Nokea
The nurse is caring for a client who was diagnosed with schizoaffective disorder. Based on the nurse?s understanding of this disorder, the nurse develops a plan of care to address which issue as the top priority?
- A. Suicide
- B. Aggression
- C. Substance abuse
- D. Eating disorder
Correct Answer: A
Rationale: Suicide (A) is the top priority in schizoaffective disorder due to the combined risk of mood disturbances (e.g., depression) and psychosis, both of which elevate suicide risk. Aggression (B), substance abuse (C), and eating disorders (D) are concerns but less immediate unless actively present.
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A nurse is providing care to a client just recently diagnosed with schizophrenia during an inpatient hospital stay. Throughout the day, the nurse observes the client drinking from the water fountain quite frequently as well as carrying cans of soda and bottles of water with him wherever he goes. Upon entering the client?s room, the nurse sees numerous empty cups that had been filled with fluids on his table and in the trash can. The room has an odor of urine. The nurse suspects which of the following?
- A. Diabetes mellitus
- B. Disordered water balance
- C. Tardive dyskinesia
- D. Orthostatic hypotension
Correct Answer: B
Rationale: Excessive fluid intake and urine odor suggest disordered water balance (B), such as psychogenic polydipsia, common in schizophrenia, leading to excessive drinking and urination. Diabetes mellitus (A) may cause thirst but not typically urine odor in this context. Tardive dyskinesia (C) and orthostatic hypotension (D) are unrelated to these symptoms.
The nurse is caring for a client in an inpatient mental health setting. The nurse notices that when the client is conversing with other clients, he repeats what they are saying word for word. The nurse interprets this finding and documents it as which of the following?
- A. Echopraxia
- B. Neologisms
- C. Tangentiality
- D. Echolalia
Correct Answer: D
Rationale: Echolalia (D) is the correct term for the client?s behavior of repeating others? words verbatim, a common symptom in schizophrenia or other psychotic disorders, reflecting impaired communication processing. Echopraxia (A) involves mimicking movements, not speech. Neologisms (B) are made-up words, and tangentiality (C) refers to responses that veer off-topic, neither of which apply here.
The nurse is assessing a newly admitted client diagnosed with schizoaffective disorder. The nurse assesses the client?s level of anxiety and reactions to stressful situations, obtaining this information for which reason?
- A. To help determine the client?s outcomes after treatment
- B. To help identify whether or not the client?s mental competency is intact
- C. To act as a predictor of the client?s risk for a suicide attempt
- D. To provide a basis for evaluating the client?s social skills
Correct Answer: C
Rationale: Assessing anxiety and stress reactions (C) in schizoaffective disorder helps predict suicide risk, as heightened anxiety can exacerbate mood and psychotic symptoms. Outcomes (A), competency (B), and social skills (D) are less directly tied to this assessment.
A nurse is preparing an in-service program for a group of psychiatric-mental health nurses about schizophrenia. Which of the following would the nurse include as a major reason for relapse?
- A. Lack of family support
- B. Accessibility to community resources
- C. Non-adherence to prescribed medications
- D. Stigmatization of mental illness
Correct Answer: C
Rationale: Non-adherence to prescribed medications (C) is a primary cause of relapse in schizophrenia, as antipsychotics are critical for symptom control. Lack of family support (A) and stigmatization (D) contribute indirectly, while accessibility to resources (B) is a protective factor.
A client is being released from the inpatient psychiatric unit with a diagnosis of schizophrenia and treatment with antipsychotic medications. After teaching the client and family about managing the disorder, the nurse determines that the teaching was effective when they state which of the following should be reported immediately?
- A. Elevated temperature
- B. Tremor
- C. Decreased blood pressure
- D. Weight gain
Correct Answer: A
Rationale: Elevated temperature (A) could indicate a serious side effect like neuroleptic malignant syndrome or infection (e.g., agranulocytosis with clozapine), requiring immediate reporting. Tremor (B), decreased blood pressure (C), and weight gain (D) are less urgent, though they warrant monitoring.