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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.
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A client with schizophrenia is seen sitting alone and talking out loud. Suddenly, the client stops and turns as if listening to someone. The nurse approaches and sits down beside the client. Which of the following is the best initial response by the nurse?
- A. I can see you want to be alone. I'll come back another time.
- B. What are you hearing and seeing?
- C. I don't hear or see anyone else, what are you hearing and seeing?
- D. I can tell you are hearing voices but they are not real.
Correct Answer: C
Rationale: Asking what the client is experiencing while presenting reality validates their perception and encourages discussion, unlike dismissing, assuming, or denying the experience.
The nurse is assessing for negative symptoms of schizophrenia in a newly admitted client. The nurse would note which behavior as indicative of a negative symptom?
- A. Difficulty staying on subject when responding to assessment questions
- B. Belief of owning a transportation device allowing for travel to the center of the Earth
- C. Hesitant to answer the nurse's questions during the assessment interview
- D. Mimicking the postural changes made by the nurse during the assessment interview
Correct Answer: C
Rationale: Hesitancy to answer reflects alogia, a negative symptom, unlike associative looseness, delusions, or echopraxia, which are positive symptoms of schizophrenia.
The nurse observes a client with schizophrenia sitting alone, laughing occasionally, and turning his head as if listening to another person. The nurse assesses this behavior to indicate that the client is experiencing auditory hallucinations and says,
- A. Are you hearing something?
- B. It's a beautiful day, isn't it?
- C. Would you like to go to your room to talk?
- D. Would you like to take some of your PRN medication?
Correct Answer: A
Rationale: Asking if the client is hearing something validates the observed behavior and opens dialogue about hallucinations, unlike unrelated or premature interventions.
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.
All of the following are nursing diagnoses identified for a client with schizophrenia. The student nurse correctly anticipates which diagnosis will resolve when the client's negative symptoms improve?
- A. Impaired verbal communication
- B. Risk for other-directed violence
- C. Disturbed thought processes
- D. Social isolation
Correct Answer: D
Rationale: Social isolation, a negative symptom, improves with negative symptom reduction, unlike impaired communication, violence risk, or thought processes, which are positive symptom-related.