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A nurse is developing a teaching plan for a client with schizophrenia. Which method would the nurse use to be most effective?
- A. Engaging the client in trial and error learning
- B. Having the client write down information after directly being given the correct information
- C. Asking the client questions that encourage the client to guess at the correct answer
- D. Using visual aids that are very colorful and full of descriptive graphic images
Correct Answer: B
Rationale: Having the client write down information (B) reinforces learning through repetition and active engagement, accommodating cognitive deficits in schizophrenia. Trial and error (A) or guessing (C) may confuse, and colorful visuals (D) may overstimulate psychotic clients.
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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 an elderly client who has been taking an antipsychotic medication for 1 week. The nurse notifies the physician when he observes that the client has muscle rigidity that resembles Parkinson?s disease. Which agent would the nurse expect the physician to prescribe?
- A. Anticholinergic
- B. Anxiolytic
- C. Benzodiazepine
- D. Beta-blocker
Correct Answer: A
Rationale: Anticholinergic agents (A), such as benztropine, are used to treat extrapyramidal symptoms (EPS) like parkinsonian muscle rigidity caused by antipsychotics, by balancing acetylcholine and dopamine. Anxiolytics (B) and benzodiazepines (C) address anxiety, not EPS, and beta-blockers (D) treat akathisia or other symptoms, not rigidity.
When assessing a client for possible disordered water balance, the nurse checks the client?s urine specific gravity. Which result would lead the nurse to suspect that the client is experiencing severe disordered water balance?
- A. 1.02
- B. 1.011
- C. 1.005
- D. 1.002
Correct Answer: D
Rationale: A urine specific gravity of 1.002 (D) is extremely low, indicating overly dilute urine, consistent with severe disordered water balance (e.g., psychogenic polydipsia). Normal range is 1.010?1.030, so 1.020 (A) and 1.011 (B) are closer to normal, and 1.005 (C) is less severe.
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.
While assessing a client with schizophrenia, the client states, Everywhere I turn, the government is watching me because I know too much. They are afraid that I might go public with the information about all those conspiracies. The nurse interprets this statement as indicating which type of delusion?
- A. Grandiose
- B. Nihilistic
- C. Persecutory
- D. Somatic
Correct Answer: C
Rationale: The client?s belief that the government is watching them due to their knowledge reflects a persecutory delusion (C), characterized by fears of harm or surveillance. Grandiose delusions (A) involve inflated self-importance, nihilistic delusions (B) involve beliefs in nonexistence, and somatic delusions (D) focus on bodily concerns.