Nokea
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.
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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 caring for a client who has been receiving treatment for schizophrenia with chlorpromazine for the past year. It would be essential for the nurse to monitor the client for which of the following?
- A. Weight loss
- B. Torticollis
- C. Hypoglycemia
- D. Tardive dyskinesia
Correct Answer: D
Rationale: Tardive dyskinesia (D), a potentially irreversible side effect of long-term use of typical antipsychotics like chlorpromazine, involves involuntary movements and requires ongoing monitoring. Weight loss (A) is unlikely (weight gain is more common), torticollis (B) is an acute dystonia, and hypoglycemia (C) is not a typical side effect.
A client with schizoaffective disorder is having difficulty adhering to the medication regimen that requires the use of several agents. The client also is experiencing several side effects contributing to this nonadherence. The physician plans to change the client?s medication. Which agent would the nurse anticipate that the physician would prescribe?
- A. Lithium
- B. Aripiprazole
- C. Clozapine
- D. Olanzapine
Correct Answer: B
Rationale: Aripiprazole (B) is a second-generation antipsychotic with a favorable side effect profile and efficacy for schizoaffective disorder, improving adherence. Lithium (A) is for mood stabilization, clozapine (C) is for treatment-resistant cases, and olanzapine (D) has more side effects.
Assessment of a client with schizophrenia reveals that he is hearing voices that tell him that people are staring at him and illusions. When developing the plan of care for this client, which nursing diagnosis would be most appropriate?
- A. Disturbed thought processes
- B. Risk for self-directed violence
- C. Disturbed sensory perception
- D. Ineffective coping
Correct Answer: C
Rationale: Disturbed sensory perception (C) is most appropriate, as the client?s hallucinations (voices) and illusions directly indicate altered sensory processing. Disturbed thought processes (A) is less specific, risk for violence (B) is not indicated, and ineffective coping (D) is secondary.
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.