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When assessing a client with delusional disorder, the nurse would most likely expect to find impairment in which of the following? Select all that apply.
- A. Social functioning
- B. Marital functioning
- C. Intellectual functioning
- D. Occupational functioning
- E. Mental status functioning
Correct Answer: A,B,D
Rationale: Delusional disorder often impairs social (A), marital (B), and occupational functioning (D) due to the impact of delusions on relationships and work. Intellectual (C) and mental status functioning (E) typically remain intact, as the disorder is focal.
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A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer?
- A. Diphenhydramine (Benadryl)
- B. Propranolol (Inderal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: A
Rationale: Diphenhydramine (A), an antihistamine with anticholinergic properties, is commonly used to treat acute dystonic reactions caused by antipsychotics, relieving muscle spasms. Propranolol (B) treats akathisia, while risperidone (C) and aripiprazole (D) are antipsychotics that could worsen dystonia.
A family member of a client diagnosed with schizoaffective disorder asks a nurse what causes the disorder. Which response by the nurse would be most appropriate?
- A. Dysfunctional family dynamics has been identified as a strong link.
- B. Research has suggested that the cause is predominately genetic.
- C. Dopamine, a substance in the brain, appears to be underactive.
- D. Studies have indicated that birth order is strongly associated with this disorder.
Correct Answer: B
Rationale: Research indicates a strong genetic component (B) in schizoaffective disorder, with heritability estimates similar to schizophrenia. Family dynamics (A) are not a primary cause, dopamine is overactive (C) in psychosis, and birth order (D) lacks evidence as a cause.
The nurse is caring for a hospitalized client who has schizophrenia. The client has been taking antipsychotic medications for 1 week when the nurse observes that the client?s eyes are fixed on the ceiling. The nurse interprets this finding as which of the following?
- A. Akathisia
- B. Oculogyric crisis
- C. Retrocollis
- D. Tardive dyskinesia
Correct Answer: B
Rationale: Oculogyric crisis (B) is an acute dystonic reaction characterized by fixed upward gaze, often caused by antipsychotics within days of starting treatment. Akathisia (A) involves restlessness, retrocollis (C) is neck muscle dystonia, and tardive dyskinesia (D) involves late-onset involuntary movements, none of which match the symptom.
The nurse is caring for a client diagnosed with a delusional disorder. While assessing this client, which of the following would the nurse expect to find?
- A. History of chronic major depression
- B. Consistently disrupting behavior patterns
- C. Verbalization of bizarre delusions
- D. Living with one or more delusions for a period of time
Correct Answer: D
Rationale: Delusional disorder (D) is characterized by persistent, non-bizarre delusions lasting at least one month without prominent mood or psychotic symptoms. Depression (A) is not typical, disruptive behavior (B) is uncommon, and delusions are not bizarre (C) but plausible.
The nurse is caring for an elderly client who has been taking an antipsychotic medication for 1 week. The nurse notifies the physician when he observes that the client has muscle rigidity that resembles Parkinson?s disease. Which agent would the nurse expect the physician to prescribe?
- A. Anticholinergic
- B. Anxiolytic
- C. Benzodiazepine
- D. Beta-blocker
Correct Answer: A
Rationale: Anticholinergic agents (A), such as benztropine, are used to treat extrapyramidal symptoms (EPS) like parkinsonian muscle rigidity caused by antipsychotics, by balancing acetylcholine and dopamine. Anxiolytics (B) and benzodiazepines (C) address anxiety, not EPS, and beta-blockers (D) treat akathisia or other symptoms, not rigidity.