Schizophrenia

Question 1

The family of a client with schizophrenia asks the nurse about the difference between conventional and atypical antipsychotic medications. The nurse’s best answer may include which information?
a. Atypical antipsychotics are newer medications but act in the same ways as conventional antipsychotics.
b. Conventional antipsychotics are dopamine antagonists; atypical antipsychotics inhibit the reuptake of serotonin.
c. Conventional antipsychotics have serious side effects; atypical antipsychotics have virtually no side effects.
d. Atypical antipsychotics are dopamine and serotonin antagonists; conventional antipsychotics are only dopamine antagonists.

Answer 1

d. Atypical antipsychotics are dopamine and serotonin antagonists;
conventional antipsychotics are only dopamine antagonists.

Question 2

The nurse is planning discharge teaching for a client taking clozapine (Clozaril) (2nd gen anyipsychotic). Which teaching is essential to include?
a. Caution the client not to be outdoors in the sunshine without protective clothing.
b. Remind the client to go to the lab to have blood drawn for a white blood cell count.
c. Instruct the client about dietary restrictions.
d. Give the client a chart to record the daily pulse rate.

Answer 2

b. Remind the client to go to the lab to have blood drawn for a white blood cell count.

Question 3

Which of the following statements would indicate family teaching about schizophrenia had been effective?
a. “If our son takes his medication properly, he won’t have another psychotic episode.”
b. “I guess we’ll have to face the fact that our daughter will eventually be institutionalized.”
c. “It’s a relief to find out that we did not cause our son’s schizophrenia.”
d. “It is a shame our daughter will never be able to have children.”

Answer 3

c. “It’s a relief to find out that we did not cause our son’s schizophrenia.”

Question 4

When the client describes fear of leaving his apartment as well as the desire to get out and meet others, it is called
a. ambivalence.
b. anhedonia.
c. alogia.
d. avoidance.

Answer 4

a. ambivalence.

Question 5

The client who hesitates 30 seconds before responding to any question is described as having
a. blunted affect.
b. latency of response.
c. paranoid delusions.
d. poverty of speech.

Answer 5

b. latency of response.

Question 6

The overall goal of psychiatric rehabilitation is for the client to gain
a. control of symptoms.
b. freedom from hospitalization.
c. management of anxiety.
d. recovery from the illness.

Answer 6

d. recovery from the illness.

Question 7

Select all that apply.
A teaching plan for the client taking an antipsychotic medication will include which instructions?
a. Apply sunscreen before going outdoors.
b. Drink sugar-free beverages for dry mouth.
c. Have serum blood levels drawn once a month.
d. Rise slowly from a sitting position.
e. Skip any dose that is not taken on time.
f. Take medication with food to avoid nausea.

Answer 7

a, b, d

Question 8

Select all that apply.
Which of the following are considered to be positive signs of schizophrenia?
a. Anhedonia
b. Delusions
c. Hallucinations
d. Disorganized thinking
e. Illusions
f. Social withdrawal

Answer 8

b, c, d

Question 9

schizophrenia diagnostic criteria

Answer 9

• delusions
• hallucinations
• disorganized speech (e.g., frequent derailment or incoherence)
• grossly disorganized or catatonic behavior (little rxn to surroundings)
• negative symptoms, i.e., affective flattening, alogia, or avolition

Question 10

describe subtypes of schizophrenia (3).

Answer 10

 Schizophreniform Disorder: duration of more than 1 mth but less than 6 mths

 Schizoaffective Disorder (Not the same as Mood Disorder): schizophrenia+ mood disorder. The disturbance is not due to the direct physiologic effects of a substance
(e.g, illicit drugs, medications) or a general medical condition.
The bipolar type is diagnosed if the disturbance includes a manic or a mixed episode (or a manic or a mixed episode and major depressive
episodes

 Delusional Disorder: Characterized by the presence of non
bizarre delusions in the absence of other
mood or psychotic symptoms
1. Erotomania (Stalkers)
2. Paranoid
3. Persecutory
4. Grandiose
5. Somatic
6. Morbid Jealousy

Question 11

Discuss treatments of schizophrenia

Answer 11

1. electroconvulsive therapy (ECT): Administered under a light general anesthesia. used if resistant to other treatments
2. Psychosocial Treatment: multidisciplinary

Question 12

schizophrenia is a type of ___

Answer 12

Psychosis. other types include:
- Schizophrenia,
- Drug-related Psychosis (Usually recreational drugs),
- Brief reactive psychosis
- Psychosis 2nd to physical Illness (Thyroid disorders)
- Paranoid disorder
- Schizophreniform
disorder (<6 months
symptoms)
- Manic-depressive Psychosis (Bipolar
Disorders)