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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.
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A client hospitalized for treatment of schizophrenia has been receiving olanzapine (Zyprexa) for the past 2 months. The nurse would be especially alert for which of the following?
- A. Weight loss
- B. Hypertension
- C. Diarrhea
- D. Diabetes
Correct Answer: D
Rationale: Olanzapine (D) is associated with metabolic side effects, including an increased risk of diabetes due to weight gain and insulin resistance. Weight loss (A) is unlikely, hypertension (B) is less common, and diarrhea (C) is not a primary concern with olanzapine.
A client with schizoaffective disorder is having difficulty adhering to the medication regimen that requires the use of several agents. The client also is experiencing several side effects contributing to this nonadherence. The physician plans to change the client?s medication. Which agent would the nurse anticipate that the physician would prescribe?
- A. Lithium
- B. Aripiprazole
- C. Clozapine
- D. Olanzapine
Correct Answer: B
Rationale: Aripiprazole (B) is a second-generation antipsychotic with a favorable side effect profile and efficacy for schizoaffective disorder, improving adherence. Lithium (A) is for mood stabilization, clozapine (C) is for treatment-resistant cases, and olanzapine (D) has more side effects.
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.
The nurse is caring for a client who was diagnosed with schizoaffective disorder. Based on the nurse?s understanding of this disorder, the nurse develops a plan of care to address which issue as the top priority?
- A. Suicide
- B. Aggression
- C. Substance abuse
- D. Eating disorder
Correct Answer: A
Rationale: Suicide (A) is the top priority in schizoaffective disorder due to the combined risk of mood disturbances (e.g., depression) and psychosis, both of which elevate suicide risk. Aggression (B), substance abuse (C), and eating disorders (D) are concerns but less immediate unless actively present.
The nurse is assessing a newly admitted client diagnosed with schizoaffective disorder. The nurse assesses the client?s level of anxiety and reactions to stressful situations, obtaining this information for which reason?
- A. To help determine the client?s outcomes after treatment
- B. To help identify whether or not the client?s mental competency is intact
- C. To act as a predictor of the client?s risk for a suicide attempt
- D. To provide a basis for evaluating the client?s social skills
Correct Answer: C
Rationale: Assessing anxiety and stress reactions (C) in schizoaffective disorder helps predict suicide risk, as heightened anxiety can exacerbate mood and psychotic symptoms. Outcomes (A), competency (B), and social skills (D) are less directly tied to this assessment.