Nokea
A patient diagnosed with schizophrenia says, 'High heat. Last time here. Did you get a coat?' What type of verbalization is evident?
- A. Neologism
- B. Idea of reference
- C. Thought broadcasting
- D. Associative looseness
Correct Answer: D
Rationale: Looseness of association refers to jumbled thoughts incoherently expressed to the listener. Neologisms are newly coined words. Ideas of reference are a type of delusion. Thought broadcasting is the belief that others can hear one's thoughts.
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Patients diagnosed with schizophrenia who are suspicious and withdrawn generally present with what additional characteristic?
- A. Universally fear sexual involvement with therapists.
- B. Are socially disabled by the positive symptoms of schizophrenia.
- C. Exhibit a high degree of hostility as evidenced by rejecting behavior.
- D. Avoid relationships because they become anxious with emotional closeness.
Correct Answer: D
Rationale: When an individual is suspicious and distrustful and perceives the world and the people in it as potentially dangerous, withdrawal into an inner world can be a defense against uncomfortable levels of anxiety. When someone attempts to establish a relationship with such a patient, the patient's anxiety rises until trust is established. No evidence suggests that withdrawn patients with schizophrenia universally fear sexual involvement with therapists. In most cases, it is not considered true that withdrawn patients with schizophrenia are socially disabled by the positive symptoms of schizophrenia or exhibit a high degree of hostility by demonstrating rejecting behavior.
A patient diagnosed with schizophrenia begins a new prescription for lurasidone HCl. The patient is 5 feet 6 inches tall and currently weighs 204 pounds. Which topic is most important for the nurse to include in the teaching plan related to this medication?
- A. How to recognize tardive dyskinesia?
- B. Weight management strategies.
- C. Ways to manage constipation.
- D. Sleep hygiene measures.
Correct Answer: B
Rationale: Lurasidone HCl (Latuda) is an atypical antipsychotic medication. The incidence of weight gain, diabetes, and high cholesterol is high with this medication. The patient is overweight now, so weight management is especially important. The incidence of tardive dyskinesia is low with atypical antipsychotic medications. Constipation may occur, but it is less important than weight management. This drug usually produces drowsiness.
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 receiving risperidone reports severe muscle stiffness at 10:30 am. By noon, the patient is diaphoretic, drooling, and has difficulty swallowing. By 4:00 pm, vital signs are body temperature, 102.8°F; pulse, 110 beats/min; respirations, 26 breaths per minute; and blood pressure, 150/90 mm Hg. Select the nurse's best analysis and action.
- A. Agranulocytosis. Institute reverse isolation.
- B. Tardive dyskinesia. Withhold the next dose of medication.
- C. Cholestatic jaundice. Begin a high-protein, low-fat diet.
- D. Neuroleptic malignant syndrome. Immediately notify the health care provider.
Correct Answer: D
Rationale: Taking an antipsychotic medication coupled with the presence of extrapyramidal symptoms, such as severe muscle stiffness and difficulty swallowing, hyperpyrexia, and autonomic symptoms (pulse elevation), suggest neuroleptic malignant syndrome, a medical emergency. The symptoms given in this scenario are not consistent with the medical problems listed in the incorrect options.
A patient diagnosed with schizophrenia begins to talk about 'cracklomers' in the local shopping mall. The term 'cracklomers' should be documented using what term?
- A. Neologism
- B. Concrete thinking
- C. Thought insertion
- D. An idea of reference
Correct Answer: A
Rationale: A neologism is a newly coined word having special meaning to the patient. 'Cracklomers' is not a known word. Concrete thinking refers to the inability to think abstractly. Thought insertion refers to thoughts of others that are implanted in one's mind. An idea of reference is a type of delusion in which trivial events are given personal significance.