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The nurse reviews current literature and identifies that which of the following are included in current studies of biologic theories regarding the etiology of schizophrenia?
- A. That there is a particular pathologic structure associated with the disease.
- B. That genetics is the cause of schizophrenia.
- C. Persons with schizophrenia have decreased brain volume and abnormal brain function in the frontal and temporal areas of persons with schizophrenia.
- D. The brain activity of persons with schizophrenia differs from people who do not have schizophrenia.
- E. That the etiology of schizophrenia may be related to the body's response to exposure of a virus.
Correct Answer: B,C,D,E
Rationale: Biologic theories include genetics, decreased brain volume, abnormal brain function, and immunovirology (viral response), but no specific pathologic structure has been identified.
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The nurse enters the room of a client with schizophrenia the day after he has been admitted to an inpatient setting and says, 'I would like to spend some time talking with you.' The client stares straight ahead and remains silent. The best response by the nurse is,
- A. I can see you want to be alone. I'll come back another time.
- B. If you don't need to talk right now, I'll just sit here for a few minutes.
- C. I've got some other things I can do now. I hope you'll feel like talking later.
- D. You would feel better if you would tell me what you're thinking.
Correct Answer: B
Rationale: Sitting quietly shows acceptance and builds trust, supporting the client's limited tolerance for interaction, unlike leaving or assuming feelings.
A college freshman is admitted to the hospital with a diagnosis of schizophrenia. Friends reported that she had been in her room for 2 days in a trance-like state, not eating nor speaking to anyone. Which of the following is the highest priority for this client?
- A. Assessing fluid intake and output
- B. Completing an assessment of mental status
- C. Obtaining more data about her college experiences
- D. Providing for adequate rest
Correct Answer: A
Rationale: Assessing fluid intake and output prioritizes physiologic homeostasis, critical for a client not eating, over mental status, rest, or background data.
One evening, a client with schizophrenia leaves his room and begins marching in the hall. When approached by the nurse, the client says, 'Goodays I'm supposed to guard the area.' Which of the following responses would be best?
- A. I understand you hear a voice. You and I are the only ones in the hall, and I don't hear a voice.
- B. The voices are part of your illness, and they will leave in time.
- C. This guarding responsibility can make you tired. You rest for now, and I'll guard a while.
- D. You are just imagining these things. Do not pay any attention to the voices.
Correct Answer: A
Rationale: Acknowledging the client's experience while presenting reality validates their perception without reinforcing the delusion, unlike dismissive or reinforcing responses.
The parents of a young adult male who has schizophrenia ask how they can recognize when their son is beginning to relapse. The nurse teaches the family to look for which of the following?
- A. Excessive sleeping
- B. Fatigue
- C. Irritability
- D. Increased inhibition
- E. Negativity
Correct Answer: B,C,E
Rationale: Fatigue, irritability, and negativity are early relapse signs, unlike excessive sleeping or increased inhibition, which are less specific to schizophrenia relapse.
A client with schizophrenia reads the advice column in the newspaper daily. When asked why the client is so interested in the advice column, the client replies, 'This person is my guide and tells me what I must do every day.' The nurse would best describe this type of thinking as which of the following?
- A. Referential delusion
- B. Grandiose delusion
- C. Thought insertion
- D. Personalization
Correct Answer: A
Rationale: Believing the advice column has personal significance indicates a referential delusion, unlike grandiose delusions (exaggerated self-importance), thought insertion, or personalization.