A psychiatric-mental health nurse is aripiprazole are antipsychotics that may

teaching a class about schizophrenia. cause dystonic reactions.

When describing delusions, which Trihexyphenidyl is used to treat
information would the nurse most likely parkinsonism due to antipsychotic
include? drugs.
You Selected: A client with schizoaffective disorder is
​ They may include elements of a engaging in an extremely long
situation that could occur in real conversation about a current affairs in
life. the world. The client goes on to provide
the nurse with minute details. The nurse
Correct response: interprets this as suggesting what?
​ They may include elements of a You Selected:
situation that could occur in real
life. ​ Circumstantiality
Correct response:
Explanation:

Delusions are fixed, false beliefs that ​ Circumstantiality

cannot be changed by conflicting Explanation:
evidence. They can be situations that
The client is demonstrating
could occur in real life and are plausible
circumstantiality, which refers to
in the context of the person’s ethnic and
extremely detailed and lengthy
cultural background, or they may be
discourse about a topic.This can be
clearly fantastical. They usually involve
commonly found in a client with
a misinterpretation of the client's
euphoric or elevated mood due to the
experience.
affective component of schizoaffective
disorder. Clang associations are ideas
Which would a nurse expect to that are related to one another based on
administer to a client with schizophrenia sound or rhyming rather than meaning.
who is experiencing a dystonic reaction? Neologisms are words invented by the
You Selected: client. A verbigeration is the stereotyped
repetition of words or phrases that may
​ Risperidone or may not have meaning to the listener.
Correct response:
A hospitalized client diagnosed with
​ Benztropine schizophrenia is receiving antipsychotic
Explanation:
medications. While assessing the client,
a nurse identifies signs and symptoms
A client experiencing a dystonic reaction of a dystonic reaction. Which agent
should receive immediate treatment with would the nurse expect to administer?
benztropine. Risperidone and
You Selected:
 ​ Propranolol frightening to occur. Retardation refers
to slowed movements.
Correct response:

​ Diphenhydramine A client with schizophrenia is prescribed

clozapine. The nurse would monitor the
Explanation: client closely for specific signs of:
For dystonic reactions, the drug of You Selected:
choice is benztropine mesylate or
diphenhydramine. Propranolol could be ​ nausea.
used to treat akathisia. Risperidone and Correct response:
aripiprazole are antipsychotic agents
​ infection.
used to treat schizophrenia.
Explanation:
A client is admitted to the psychiatric
hospital with a diagnosis of Agranulocytosis can develop with the
schizophrenia. During the physical use of all antipsychotic drugs, but it is
examination, the client's arm remains most likely to develop with clozapine
outstretched after the nurse obtains the use. Therefore, the nurse needs to be
pulse and blood pressure, and the nurse alert for signs of infection, particularly
must reposition the arm. The nurse bacterial infection. Hypotension may
interprets this as what? occur with any antipsychotic drug.
Nausea is a common side effect of
You Selected:
many drugs. Weight gain, not loss, can
​ Waxy flexibility occur with olanzapine and clozapine.
Correct response: A psychiatric-mental health nurse is
​ Waxy flexibility conducting a review class for a group of
colleagues about schizoaffective
Explanation: disorder. The nurse determines that the
Waxy flexibility, the ability to assume class was successful based on which
and maintain awkward or uncomfortable description of the condition by the
positions for long periods, is group?
characteristic of catatonic You Selected:
schizophrenia. Clients commonly remain
in these awkward positions until ​ Delusions are present but
someone repositions them. Exchopraxia hallucinations are absent.
refers to the involuntary imitation of Correct response:
another person's movements and
​ Clients are often misdiagnosed
gestures. Hypervigilance refers to the
as having schizophrenia.
sustained attention to external stimuli,
as if expecting something important or Explanation:
Mental health providers find SAD difficult A client diagnosed with schizophrenia
to conceptualize, diagnose, and treat has been prescribed clozapine. Which is
because of the variable clinical course. a potentially fatal side effect of this
Clients are often misdiagnosed as medication?
having schizophrenia. To be diagnosed
You Selected:
with SAD, a client must have an
uninterrupted period of illness when ​ Tardive dyskinesia
there is a major depressive, manic, or Correct response:
mixed episode along with two of the
​ Agranulocytosis
following symptoms of schizophrenia:
delusions, hallucinations, disorganized Explanation:
speech, disorganized or catatonic
Agranulocytosis is manifested by a
behavior, or negative symptoms (e.g.,
failure of the bone marrow to produce
diminished emotional expression,
adequate white blood cells. Neuroleptic
alogia, or avolition). In addition, the
malignant syndrome is a life-threatening
positive symptoms (delusions or
reaction to neuroleptic medication that
hallucinations) must be present without
requires immediate treatment. Tardive
the mood symptoms at some time
dyskinesia causes involuntary
during this period (for at least 2 weeks).
movements of the tongue, mouth, facial
The nurse is developing a care plan for muscles, and arm and leg muscles.
a client with somatic delusions. Which Dystonia is characterized by cramps
would be an appropriate nursing and rigidity of the tongue, face, neck,
diagnosis for this client? and back muscles.
You Selected: When assuming the management of the
​ Disturbed thought process care of a delusional client, which should
be the nurse's priority intervention?
Correct response:
You Selected:
​ Disturbed thought process
​ Assure the client that he or she
Explanation: is safe in this milieu
The most appropriate nursing diagnosis Correct response:
for this client is disturbed thought
​ Assure the client that he or she
process related to misperception of
is safe in this milieu
environmental stimuli. Disturbed sleep
pattern, risk for self-directed violence, Explanation:
and chronic low self-esteem would not
Assuring the client that he or she is in a
be the most appropriate nursing
safe environment is the first step in the
diagnosis for this client.
establishment of a therapeutic
relationship that is vital to successful Ideas of reference occur when a client
psychiatric treatment. has self-centered thoughts and falsely
believes ideas are centered on
A 44-year-old client has been
something the client is doing, thinking,
experiencing intense job stress. In
or feeling. Looseness of association is
recent weeks, the client has confided in
the inability to think logically.
the client's spouse that the client
Ambivalence refers to contradictory or
believes the client's firm monitors every
opposing emotions, attitudes, ideas, or
aspect of the client's personal
desires for the same person or things or
performance and that the firm is
toward the environment. Echolalia is a
engaged in deception and cover-up of
pathological parrot-like response of a
its "true purpose." A nurse would
word or phrase.
recognize that the primary theme of the
client's delusional disorder is what? Although a psychotic episode can be
brief, the client impact can last a long
You Selected:
time. For this reason, the nurse is aware
​ Persecutory of what?
Correct response: You Selected:
​ Persecutory ​ Supervision may be required to
Explanation: protect the person

Clients who exhibit persecutory Correct response:

delusions believe that they are being ​ Supervision may be required to

conspired against, spied on, poisoned or protect the person
drugged, cheated, harassed, maliciously
Explanation:
maligned, or obstructed in some way.
This delusion is not characteristic of Although episodes are brief, impairment
somatic, conjugal, or grandiose subtype. can be severe. Consequently,
supervision may be required to protect
A client with delusions presents with
the person during a brief psychotic
strong defensiveness, even when
episode.
watching the news or listening to the
radio. The nurse would document this Which is the central focus of
finding in the health history as what? persecutory delusions?
You Selected: You Selected:

​ Ambivalence ​ Injustice that must be remedied

by legal action
Correct response:
Correct response:
​ Ideas of reference
Explanation:
 ​ Injustice that must be remedied ​ Haloperidol
by legal action
Correct response:
Explanation:
​ Benztropine
The focus of persecutory delusions is Explanation:
often on some injustice that must be
remedied by legal action. Clients often Benzotropine is an anticholinergic drug
see satisfaction by repeatedly appealing used to relieve drug-induced
to courts and other government extrapyramidal adverse effects, such as
agencies. The central theme of somatic muscle weakness, involuntary muscle
delusions involves bodily functioning or movement, pseudoparkinsonism, and
sensations. The central theme of the tardive dyskinesia.
jealous subtype is the unfaithfulness or A client has been prescribed clozapine
infidelity of a spouse or lover. Clients for schizoaffective disorder (SCA) with
representing with grandiose delusions depression. The nurse should explain to
are convinced they have a great, the client that one advantage of
unrecognized talent or have made an clozapine is that it can provide what?
important discovery.
You Selected:
Catatonia as seen in clients with
​ Combination with lithium for
schizophrenia is unique in the existence
greater effect
of which feature?
Correct response:
You Selected:
​ Reduction of hospitalizations and
​ Immobility like being in a trance
risk for suicide
Correct response:
Explanation:
​ Immobility like being in a trance
Clozapine, reported effective for SCA by
Explanation: several authorities, can reduce
Catatonia, as seen in clients with hospitalizations and risk for suicide. A
schizophrenia, is a psychologically significant portion of clients whose
induced immobility occasionally marked symptoms have resisted other
by periods of agitation or excitement; neuroleptic agents improve on
the client seems motionless as if in a clozapine.
trance. A client who has a major depressive
Which medication is used to control the episode tells a nurse that, for the past 2
extrapyramidal effects associated with weeks, the client has been hearing
antipsychotic medications? voices and at times thinks that they are
being followed. History reveals that the
You Selected:
client had these alternating symptoms
before. The client also has experienced Outcome research has shown that
time with neither of these symptoms and schizophrenia can be successfully
has been able to function adequately. treated and managed. Continuity of care
The nurse interprets these findings as has been identified as a major goal of
suggesting which condition? recovery for clients with schizophrenia
because they are at risk for becoming
You Selected:
lost to services if left alone after
​ Paranoid schizophrenia discharge. Although inpatient
Correct response: hospitalizations that are brief and focus
on client stabilization, and crisis
​ Schizoaffective disorder
management is key to emergency care,
Explanation: and decreased social isolation through
social engagement are all important,
Schizoaffective disorder is characterized
they are not considered major goals for
by intervals of intense symptoms
recovery.
between quiescent periods. At times,
there are symptoms of schizophrenia, Which is an appropriate intervention for
and at other times, there seems to be a a client having auditory hallucinations?
mood disorder. Because the symptoms
You Selected:
alternate with quiet periods,
schizophrenia, either paranoid or ​ Tell the client to talk back to the
undifferentiated, would not apply. A brief voices and tell them to go away.
psychotic episode involves symptoms of Correct response:
at least 1 day but less than 1 month,
and the onset is sudden. The client ​ Tell the client to talk back to the
generally experiences emotional turmoil voices and tell them to go away.
or overwhelming confusion and rapid Explanation:
intense shifts of affect.
Interventions for managing
A nurse is preparing a presentation hallucinations include dismissal
about schizophrenia and outcomes intervention (i.e., telling the voices to go
focusing on recovery for families of away), various coping strategies (e.g.,
clients with schizophrenia. Which main jogging, telephoning, playing games,
goal would the nurse include? seeking out others, employing relaxation
techniques), or competing stimuli (e.g.,
You Selected:
listening to music or the voice of oneself
​ Immediate crisis stabilization or another to overcome auditory
Correct response: hallucinations and using visual stimuli to
overcome visual hallucinations).
​ Continuity of care
Some clients desire to discuss their
Explanation:
hallucinations with health care staff to
gain understanding. In any event, the concern for the client is fear. Defensive
nurse may elicit a description of the coping is not in evidence, and impaired
hallucination to seek understanding of social interactions are secondary to the
how to calm or reassure the client, client's immediate fear.
protecting the client and others. While
After educating a client on antipsychotic
the nurse should never endorse a
agents, a nurse determines that the
hallucination as real, the nurse should
education was successful when the
also not scold the client for having
client identifies which medication as an
hallucinations. Isolation is not helpful for
example of a second-generation
the client with hallucinations; the nurse
antipsychotic agent?
should help maintain reality through
frequent contact with client, and the You Selected:
client should be engaged in ​ Chlorpromazine
reality-based activities and reintegrated
into the treatment milieu as soon as Correct response:

possible. ​ Quetiapine
A client broke down in tears when Explanation:
speaking with the nurse, stating, “You
Quetiapine is an example of a
have no idea what it's like to be
second-generation antipsychotic agent.
responsible for finding terrorist leaders.
Fluphenazine, thiothixene, and
Every day I have to stay one step ahead
chlorpromazine are examples of
of the operatives that have been sent
first-generation antipsychotic agents.
after me.” In light of the client's
statement, which nursing diagnosis Which client exhibits the characteristics
should the nurse prioritize? that are typical of the prodromal phase
of schizophrenia?
You Selected:
You Selected:
​ Fear related to persecutory
delusions ​ A 20-year-old is experiencing a
gradual decrease in the ability to
Correct response:
concentrate, be productive, and
​ Fear related to persecutory sleep restfully.
delusions
Correct response:
Explanation:
​ A 20-year-old is experiencing a
The client is expressing fear and anxiety gradual decrease in the ability to
resulting from a perceived threat. The concentrate, be productive, and
client is confused about the client's role sleep restfully.
and/or identity. There is no evidence of
Explanation:
labile affect, despite the client having
grandiose delusions. The primary
Gradual, subtle behavioral changes You Selected:
appear during the prodromal phase of ​ Insight-oriented therapy
schizophrenia, such as tension, the
inability to concentrate, insomnia, Correct response:

withdrawal, or cognitive deficits. No ​ Individual therapy

symptoms are present in the premorbid
Explanation:
phase, and relapses occur in the
progressive and chronic phases. Individual psychotherapy is the
Diagnosis of the disease marks the treatment of choice because clients with
beginning of the onset phase. delusional thoughts do not respond well
to insight-oriented, problem-oriented, or
A client with schizoaffective disorder is
group therapy in which delusions are
prescribed long-term medication
confronted by peers or therapists.
therapy. The nurse would most likely
Establishing the therapeutic relationship
expect what to be prescribed as the
with the client is the critical first step.
mainstay of treatment?
Individual therapy would be the most
You Selected: therapeutic intervention for the client's
​ Typical antipsychotic current circumstance.

Correct response: Which statements characterizes the

major difference between the typical and
​ Atypical antipsychotic atypical antipsychotic medications?
Explanation: You Selected:
Pharmacologic intervention is needed to ​ Atypical antipsychotics tend to
stabilize the symptoms, and it presents cause many more extrapyramidal
specific challenges. Long-term atypical side effects than do the typical
antipsychotic agents, now the mainstay antipsychotics.
of pharmacologic treatment, are as
effective as the traditional combination Correct response:

of a standard antipsychotic agent and ​ Typical antipsychotics most often

an antidepressant drug. Mood relieve positive symptoms but do
stabilizers, such as lithium or valproic not have a significant impact on
acid, may be used. A combination of negative symptoms.
antipsychotic and antidepressant agents
Explanation:
is often used.
Traditional antipsychotics treat the
A client who is newly admitted to an
positive symptoms of schizophrenia
inpatient unit is exhibiting acute
(i.e., hallucinations and delusions).
delusional thoughts. The most
Atypical antipsychotics relieve both the
therapeutic intervention for this client
positive and negative symptoms (e.g.,
would include what?
apathy, avolition, social withdrawal) of
schizophrenia and are less likely to with catatonic schizophrenia cannot
cause distressing extrapyramidal side meet their own needs by themselves.
effects typically seen with traditional Clients with catatonic schizophrenia are
antipsychotics. unable to express their concerns.
Lithium is used for the manic phase of
The nurse should consider which during
bipolar disorder. The nurse needs to
a psychiatric assessment of a newly
give support to the client and be present
immigrated client who is being
for him or her as reassurance.
evaluated for possible religious
delusions? After teaching a class of nursing
students about the different types of
You Selected:
delusions, the instructor determines that
​ The nurse's cultural religious the education was successful when the
beliefs may differ from those of class identifies which type as most
the client's common?
Correct response: You Selected:
​ Some cultures hold religious ​ Somatic
beliefs that might be confused
Correct response:
with delusional thought
​ Persecutory
Explanation:
Explanation:
Some cultures have widely held and
culturally sanctioned beliefs that might Of the different types of delusions,
be considered delusional in other persecutory delusions are the most
cultures. common.
The nurse is assigned to a client with A client with a diagnosis of
catatonic schizophrenia. Which schizophrenia has been brought to the
intervention should the nurse include in emergency department by a worker
the client's care plan? from the group home where the client
resides. The worker states that the client
You Selected:
has stopped taking medications and
​ Giving the client an opportunity drank 2 to 3 gallons of water over the
to express concerns past several hours. What assessments
Correct response: should the nurse who is caring for this
client prioritize?
​ Meeting all of the client's
physical needs You Selected:

Explanation: ​ Assessing for allergic reactions,

dry mouth, and lethargy
Meeting all of the client's physiologic
needs is most important because clients Correct response:
 ​ Neurological assessment and Explanation:
monitoring of electrolyte levels Schizophrenia is thought to have
Explanation: multiple etiologies. The overwhelming
body of scientific evidence suggests that
Hyponatremia, electrolyte imbalances,
schizophrenia is a brain disease.
and seizures may result from polydipsia.
Computed tomography scanning and
Consequently, close monitoring of the
magnetic resonance imaging have
client's electrolytes and neurological
shown frequent enlargement of the
status assessment are prioritized at this
lateral cerebral ventricles in people with
stage.
schizophrenia.
A client is diagnosed with
The psychiatric nurse recognizes that a
schizophreniform disorder. The nurse is
client's cultural background can
reviewing the client's medical record and
contribute to the misdiagnosis of
finds that the client's symptoms have
schizophrenia primarily for which
been present for at least how long?
reason?
You Selected:
You Selected:
​ 1 year
​ Clinicians diagnose culturally
Correct response: accepted beliefs as psychotic
​ 1 month thinking
Correct response:
Explanation:

The essential features of ​ Clinicians diagnose culturally

schizophreniform disorder are identical accepted beliefs as psychotic
to those of criteria A for schizophrenia, thinking
with the exception of the duration of the Explanation:
illness, which can be less than 6
Always consider cultural differences
months. Symptoms must be present for
when assessing clinical symptoms in
at least 1 month to be classified as a
clients with suspected psychotic
schizophreniform disorder.
disorders. Ideas that appear delusional
Which group of theories is believed in one culture may be acceptable in
currently to explain the etiology of another; speaking in tongues and visual
schizophrenia? or auditory hallucinations with religious
content are possible examples.
You Selected:

​ Cognitive client tells the nurse that the client has

bugs in the client's brain and asks the
Correct response: nurse if the nurse can see them. Which
​ Biologic response by the nurse is most
therapeutic?
You Selected: Common negative symptoms of
​ “Your thinking is a little illogical. I schizophrenia include alogia, affective
wouldn't be able to see bugs if blunting, avolition, anhedonia, and
they were inside your brain. attentional impairment.
Would you like to talk more about Positive symptoms seen in
this?” schizophrenia are believed to be a result
Correct response: of which type of neurological
dysfunction?
​ “No, I don't see any bugs. That
sounds scary for you.” You Selected:

Explanation: ​ Increased amount of dopamine

The person who hallucinates is Correct response:

preoccupied and frightened by what he ​ Increased amount of dopamine
or she hears or sees. The hallucination
Explanation:
is real to the client, and the nurse
cannot argue away, dismiss, or ignore it. Positive (or productive) symptoms
Although the hallucination is real to the reflect an increased amount of
client, nurses make it clear that they do dopamine affecting the cortical areas of
not hear the voices or see the visual the brain. Negative symptoms reflect an
images. Nurses do, however, inadequate amount of dopamine,
communicate concern that the client is cerebral atrophy, and organic functional
bothered, upset, or frightened by the changes in the brain.
hallucination.
The relationships and associations
A client had been withdrawn in the among the words used to express
client's room for 3 days, not eating or thoughts are markedly disturbed in
sleeping, prior to his admission to the clients with schizophrenia. What is this
inpatient unit. Upon interview, the client disturbance characterized by?
demonstrates difficulty answering
You Selected:
questions, appears to have no facial
expressions, and cannot follow simple ​ Disorganized speech
instructions. This cluster of symptoms Correct response:
can be described as what?
​ Disorganized speech
You Selected:
Explanation:
​ Thought disorder
The lack of a logical relationship
Correct response: between thoughts and ideas may be
​ Negative symptoms manifested by speech that is vague,
diffuse, unfocused (loose associations),
Explanation:
or incoherent (using words that are
totally unrelated, called “word salad”) or Hallucinations are sensory perceptions
by a client's inability to get to the point with a compelling sense of reality but
(tangentiality). with no actual objective basis. During
auditory hallucinations (the most
A novice nurse on a psychiatric unit may
common form), clients may hear the
find it challenging to care for a client
voice of God or close relatives, two or
newly diagnosed with schizophrenia
more voices with a running commentary
primarily for which reason?
about the client's behavior, or voices
You Selected: that command certain acts. Usually the
​ The characteristic disintegration voices are obscene, accusatory, or
of the client's personality is insulting. They may call clients names
difficult to watch and make nasty remarks.

Correct response: Which should the nurse anticipate when

providing therapy and evaluating
​ The nurse may feel defensive
outcomes for a client with delusional
when a delusional client makes
disorder?
accusations
You Selected:
Explanation:
​ Maintained for a short period
It is not uncommon for novice nurses to only
take client's statements or behavior as a
personal accusation, which can cause Correct response:

the nurse to feel or react defensively; ​ Often not met completely

this is counterproductive to the
Explanation:
therapeutic relationship.
In evaluating progress, the nurse must
During an admission assessment with a
remember that outcomes are often not
psychiatric–mental health nurse, a client
met completely.
states that the client hears the voice of
God in the client's head and the voice is The psychiatric nurse documents that a
telling the client that the client is client is expressing nihilistic delusions
worthless. How should the nurse when the client makes which statement?
document this symptom?
You Selected:
You Selected:
​ "I can't eat; I have no mouth or
​ Thought insertion stomach."
Correct response: Correct response:

​ A hallucination ​ "I can't eat; I have no mouth or

stomach."
Explanation:
Explanation:
The client expresses a nihilistic delusion Correct response:
when denying reality or existence of ​ Tardive dyskinesia
self, part of self, or some external
object. Believing oneself to have a Explanation:
unique cancer represents a somatic Unusual movements of the tongue,
delusion, while believing oneself to be neck, and arms suggest tardive
friends with a president or the sister to a dyskinesia, an adverse reaction to
queen represents delusions of grandeur. neuroleptic medication. Dystonia is
A client has been prescribed clozapine characterized by cramps and rigidity of
for treatment of schizophrenia. The the tongue, face, neck, and back
client must be taught to monitor which muscles. Neuroleptic malignant
blood concentrations weekly while syndrome causes rigidity, fever,
taking this drug? hypertension, and diaphoresis. Akathisia
causes restlessness, anxiety, and
You Selected: jitteriness.
​ white blood cells The severity of a client's positive and
Correct response: negative symptoms of schizophrenia
has not significantly improved since
​ white blood cells
treatment began, despite the use of
Explanation: three different neuroleptic medications.
Agranulocytosis can develop with the The nurse should anticipate that this
use of all antipsychotic drugs but it is client may benefit from treatment with
most likely to develop with clozapine which medication?
use. Clients taking clozapine should You Selected:
have regular blood tests. White blood
​ Clozapine
cell and granulocyte counts should be
measured before treatment is initiated Correct response:
and at least weekly or twice weekly after ​ Clozapine
treatment begins.
Explanation:
A client has been taking neuroleptic
medications for many years as a Clozapine may be used if the client has
treatment for schizophrenia. The client not responded favorably to the use of
is exhibiting tongue protrusion, facial two different neuroleptics. It is not
grimacing, and excessive blinking. normally a drug of first resort, however,
These manifestations are characteristic due to significant adverse effects.
of which side effect? lient in an inpatient setting has a
You Selected: delusion that there are a multitude of
undetectable noxious gases in
​ Dystonia circulation that have the potential to
poison the client and others. Which of help address mood symptoms.
the nurse's responses is most Medication should not be stopped if the
therapeutic? client feels better.
You Selected: Which has not been proposed as a
​ “If we detect a poison gas here, I potential mechanism for the etiology of
promise that you'll be the first to thought disorders?
know.” You Selected:

Correct response: ​ Hemispheric brain dysfunction

​ “I can assure you that you are Correct response:
actually very safe here.”
​ Neglect in childhood
Explanation:
Explanation:
Assuring a client of his or her safety is a
Many studies strongly suggest that
more therapeutic intervention than
genetics plays a part in the development
expressing exasperation with the client's
of schizophrenia. Neuroanatomical
delusions, arguing against them, or
imaging and study may link
implicitly confirming them.
schizophrenia to certain patterns of
After teaching a client with hemispheric brain dysfunction. The most
schizoaffective disorder about the recent research into the etiology of
condition and treatment, the nurse schizophrenia has focused on brain
determines that the education was imaging and neurochemical and
successful when the client states what? neuropathologic changes in the brains
of clients with the disorder.
You Selected:

​ "I should go to sleep at night A client with a diagnosis of

when I feel tired." schizophrenia believes that the client is
an undercover operative for the Central
Correct response: Intelligence Agency and that voices of
​ "I need to eat properly so that I various representatives of the
can control my weight." organization give the client regular
updates on the client's missions. The
Explanation:
client is unwilling to participate in many
Client education should focus on interventions because the client is “too
nutrition and prevention of weight gain, busy with things that are more important
which is a side effect of medication than you could possibly understand.”
therapy. Establishing a regular sleep The primary theme of the client's
pattern by setting a routine can help to delusions is consistent with what?
promote or reestablish normal patterns
You Selected:
of rest. Establishing a daily routine can
 ​ Undifferentiation disrupted because of the central and
overpowering nature of the delusions.
Correct response:

​ Paranoia The nurse is evaluating the plan of care

for a client with schizophrenia. Which
Explanation: observation best suggests that the plan
Clients with a diagnosis of has been effective?
schizophrenia who exhibit paranoid You Selected:
delusions tend to experience
persecutory or grandiose delusions and ​ The client has resumed
auditory hallucinations. employment and attends social
functions.
When assessing a client with a
Correct response:
delusional disorder who is experiencing
somatic delusions, which would the ​ The client has resumed
nurse expect as within normal employment and attends social
parameters? Select all that apply. functions.
Explanation:
​ Thinking
​ Orientation Major goals for the care of a client with
​ Attention schizophrenia are to experience
improved thought processes and fewer
psychotic symptoms, to not engage in
Correct response: violent behavior, to acquire improved
Incorrect response: social skills and engage in satisfying
Your selection: social interaction, and to gain
knowledge about the disease process
Explanation:
and treatment. Increased conversations
In clients with delusional disorders, with the staff is unrelated to the overall
mental status is not generally affected. plan of care for the client with
Thinking, orientation, affect, attention, schizophrenia.
memory, perception, and personality are
generally intact. Most clients who
receive diagnoses of delusional disorder
do not experience functional difficulties
or impairments. Self-care patterns may
be disrupted in clients with the somatic
subtype by the elaborate processes
used to treat perceived illness (e.g.,
bathing rituals, creams). Sleep may be