Nokea
All of the following are nursing diagnoses identified for a client with schizophrenia. The student nurse correctly anticipates which diagnosis will resolve when the client's negative symptoms improve?
- A. Impaired verbal communication
- B. Risk for other-directed violence
- C. Disturbed thought processes
- D. Social isolation
Correct Answer: D
Rationale: Social isolation, a negative symptom, improves with negative symptom reduction, unlike impaired communication, violence risk, or thought processes, which are positive symptom-related.
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The nurse enters the room of a client with schizophrenia the day after he has been admitted to an inpatient setting and says, 'I would like to spend some time talking with you.' The client stares straight ahead and remains silent. The best response by the nurse is,
- A. I can see you want to be alone. I'll come back another time.
- B. If you don't need to talk right now, I'll just sit here for a few minutes.
- C. I've got some other things I can do now. I hope you'll feel like talking later.
- D. You would feel better if you would tell me what you're thinking.
Correct Answer: B
Rationale: Sitting quietly shows acceptance and builds trust, supporting the client's limited tolerance for interaction, unlike leaving or assuming feelings.
A client with schizophrenia is attending a follow-up appointment at the community mental health clinic. The client reports to the nurse, 'I stopped taking the antipsychotic medication because I can't get a hard-on with my girlfriend anymore.' Which of the following should the nurse recommend to enhance the client's well-being?
- A. It sounds like that is a problem for you. Don't you still find her to be sexy enough?
- B. Sexual dysfunction is a temporary side effect and should get better once your body is used to the medication.
- C. You should avoid having sex with your girlfriend anyway. Do you really want her to get pregnant?
- D. It is important for you to take an antipsychotic medication. You may need a different type that will be less likely to affect your sexual functioning. I would like to call your physician about this.
Correct Answer: D
Rationale: Suggesting a medication change addresses sexual dysfunction, a common side effect, promoting adherence and well-being, unlike dismissive or inappropriate responses.
The nurse is preparing a client with schizophrenia for discharge. The nurse asks the client, 'How are you going to care for yourself at home?' The purpose of the nurse's question is to assess the client's
- A. Self concept
- B. Judgment
- C. Insight
- D. Social support system
Correct Answer: C
Rationale: Asking about self-care plans assesses insight, the client's awareness of their illness and ability to manage it, unlike self-concept, judgment, or social support.
The nurse observes a client with schizophrenia sitting alone, laughing occasionally, and turning his head as if listening to another person. The nurse assesses this behavior to indicate that the client is experiencing auditory hallucinations and says,
- A. Are you hearing something?
- B. It's a beautiful day, isn't it?
- C. Would you like to go to your room to talk?
- D. Would you like to take some of your PRN medication?
Correct Answer: A
Rationale: Asking if the client is hearing something validates the observed behavior and opens dialogue about hallucinations, unlike unrelated or premature interventions.
When performing discharge planning for a client who has schizophrenia, the nurse anticipates barriers to adhering to the medication regimen. The nurse assesses which of the following as improving the likelihood that the client will follow the prescribed medication regimen?
- A. Short-term memory intact
- B. History of missing appointments
- C. Receives monthly disability checks
- D. Walking is primary mode of transportation
- E. States location of pharmacy nearest his residence
Correct Answer: A,C,E
Rationale: Intact short-term memory, financial resources, and knowing the pharmacy location enhance medication adherence, unlike appointment history or transportation barriers.