Nokea
Which nursing action is most helpful in managing the positive symptoms of schizophrenia?
- A. Therapeutic communication
- B. Physical activity
- C. Medication administration
- D. Drawing
Correct Answer: C
Rationale: Positive symptoms of schizophrenia include delusions, hallucinations, and fluent but disorganized speech. Positive symptoms are managed by medication administration. Therapeutic communication, physical activity, and drawing are excellent ways to express emotions.
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The nurse is caring for a 24-year-old client newly diagnosed with schizophrenia. The client asks: 'How could this be happening? What is wrong with my brain?' The nurse is most correct to identify which neurotransmitter as having the highest imbalance?
- A. Acetylcholine
- B. Dopamine
- C. Serotonin
- D. Gamma-aminobutyric acid
Correct Answer: B
Rationale: Schizophrenia is characterized as a psychobiologic disease because of findings in brain and neurotransmitter chemistry. Dopamine excess is believed to be the major cause of symptoms, with imbalance of norepinephrine, serotonin, and gamma-aminobutyric acid also playing a role.
A client diagnosed with schizophrenia is constantly repeating what others say. The nurse would document these symptoms as which of the following?
- A. Loose associations
- B. Delusions
- C. Echolalia
- D. Neologism
Correct Answer: C
Rationale: Echolalia is repeating what others say. Loose associations are a sequence of ideas that are slightly connected. Delusions are false beliefs that cannot be changed by logical reasoning. Neologism is the inventing of new words.
The nurse is teaching the family of clients with Alzheimer disease about the disease process. The nurse is using a picture of the brain and highlighting which structures?
- A. Neurotransmitters and cell receptors
- B. Neurofibrillary tangles and amyloid plaques
- C. Brain tissue and receptor sites
- D. Blood vessels with valves
Correct Answer: B
Rationale: The nurse is most correct to instruct the families on neurofibrillary tangles and amyloid plaques. These are characteristic in clients with Alzheimer disease. The other options may have some effect related to the disease but are not characteristic.
The nurse is caring for a client who has experienced readmission to the behavioral health unit for an exacerbation of schizophrenia. Which assessment question asked by the nurse identifies a possible cause for the return?
- A. Do you take a generic form of your medications?
- B. When was your last dose of medication?
- C. Are you having any side effects of the medication?
- D. Can you afford to purchase your medication?
Correct Answer: B
Rationale: The nurse is correct to identify that noncompliance with drug therapy is the leading cause of the return of disease symptoms and the need for short-term hospitalization. Asking when the client's last dose of medication was opens communication for when the medication was last administered. If it was not at the prescribed time, the conversation allows the nurse to probe why. Taking a generic medication does not change the effectiveness. Asking if the client can afford the medication or if the medication causes side effects does not directly address the question of noncompliance.
The nurse is providing community education regarding Alzheimer disease. Which client scenario is best for the client with progressing Alzheimer symptoms?
- A. Transfer the client to a behavioral health unit.
- B. Place the client in a personal care home.
- C. Place the client in a long-term care dementia unit.
- D. Maintain the client in the home and bring assistance to the care provider.
Correct Answer: D
Rationale: The best client scenario allows the client to remain in the familiar environment of the client's home while maintaining safety. Home health nurses and nurse aides can aid families in managing client care. Transferring clients to the behavioral health unit, to a personal care home, or a dementia unit all take the client from the home setting, which can be confusing.