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The nurse is caring for a client diagnosed with a delusional disorder. While assessing this client, which of the following would the nurse expect to find?
- A. History of chronic major depression
- B. Consistently disrupting behavior patterns
- C. Verbalization of bizarre delusions
- D. Living with one or more delusions for a period of time
Correct Answer: D
Rationale: Delusional disorder (D) is characterized by persistent, non-bizarre delusions lasting at least one month without prominent mood or psychotic symptoms. Depression (A) is not typical, disruptive behavior (B) is uncommon, and delusions are not bizarre (C) but plausible.
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A client with schizoaffective disorder is prescribed clozapine to treat her symptoms. Which of the following instructions would the nurse provide?
- A. Keep a record of how often and how long you experience the side effect of dry mouth.
- B. Monitor your urinary output and notify your doctor if your urine changes color.
- C. Keep an eye on your weight, and if you gain weight rapidly, notify your doctor.
- D. If you experience any drowsiness, discontinue taking this medication.
Correct Answer: C
Rationale: Clozapine (C) is associated with significant weight gain, a metabolic side effect requiring monitoring and reporting if rapid. Dry mouth (A) is minor, urine color changes (B) are not typical, and discontinuing for drowsiness (D) is incorrect without medical guidance.
A client hospitalized for treatment of schizophrenia has been receiving olanzapine (Zyprexa) for the past 2 months. The nurse would be especially alert for which of the following?
- A. Weight loss
- B. Hypertension
- C. Diarrhea
- D. Diabetes
Correct Answer: D
Rationale: Olanzapine (D) is associated with metabolic side effects, including an increased risk of diabetes due to weight gain and insulin resistance. Weight loss (A) is unlikely, hypertension (B) is less common, and diarrhea (C) is not a primary concern with olanzapine.
Which of the following would be most important for the nurse to keep in mind when establishing the nurse-patient relationship with a client with schizophrenia to promote recovery?
- A. The relationship typically develops over a short period of time.
- B. Decisions about care are the responsibility of interdisciplinary team.
- C. Short, time-limited interactions are best for the client experiencing psychosis.
- D. Typically, clients with schizophrenia readily engage in a therapeutic relationship.
Correct Answer: C
Rationale: Short, time-limited interactions (C) are most effective for clients with schizophrenia experiencing psychosis, as they reduce overstimulation and build trust gradually. Relationships take time (A), interdisciplinary teams share decisions (B), and engagement is often challenging (D), not readily achieved.
A group of nursing students is reviewing information about other psychotic disorders. The students demonstrate understanding of this information when they identify which disorder as involving an inducer?
- A. Brief psychotic disorder
- B. Schizophreniform disorder
- C. Shared psychotic disorder
- D. Psychotic disorder attributable to a substance
Correct Answer: C
Rationale: Shared psychotic disorder (C), or folie à deux, involves an inducer who transmits delusional beliefs to another person. Brief psychotic disorder (A) is time-limited, schizophreniform disorder (B) mimics schizophrenia, and substance-induced psychosis (D) is caused by substances, not an inducer.
The nurse is caring for a hospitalized client who has schizophrenia. The client has been taking antipsychotic medications for 1 week when the nurse observes that the client?s eyes are fixed on the ceiling. The nurse interprets this finding as which of the following?
- A. Akathisia
- B. Oculogyric crisis
- C. Retrocollis
- D. Tardive dyskinesia
Correct Answer: B
Rationale: Oculogyric crisis (B) is an acute dystonic reaction characterized by fixed upward gaze, often caused by antipsychotics within days of starting treatment. Akathisia (A) involves restlessness, retrocollis (C) is neck muscle dystonia, and tardive dyskinesia (D) involves late-onset involuntary movements, none of which match the symptom.