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While caring for a hospitalized client with schizophrenia, the nurse observes that the client is listening to the radio. The client tells the nurse that the radio commentator is speaking directly to him. The nurse interprets this finding as which of the following?
- A. Autistic thinking
- B. Concrete thinking
- C. Referential thinking
- D. Illusional thinking
Correct Answer: C
Rationale: Referential thinking (C) describes the client?s belief that neutral events, like a radio broadcast, are personally directed at them, a common delusion in schizophrenia. Autistic thinking (A) involves private, illogical thoughts, concrete thinking (B) is overly literal interpretation, and illusional thinking (D) is not a standard term, making them incorrect.
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A client with schizoaffective disorder is prescribed clozapine to treat her symptoms. Which of the following instructions would the nurse provide?
- A. Keep a record of how often and how long you experience the side effect of dry mouth.
- B. Monitor your urinary output and notify your doctor if your urine changes color.
- C. Keep an eye on your weight, and if you gain weight rapidly, notify your doctor.
- D. If you experience any drowsiness, discontinue taking this medication.
Correct Answer: C
Rationale: Clozapine (C) is associated with significant weight gain, a metabolic side effect requiring monitoring and reporting if rapid. Dry mouth (A) is minor, urine color changes (B) are not typical, and discontinuing for drowsiness (D) is incorrect without medical guidance.
A nurse is working with a group of clients diagnosed with schizophrenia in a community setting. Which of the following would least likely be a priority?
- A. Improving the quality of life
- B. Instilling hope
- C. Managing psychosis
- D. Preventing relapse
Correct Answer: A
Rationale: While improving quality of life (A) is important, managing psychosis (C), preventing relapse (D), and instilling hope (B) are more immediate priorities in schizophrenia care to stabilize symptoms and maintain recovery. Quality of life is a longer-term goal.
While interviewing a client diagnosed with a delusional disorder, the client states, I have this really strange odor coming out of my mouth. I stop to brush my teeth almost every hour and then rinse with mouthwash every half hour to get rid of this smell. I?ve seen so many doctors, and they can?t tell me what?s wrong. The nurse interprets the client?s statement as reflecting which type of delusion?
- A. Erotomanic
- B. Grandiose
- C. Somatic
- D. Jealous
Correct Answer: C
Rationale: The client?s belief in a persistent, unexplained mouth odor reflects a somatic delusion (C), focusing on bodily concerns. Erotomanic (A) involves romantic beliefs, grandiose (B) involves inflated self-worth, and jealous (D) involves infidelity, none of which apply.
A client with schizophrenia tells the nurse, I?m being watched constantly by the FBI because of my job. Which response by the nurse would be most appropriate?
- A. Tell me more about how you are being watched.
- B. It must be frightening to feel like you?re always been watched.
- C. You?re not being watched; it?s all in your mind.
- D. You are experiencing a delusion because of your illness.
Correct Answer: B
Rationale: Empathizing with the client?s fear (B) validates their emotions without reinforcing the delusion, fostering trust. Asking for more details (A) may entrench the delusion, while dismissing (C) or labeling it (D) could alienate the client.
A group of nursing students is reviewing the various theories related to the etiology of schizophrenia. The students demonstrate understanding of the information when they identify which neurotransmitter as being responsible for hallucinations and delusions?
- A. Dopamine
- B. Serotonin
- C. Norepinephrine
- D. Gamma-amino butyric acid (GABA)
Correct Answer: A
Rationale: Dopamine (A) dysregulation, particularly excess in certain brain regions, is strongly linked to hallucinations and delusions in schizophrenia. Serotonin (B), norepinephrine (C), and GABA (D) play roles in other disorders or symptoms but are less directly associated with these psychotic features.