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When performing discharge planning for a client who has schizophrenia, the nurse anticipates barriers to adhering to the medication regimen. The nurse assesses which of the following as improving the likelihood that the client will follow the prescribed medication regimen?
- A. Short-term memory intact
- B. History of missing appointments
- C. Receives monthly disability checks
- D. Walking is primary mode of transportation
- E. States location of pharmacy nearest his residence
Correct Answer: A,C,E
Rationale: Intact short-term memory, financial resources, and knowing the pharmacy location enhance medication adherence, unlike appointment history or transportation barriers.
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A client asks the nurse upon discharge, 'What should I do if I forget to take my medicine?' The nurse should explain to the client which of the following?
- A. Just double the dose next time it is scheduled.
- B. Skip that dose and resume your regular with the next dose.
- C. Don't miss doses, or you will not maintain therapeutic drug levels.
- D. If you remember within 3 to 4 hours later than it is due, take it then. If you remember more than 4 hours after it was due, do not take that dose.
Correct Answer: D
Rationale: Taking a missed dose within 3-4 hours maintains therapeutic levels, but skipping it if later avoids disruption, unlike doubling doses or vague warnings.
The most commonly supported neuroanatomic theory of schizophrenia suggests which etiology?
- A. Excessive amounts of dopamine and serotonin in the brain
- B. Ineffective ability of the brain to use dopamine and serotonin
- C. Insufficient amounts of dopamine in the brain
- D. Decreased brain tissue in the frontal and temporal regions of the brain
Correct Answer: D
Rationale: Decreased brain tissue in frontal and temporal regions is the primary neuroanatomic theory for schizophrenia etiology, unlike neurochemical theories involving dopamine or serotonin.
Which of the following attitudes would be best for the nurse when the client who has schizophrenia acts as though the nurse is not trustworthy or that his or her integrity is being questioned?
- A. That the client is correct and the nurse is not trustworthy
- B. That the client wants to insult the nurse
- C. That the client's behavior is a part of the illness
- D. That the nurse's actions have failed
Correct Answer: C
Rationale: Recognizing suspicious behavior as part of schizophrenia avoids personalizing it, maintaining therapeutic objectivity, unlike assuming distrust or failure.
The client with schizophrenia tells the nurse that rats have started to eat his brain. The best response by the nurse would be.
- A. Have you discussed this with your physician?
- B. How could that be possible?
- C. You cannot have rats in your brain.
- D. You look OK to me.
Correct Answer: A
Rationale: Referring to the physician for a new symptom like a delusion prompts potential medication review, unlike defensive, dismissive, or non-therapeutic responses.
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.