Chapter 22 Schizophrenia and Schizophrenic-Like Disorders

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Chapter 22  Schizophrenia and Schizophrenic-Like Disorders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

 

A 55-year-old man was admitted to the psychiatric unit after an incident in a department store in which he accused a sales clerk of following him around the store and stealing his keys. He was subdued by the police after destroying a window display because voices had told him that it was evil. As the nurse approached the client, he says, “You’re all out to get me, and you’re one of them. They’re Rostoputians and grog babies here.” This demonstrates what?
A)
Loose associations and flight of ideas
B)
Suspiciousness and neologisms
C)
Illusions and loss of ego boundaries
D)
Echolalia and echopraxia
Ans:
B

Feedback:

The client is demonstrating suspiciousness (“you’re all out to get me”) and neologisms (use of the words “Rostoputians and grog babies”). Loose associations and flight of ideas occur when the client talks about many topics in rapid sequence, but they are not connected with each other. Illusions are when the client sees something that is not there; echolalia is the repetition of words (or words that sound similar) said by someone else.

2.
A client was admitted to the psychiatric ICU with schizophrenia, disorganized type. In addition to hallucinations and delusions, other assessments that the nurse would expect to find include what?
A)
Blunted inappropriate affect, withdrawal, incoherence, and regression
B)
Abnormal, bizarre posturing; stupor; echolalia; and negativism
C)
Hostility, aggression, persecutory hallucinations, and argumentativeness
D)
Depression, elation, hyperactivity, and pressure of speech
Ans:
A

Feedback:

Disorganized type schizophrenia is characterized by positive symptoms (hallucinations and delusions) as well as negative symptoms (blunt affect, withdrawal, regression, etc.). Catatonic schizophrenia is characterized by bizarre posturing, negativism, stupor, and echolalia.

3.
Data from more than 45 family and twin studies spanning seven decades of research point to the following fact about the inheritability of schizophrenia:
A)
Schizophrenia inheritability has been found to have very little genetic basis.
B)
A person whose twin has schizophrenia has a 40% chance of having the disease.
C)
The risk of inheriting schizophrenia to relatives of someone who has the disorder is less than the risk to relatives of normal controls.
D)
Schizophrenia is known to be inherited through behavioral family pathology, not through genetic means.
Ans:
B

Feedback:

The risk of inheriting schizophrenia is 10% to 20% in those who have one immediate family member with the disease and approximately 40% if the disease affects both parents or an identical twin.

4.
In working with the individual and family, the most accurate statement that the nurse can teach the client and family about schizophrenia is what?
A)
“Individuals with schizophrenia do have differences in brain structure and function that cause a variety of symptoms such as amotivation and hearing voices.”
B)
“Schizophrenia is being found to be related more closely to family dysfunction than to physiology, which is why family therapy is the most effective treatment for this disorder.”
C)
“Medications for schizophrenia have not changed much since the early 1950s, although there are some medications that may be helpful.”
D)
“It is more effective to treat the individual on a one-to-one basis than to involve the family in treatment because it is a very complicated process.”
Ans:
A

Feedback:

Excessive amount of the neurotransmitter dopamine allows nerve impulses to bombard the mesolimbic pathway, the part of the brain normally involved in arousal and motivation. Normal cell communications are disrupted, resulting in the development of hallucinations and delusions. Abnormalities in brain shape and brain circuitry are being researched.

5.
One of the primary goals in caring for the client with schizophrenia is to establish clear, consistent, open communication. Which of the following nursing interventions would be most effective in accomplishing this goal?
A)
Assist the client to do at least one physical activity each day.
B)
Supervise all of the client’s activities of daily living.
C)
Present reality in clear simple language, and demonstrate patience.
D)
Arrange for the client to go home as soon as possible on a day pass.
Ans:
C

Feedback:

The most effective intervention in accomplishing the stated goal would be to maintain a patient, calm attitude and present reality in clear, simple language that is easy to understand.

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