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A student nurse is having a first experience in an inpatient psychiatric unit and is frightened by the behaviors of the clients with schizophrenia. The student should take which of the following actions to deal with fear?
- A. Express fear to the psychiatrist during rounds
- B. Pretend to not be afraid
- C. Stay in an open area while talking with the clients
- D. Insist that the clients behave appropriately
Correct Answer: C
Rationale: Staying in an open area ensures safety, addressing fear constructively, unlike pretending, expressing fear publicly, or demanding client behavior changes.
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During the nursing assessment, a client describes constantly hearing voices mumbling in the background. The client denies that the voices are telling him to do anything harmful. The nurse documents that the client is experiencing which of the following?
- A. Command hallucinations
- B. Auditory hallucinations
- C. Olfactory hallucinations
- D. Gustatory hallucinations
Correct Answer: B
Rationale: Hearing non-command voices indicates auditory hallucinations, the most common type in schizophrenia, distinct from command, olfactory, or gustatory hallucinations.
The nurse is assessing for negative symptoms of schizophrenia in a newly admitted client. The nurse would note which behavior as indicative of a negative symptom?
- A. Difficulty staying on subject when responding to assessment questions
- B. Belief of owning a transportation device allowing for travel to the center of the Earth
- C. Hesitant to answer the nurse's questions during the assessment interview
- D. Mimicking the postural changes made by the nurse during the assessment interview
Correct Answer: C
Rationale: Hesitancy to answer reflects alogia, a negative symptom, unlike associative looseness, delusions, or echopraxia, which are positive symptoms of schizophrenia.
A client with schizophrenia is seen sitting alone and talking out loud. Suddenly, the client stops and turns as if listening to someone. The nurse approaches and sits down beside the client. Which of the following is the best initial response by the nurse?
- A. I can see you want to be alone. I'll come back another time.
- B. What are you hearing and seeing?
- C. I don't hear or see anyone else, what are you hearing and seeing?
- D. I can tell you are hearing voices but they are not real.
Correct Answer: C
Rationale: Asking what the client is experiencing while presenting reality validates their perception and encourages discussion, unlike dismissing, assuming, or denying the experience.
The nurse is working with a client with schizophrenia, disorganized type. It is time for the client to get up and eat breakfast. Which of the following statements by the nurse would be most effective in helping the client prepare for breakfast?
- A. I'll expect you in the dining room in 20 minutes.
- B. It's time to put your dress on now.
- C. Stay right there and I'll get your clothes for you.
- D. Why don't you stay here and I'll get your tray for you.
Correct Answer: B
Rationale: Clear, simple directions like dressing support self-care in disorganized schizophrenia, unlike authoritarian demands or doing tasks for the client.
A client asks the nurse upon discharge, 'What should I do if I forget to take my medicine?' The nurse should explain to the client which of the following?
- A. Just double the dose next time it is scheduled.
- B. Skip that dose and resume your regular with the next dose.
- C. Don't miss doses, or you will not maintain therapeutic drug levels.
- D. If you remember within 3 to 4 hours later than it is due, take it then. If you remember more than 4 hours after it was due, do not take that dose.
Correct Answer: D
Rationale: Taking a missed dose within 3-4 hours maintains therapeutic levels, but skipping it if later avoids disruption, unlike doubling doses or vague warnings.