A 32-year-old client with an admitting diagnosis of catatonic schizophrenia has been mute and motionless for 2 days. The priority nursing diagnosis is:

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Question 1 of 5

A 32-year-old client with an admitting diagnosis of catatonic schizophrenia has been mute and motionless for 2 days. The priority nursing diagnosis is:

Correct Answer: A

Rationale: The correct answer is A: Risk for deficient fluid volume. The priority nursing diagnosis in this case is to address the client's physical needs to ensure their safety and well-being. The client's mutism and immobility put them at risk for dehydration and malnutrition. By prioritizing the risk for deficient fluid volume, the nurse can address the immediate physiological needs of the client. Choice B: Impaired physical mobility is incorrect because while the client is motionless, the immediate concern is addressing the risk of dehydration. Choice C: Impaired social interaction is incorrect as addressing social interaction is not the priority when the client's physical needs are not being met. Choice D: Ineffective coping is incorrect because the client's presentation is indicative of a more urgent physical need for hydration and nutrition.

Question 2 of 5

The wife of a client newly diagnosed with paranoid schizophrenia asks the nurse, 'My husband was well adjusted until a month ago, and then, after a lot of work stress, he got sick. What can I expect? Will he be this sick for the rest of his life?' What information can the nurse provide about prognosis?

Correct Answer: A

Rationale: Step 1: Paranoid schizophrenia is a subtype that tends to have a better prognosis compared to other types. Step 2: The statement that the disorder responds well to treatment and may not recur aligns with the typical course of paranoid schizophrenia. Step 3: With proper medication and therapy, individuals with paranoid schizophrenia can experience significant improvement and have periods of stability. Step 4: Recurrence of symptoms is less likely compared to other types of schizophrenia. Step 5: Therefore, choice A is correct as it provides accurate information about the prognosis of paranoid schizophrenia. Summary: Choice B is incorrect because not all types of schizophrenia are chronic relapsing disorders. Choice C is incorrect as outcomes are not solely determined by prehospital disorganization. Choice D is incorrect as partial remission is not the usual outcome for paranoid schizophrenia.

Question 3 of 5

When a patient with paranoid schizophrenia has a recurrence of positive symptoms after stopping his antipsychotic medication because of its postural hypotension (orthostasis) side effect, he is readmitted to the mental health unit. What measure should the nurse suggest to help the patient address this side effect?

Correct Answer: D

Rationale: The correct answer is D because wearing elastic support hose, drinking adequate fluids, and changing positions slowly can help prevent postural hypotension associated with antipsychotic medications. Elastic support hose can improve blood circulation and prevent blood pooling in the legs. Adequate fluid intake can help maintain blood volume and blood pressure. Changing positions slowly can prevent sudden drops in blood pressure upon standing. Choice A (anticholinergic drug) is incorrect as it may worsen symptoms of schizophrenia. Choice B (sugarless gum or candy) is unrelated to postural hypotension. Choice C (increasing sleep and rest breaks) may help with fatigue but does not address postural hypotension directly.

Question 4 of 5

The physician prescribes haloperidol (Haldol), a first-generation antipsychotic drug, for a patient with schizophrenia who displays delusions, hallucinations, apathy, and social isolation. Which symptoms should most be monitored to evaluate the expected improvement from this medication?

Correct Answer: A

Rationale: The correct answer is A because the symptoms of delusions and hallucinations are key indicators of improvement in schizophrenia with antipsychotic treatment. These symptoms directly relate to the patient's perception of reality and are core features of the disorder. Monitoring these symptoms provides objective evidence of the medication's effectiveness in addressing the patient's psychotic symptoms. Choices B, C, and D are incorrect because they mainly indicate negative symptoms of schizophrenia, such as flat affect, social withdrawal, and cognitive deficits. While monitoring these symptoms is important for assessing overall functioning and quality of life, they are not the primary target of improvement with antipsychotic medications. Symptoms like delusions and hallucinations are considered primary targets for evaluating the efficacy of antipsychotic treatment in schizophrenia.

Question 5 of 5

A patient with schizophrenia tells the nurse 'I don't know, it's just all the same. You never know. It comes, it goes, it blows away. Get it?' The best response for the nurse to make would be:

Correct Answer: D

Rationale: The correct answer is D because it reflects active listening and acknowledges the patient's communication difficulties without being dismissive. By stating difficulty in understanding, the nurse shows empathy and openness to further clarification. Choice A is incorrect as it may be perceived as judgmental. Choice B is incorrect as it does not address the patient's communication challenges. Choice C is incorrect as it places the responsibility solely on the patient without offering support.

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