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Which of the following would be most important for the nurse to keep in mind when establishing the nurse-patient relationship with a client with schizophrenia to promote recovery?
- A. The relationship typically develops over a short period of time.
- B. Decisions about care are the responsibility of interdisciplinary team.
- C. Short, time-limited interactions are best for the client experiencing psychosis.
- D. Typically, clients with schizophrenia readily engage in a therapeutic relationship.
Correct Answer: C
Rationale: Short, time-limited interactions (C) are most effective for clients with schizophrenia experiencing psychosis, as they reduce overstimulation and build trust gradually. Relationships take time (A), interdisciplinary teams share decisions (B), and engagement is often challenging (D), not readily achieved.
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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 client who has been receiving treatment for schizophrenia with chlorpromazine for the past year. It would be essential for the nurse to monitor the client for which of the following?
- A. Weight loss
- B. Torticollis
- C. Hypoglycemia
- D. Tardive dyskinesia
Correct Answer: D
Rationale: Tardive dyskinesia (D), a potentially irreversible side effect of long-term use of typical antipsychotics like chlorpromazine, involves involuntary movements and requires ongoing monitoring. Weight loss (A) is unlikely (weight gain is more common), torticollis (B) is an acute dystonia, and hypoglycemia (C) is not a typical side effect.
A client with schizophrenia is prescribed clozapine because other prescribed medications have been ineffective. After teaching the client and family about the drug, the nurse determines that the teaching was successful when they state which of the following?
- A. He needs to have an electrocardiogram periodically when taking this drug.
- B. We?ll need to make sure that he has his blood count checked at least weekly.
- C. He might develop toxic levels of the drug if he smokes cigarettes.
- D. He needs to watch to make sure that he doesn?t lose too much weight.
Correct Answer: B
Rationale: Clozapine (B) requires weekly white blood cell counts due to the risk of agranulocytosis. Electrocardiograms (A) are not routine, smoking (C) affects clozapine metabolism but not toxicity directly, and weight loss (D) is unlikely (weight gain is more common).
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.
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.