Nokea
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.
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A patient presenting with delusions of persecution about being poisoned has refused all hospital meals for 3 days. Which intervention is most likely to be acceptable to the patient?
- A. Allow the patient to have supervised access to food vending machines.
- B. Allow the patient to telephone a local restaurant to deliver meals.
- C. Offer to taste each portion on the tray for the patient.
- D. Begin tube feedings or total parenteral nutrition.
Correct Answer: A
Rationale: The patient who is delusional about food being poisoned is likely to believe restaurant food might still be poisoned and to say that the staff member tasting the food has taken an antidote to the poison before tasting. Attempts to tube feed or give nutrition intravenously are considered aggressive and usually promote violence. Patients often perceive foods in sealed containers, packages, or natural shells as being safe.
A patient diagnosed with schizophrenia says, 'Everyone has skin lice that jump on you and contaminate your blood.' Which problem is evident?
- A. Poverty of content
- B. Concrete thinking
- C. Neologisms
- D. Paranoia
Correct Answer: D
Rationale: The patient's unrealistic fear of contamination indicates paranoia. Neologisms are invented words. Concrete thinking involves literal interpretation. Poverty of content refers to an inadequate fund of information.
The family of a patient diagnosed with schizophrenia is unfamiliar with the illness and their role in recovery. Which type of therapy should the nurse recommend?
- A. Psychoeducational
- B. Psychoanalytic
- C. Transactional
- D. Family
Correct Answer: A
Rationale: A psychoeducational group explores the causes of schizophrenia, the role of medications, the significance of medication compliance, and the importance of support for the ill member of the family, and also provides recommendations for living with a person with schizophrenia. Such a group can be of practical assistance to the family members. The other types of therapy do not focus on psychoeducation.
A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social functioning. The patient is also overweight. Which drug should the nurse advocate?
- A. Clozapine
- B. Ziprasidone
- C. Olanzapine
- D. Aripiprazole
Correct Answer: D
Rationale: Aripiprazole is an atypical antipsychotic medication that is effective against both positive and negative symptoms of schizophrenia. It causes little or no weight gain and no increase in glucose, high- or low-density lipoprotein cholesterol levels, or triglycerides, making it a reasonable choice for a patient with obesity or heart disease. Clozapine may produce agranulocytosis, making it a poor choice as a first-line agent. Ziprasidone may prolong the QT interval, making it a poor choice for a patient with cardiac disease. Olanzapine fosters weight gain.
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.