Nokea
The nurse is caring for a client who has been receiving treatment for schizophrenia with chlorpromazine for the past year. It would be essential for the nurse to monitor the client for which of the following?
- A. Weight loss
- B. Torticollis
- C. Hypoglycemia
- D. Tardive dyskinesia
Correct Answer: D
Rationale: Tardive dyskinesia (D), a potentially irreversible side effect of long-term use of typical antipsychotics like chlorpromazine, involves involuntary movements and requires ongoing monitoring. Weight loss (A) is unlikely (weight gain is more common), torticollis (B) is an acute dystonia, and hypoglycemia (C) is not a typical side effect.
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A family member of a client diagnosed with schizoaffective disorder asks a nurse what causes the disorder. Which response by the nurse would be most appropriate?
- A. Dysfunctional family dynamics has been identified as a strong link.
- B. Research has suggested that the cause is predominately genetic.
- C. Dopamine, a substance in the brain, appears to be underactive.
- D. Studies have indicated that birth order is strongly associated with this disorder.
Correct Answer: B
Rationale: Research indicates a strong genetic component (B) in schizoaffective disorder, with heritability estimates similar to schizophrenia. Family dynamics (A) are not a primary cause, dopamine is overactive (C) in psychosis, and birth order (D) lacks evidence as a cause.
When assessing a client for possible disordered water balance, the nurse checks the client?s urine specific gravity. Which result would lead the nurse to suspect that the client is experiencing severe disordered water balance?
- A. 1.02
- B. 1.011
- C. 1.005
- D. 1.002
Correct Answer: D
Rationale: A urine specific gravity of 1.002 (D) is extremely low, indicating overly dilute urine, consistent with severe disordered water balance (e.g., psychogenic polydipsia). Normal range is 1.010?1.030, so 1.020 (A) and 1.011 (B) are closer to normal, and 1.005 (C) is less severe.
While assessing a client with schizophrenia, the client states, Everywhere I turn, the government is watching me because I know too much. They are afraid that I might go public with the information about all those conspiracies. The nurse interprets this statement as indicating which type of delusion?
- A. Grandiose
- B. Nihilistic
- C. Persecutory
- D. Somatic
Correct Answer: C
Rationale: The client?s belief that the government is watching them due to their knowledge reflects a persecutory delusion (C), characterized by fears of harm or surveillance. Grandiose delusions (A) involve inflated self-importance, nihilistic delusions (B) involve beliefs in nonexistence, and somatic delusions (D) focus on bodily concerns.
While interviewing a client diagnosed with a delusional disorder, the client states, I have this really strange odor coming out of my mouth. I stop to brush my teeth almost every hour and then rinse with mouthwash every half hour to get rid of this smell. I?ve seen so many doctors, and they can?t tell me what?s wrong. The nurse interprets the client?s statement as reflecting which type of delusion?
- A. Erotomanic
- B. Grandiose
- C. Somatic
- D. Jealous
Correct Answer: C
Rationale: The client?s belief in a persistent, unexplained mouth odor reflects a somatic delusion (C), focusing on bodily concerns. Erotomanic (A) involves romantic beliefs, grandiose (B) involves inflated self-worth, and jealous (D) involves infidelity, none of which apply.
After teaching a group of students about the epidemiology of schizoaffective disorder, the instructor determines that the teaching was successful when the students state which of the following?
- A. The disorder occurs often in children.
- B. It is more likely to occur in women.
- C. Most persons are African Americans.
- D. The disorder is rare in family relatives.
Correct Answer: B
Rationale: Schizoaffective disorder (B) is more prevalent in women, possibly due to hormonal or genetic factors. It is rare in children (A), not specific to African Americans (C), and has a genetic component, making it more common in relatives (D).