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The nurse is caring for a client who was just admitted with a diagnosis of schizoaffective disorder with depression. Which agent would the nurse anticipate as being prescribed for this client?
- A. Lithium
- B. Haloperidol
- C. Chlorpromazine
- D. Clozapine
Correct Answer: D
Rationale: Clozapine (D) is effective for schizoaffective disorder, addressing both psychotic and mood symptoms, especially in treatment-resistant cases. Lithium (A) is primarily for bipolar disorder, and haloperidol (B) and chlorpromazine (C) are less effective for mood components.
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When obtaining a client?s history, the nurse determines that the client has been experiencing delusions and hallucinations for the past 3 months, which has caused some problems in his ability to function on a daily basis at work. He also is exhibiting catatonic excitement, echopraxia, loose associations, and pressured speech. The nurse suspects which of the following?
- A. Schizophrenia
- B. Schizoaffective disorder
- C. Brief Psychotic disorder
- D. Schizophreniform disorder
Correct Answer: D
Rationale: Schizophreniform disorder (D) involves schizophrenia-like symptoms (delusions, hallucinations, disorganized speech, catatonia) lasting 1?6 months, matching the client?s 3-month duration. Schizophrenia (A) requires 6+ months, schizoaffective disorder (B) requires mood episodes, and brief psychotic disorder (C) lasts less than 1 month.
A client with schizophrenia is prescribed clozapine because other prescribed medications have been ineffective. After teaching the client and family about the drug, the nurse determines that the teaching was successful when they state which of the following?
- A. He needs to have an electrocardiogram periodically when taking this drug.
- B. We?ll need to make sure that he has his blood count checked at least weekly.
- C. He might develop toxic levels of the drug if he smokes cigarettes.
- D. He needs to watch to make sure that he doesn?t lose too much weight.
Correct Answer: B
Rationale: Clozapine (B) requires weekly white blood cell counts due to the risk of agranulocytosis. Electrocardiograms (A) are not routine, smoking (C) affects clozapine metabolism but not toxicity directly, and weight loss (D) is unlikely (weight gain is more common).
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.
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.
A client has been diagnosed with schizophrenia. Assessment reveals that the client lives alone. His clothing is disheveled, his hair is uncombed and matted, and his body has a strange odor. During an interview, the client?s family voices a desire for the client to live with them when he is discharged. Based on the assessment findings, which nursing diagnosis would be the priority?
- A. Ineffective Role Performance related to symptoms of schizophrenia.
- B. Social Isolation related to auditory hallucinations.
- C. Dysfunctional Family Processes related to psychosis.
- D. Bathing Self-Care Deficit related to symptoms of schizophrenia.
Correct Answer: D
Rationale: Bathing Self-Care Deficit (D) is the priority nursing diagnosis, as the client?s disheveled appearance, matted hair, and body odor indicate an immediate inability to maintain personal hygiene, which affects health and social integration. Ineffective Role Performance (A) and Social Isolation (B) are relevant but secondary, and Dysfunctional Family Processes (C) is not supported by the family?s supportive stance.