Nokea
The nurse is preparing to interview a client who has a delusional disorder. Which of the following would the nurse expect?
- A. Cognitive impairment
- B. Normal behavior
- C. Labile affect
- D. Evidence of motor symptoms
Correct Answer: B
Rationale: Clients with delusional disorder typically exhibit normal behavior (B) outside their specific delusions, with intact cognition and affect. Cognitive impairment (A), labile affect (C), and motor symptoms (D) are more characteristic of other psychotic disorders like schizophrenia.
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A client who has a major depressive episode tells the nurse that for the past 2 weeks, he has been hearing voices and at times thinks that someone is following him. History reveals that he had these alternating symptoms before along with times when he has experienced neither of these symptoms and has been able to function adequately. The nurse interprets these findings as suggesting which of the following?
- A. Paranoid schizophrenia
- B. Undifferentiated schizophrenia
- C. Brief psychotic disorder
- D. Schizoaffective disorder
Correct Answer: D
Rationale: Schizoaffective disorder (D) combines mood episodes (depression) with psychotic symptoms (hallucinations, paranoia) that persist but allow periods of adequate functioning, matching the client?s history. Paranoid (A) and undifferentiated schizophrenia (B) lack prominent mood components, and brief psychotic disorder (C) is shorter in duration.
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.
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 with schizophrenia tells the nurse, I?m being watched constantly by the FBI because of my job. Which response by the nurse would be most appropriate?
- A. Tell me more about how you are being watched.
- B. It must be frightening to feel like you?re always been watched.
- C. You?re not being watched; it?s all in your mind.
- D. You are experiencing a delusion because of your illness.
Correct Answer: B
Rationale: Empathizing with the client?s fear (B) validates their emotions without reinforcing the delusion, fostering trust. Asking for more details (A) may entrench the delusion, while dismissing (C) or labeling it (D) could alienate the client.
The nurse is interviewing a client with schizophrenia when the client begins to say, Kite, night, right, height, fright. The nurse documents this as which of the following?
- A. Clang association
- B. Stilted language
- C. Verbigeration
- D. Neologisms
Correct Answer: A
Rationale: Clang association (A) describes speech patterns where words are chosen for their sound (e.g., rhyming), as seen in the client?s list, common in schizophrenia. Stilted language (B) is overly formal, verbigeration (C) is repetitive phrases, and neologisms (D) are invented words, none of which fit.