotics that could worsen dystonia.
The nurse is caring for a client who was diagnosed with schizoaffective disorder. Based on the nurse?s understanding of this disorder, the nurse develops a plan of care to address which issue as the top priority?
- A. Suicide
- B. Aggression
- C. Substance abuse
- D. Eating disorder
Correct Answer: A
Rationale: Suicide (A) is the top priority in schizoaffective disorder due to the combined risk of mood disturbances (e.g., depression) and psychosis, both of which elevate suicide risk. Aggression (B), substance abuse (C), and eating disorders (D) are concerns but less immediate unless actively present.