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A patient diagnosed with schizophrenia anxiously says, 'I can see the left side of my body merging with the wall, then my face appears and disappears in the mirror.' What phenomena is the patient describing?
- A. Derealization
- B. Concrete thinking
- C. Abstract thinking
- D. Depersonalization
Correct Answer: D
Rationale: Depersonalization: a nonspecific feeling of having lost one's identity; the self is different or unreal. People may be concerned that body parts do not belong to them, or they may have an acute sensation that the body has drastically changed. Derealization is the false perception that the environment has changed. Concrete thinking refers to an overemphasis on specific details and a literal interpretation of ideas. It is contrasted with abstract thinking. People who think in an abstract way look at the broader significance of ideas and information rather than the concrete details.
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A newly admitted patient diagnosed with schizophrenia is hypervigilant and constantly scans the environment. The patient states, 'I saw two doctors talking in the hall. They were plotting to kill me.' The nurse may correctly assess this as what classic behavior?
- A. Echolalia
- B. An idea of reference
- C. A delusion of infidelity
- D. An auditory hallucination
Correct Answer: B
Rationale: Ideas of reference are misinterpretations of the verbalizations or actions of others that give special personal meanings to these behaviors; for example, when seeing two people talking, the individual assumes they are talking about him or her. The other terms do not correspond with the scenario.
A patient diagnosed with schizophrenia says, 'My coworkers are out to get me. I also saw two doctors plotting to overdose me.' What term identifies how this patient is perceiving the environment?
- A. Disorganized
- B. Unpredictable
- C. Dangerous
- D. Bizarre
Correct Answer: C
Rationale: The patient sees the world as hostile and dangerous. This assessment is important because the nurse can be more effective by using empathy to respond to the patient. Data are not present to support any of the other options.
A nurse at the mental health clinic plans a series of psychoeducational groups for persons diagnosed with schizophrenia. Which two topics would take priority?
- A. How to complete an application for employment?
- B. The importance of correctly taking your medication.
- C. How to dress when attending community events?
- D. How to give and receive compliments?
- E. Ways to quit smoking.
Correct Answer: B,E
Rationale: Stabilization is maximized by the adherence to the antipsychotic medication regimen. Because so many patients with schizophrenia smoke cigarettes, this topic relates directly to the patients' physiological well-being. The other topics are also important but are not priority topics.
When a patient diagnosed with schizophrenia was discharged 6 months ago, haloperidol was prescribed. The patient now says, 'I stopped taking those pills. I didn't like how it made me feel.' What likely side effects did the patient experience?
- A. Sedation and muscle stiffness
- B. Sweating, nausea, and diarrhea
- C. Mild fever, sore throat, and skin rash
- D. Headache, watery eyes, and runny nose
Correct Answer: A
Rationale: Typical antipsychotic drugs often produce sedation and extrapyramidal side effects such as stiffness and gait disturbance. The side effects mentioned in the other options are usually not associated with typical antipsychotic therapy or would not have the effect described by the patient.
A patient's care plan includes monitoring for auditory hallucinations. Which assessment findings suggest the patient may be hallucinating?
- A. Aloofness, haughtiness, suspicion
- B. Darting eyes, tilted head, mumbling to self
- C. Elevated mood, hyperactivity, distractibility
- D. Performing rituals, avoiding open places
Correct Answer: B
Rationale: Clues to hallucinations include looking around the room as though to find the speaker; tilting the head to one side as though intently listening; and grimacing, mumbling, or talking aloud as though responding conversationally to someone.