Chapter 55 Drug Therapy for Psychotic Disorders


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Chapter 55  Drug Therapy for Psychotic Disorders



Complete chapter Questions And Answers

Sample Questions



1. A person is seen wandering the streets and talking in an animated way to people who are not there. From what disorder do you suspect the person is suffering?

  1. A)  Confusion
  2. B)  Delusions
  3. C)  Psychosis
  4. D)  Depression

Ans: C Feedback:

The patient is suffering from psychosis, which is a severe mental disorder characterized by disordered thought processes. Delusions are false beliefs that persist in the absence of reason or evidence and are also a symptom of a psychosis. Depression is a disorder and symptom that is not as severe as a psychotic disorder. Confusion is a more generic term that denotes a lack of clear thinking.

2. A patient is admitted to the hospital for cardiac surgery and has just come up to the postsurgical unit from the recovery room. He develops unprecedented confusion and states, “I see bugs up and down the walls. They are going to get me.” The nurse suspects the patient is suffering from what symptom?

  1. A)  Depression
  2. B)  Delusions
  3. C)  Delirium
  4. D)  Schizophrenia

Ans: C


The patient is suffering from delirium as a postoperative complication. Delusions are false beliefs that persist in the absence of reason or evidence. Schizophrenia is a variety of disorders and not a single symptom.

3. A teenage boy has begun to exhibit the characteristic signs and symptoms of schizophrenia. During his mother’s pregnancy, during what time in development could she have experienced an intrauterine insult?

  1. A)  Conception
  2. B)  First trimester
  3. C)  Second trimester
  4. D)  Third trimester

Ans: C
The neurodevelopmental model proposes that schizophrenia results when abnormal brain synapses are formed in response to an intrauterine insult during the second trimester of pregnancy, when neuronal migration is normally taking place. At conception, no implantation in the uterus has occurred. The first trimester is prior to neuronal migration. The third trimester is after neuronal migration.

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4. A patient is experiencing an episode of psychosis. He is belligerent, loud, and abusive when you enter the room. What is the best response by the nurse during future interactions?

  1. A)  Respond to him in an assertive tone.
  2. B)  Use a calm, soft voice.
  3. C)  Delegate care to the technician.
  4. D)  Place him in the quiet room.

Ans: B
The most therapeutic communication technique for this patient is to use a calm, soft voice. To respond to the patient in a loud tone will increase his agitation. Delegating care to the patient care technician can increase the patient’s agitation based on the fact that the unlicensed caretaker may not possess strong therapeutic communication skills. Placing the patient in a quiet room will not affect any changes in his behavior and may increase his hallucinations.

5. A patient who has a diagnosis of schizophrenia is likely to have which of the following pathophysiologic effects?

  1. A)  Increased dopamine
  2. B)  Increased serum potassium
  3. C)  Decreased numbers of glutamate receptors
  4. D)  Decreased interaction with GABA

Ans: A Feedback:

The patient suffering from schizophrenia has increased dopamine activity in the brain. The amount of potassium would cause other physiological symptoms, but not affect schizophrenic symptoms. The patient with schizophrenia will have widespread glutamate receptors, not decreased glutamate receptors. In addition, the glutamatergic system interacts with the dopaminergic and gamma-aminobutyric acid systems and possibly other neurotransmission systems.

6. A patient has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which of the following goals of care is the priority?

  1. A)  The patient will demonstrate independent health maintenance.
  2. B)  The patient will interact therapeutically with peers.
  3. C)  The patient will participate in activities of daily living.
  4. D)  The patient will remain safe.

Ans: D Feedback:

Safety is a priority over other goals. Goals such as participation in ADLs, health maintenance, and participation in relationships are valid, but safety is a priority.

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