A client with undifferentiated schizophrenia is readmitted for an acute exacerbation of the disorder. The goal of hospitalization is symptom stabilization. The nurse has documented that, in addition to experiencing auditory hallucinations, the client seems uninterested in activities, has difficulty completing tasks, seems forgetful, and seems puzzled by information and directions given by staff. The nurse's plans for intervention will be effective if these behaviors are attributed to:

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Question 1 of 5

A client with undifferentiated schizophrenia is readmitted for an acute exacerbation of the disorder. The goal of hospitalization is symptom stabilization. The nurse has documented that, in addition to experiencing auditory hallucinations, the client seems uninterested in activities, has difficulty completing tasks, seems forgetful, and seems puzzled by information and directions given by staff. The nurse's plans for intervention will be effective if these behaviors are attributed to:

Correct Answer: D

Rationale: The correct answer is D: Problems in cognitive functioning. In undifferentiated schizophrenia, cognitive deficits are common, leading to difficulties in memory, attention, problem-solving, and executive functioning. The client's symptoms of forgetfulness, difficulty completing tasks, being puzzled by information, and auditory hallucinations are indicative of cognitive impairment. Interventions should focus on addressing these cognitive deficits to improve the client's ability to function. Incorrect choices: A: Social isolation - This choice does not address the cognitive deficits and symptoms described by the client, such as forgetfulness and difficulty completing tasks. B: Deficient knowledge - While cognitive deficits may contribute to deficient knowledge, the primary concern in this scenario is the client's cognitive functioning impairments. C: Situational low self-esteem - This choice does not explain the cognitive deficits and symptoms experienced by the client, which are more indicative of problems in cognitive functioning.

Question 2 of 5

A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:

Correct Answer: B

Rationale: The correct answer is B: olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that is known to be effective in treating negative symptoms of schizophrenia, such as apathy, poverty of thought, and social withdrawal. These symptoms are often resistant to typical antipsychotics like haloperidol (A) and chlorpromazine (D), which are more effective for positive symptoms like hallucinations. Diphenhydramine (C) is an antihistamine and not used to treat schizophrenia symptoms. In summary, olanzapine is the best choice to address the specific symptoms described in the scenario.

Question 3 of 5

A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?

Correct Answer: D

Rationale: The correct answer is D because the patient's accusation of the nurse being homosexual and implying that other men do not trust him or want to be around him suggests projection of the patient's own homosexual urges onto the nurse. This defense mechanism of projection helps the patient avoid acknowledging and dealing with his own uncomfortable feelings by attributing them to someone else. Option A is incorrect because the patient's behavior is more about projecting feelings onto the nurse rather than unconscious hostility. Option B is incorrect as it focuses on the patient's fear of rejection rather than projecting his own feelings onto the nurse. Option C is incorrect as it does not address the specific dynamic of projecting homosexual urges onto the nurse.

Question 4 of 5

The medical records of a patient diagnosed with schizophrenia state that the patient has cognitive dysfunction. From this statement, the nurse can expect to see evidence of:

Correct Answer: D

Rationale: The correct answer is D because cognitive dysfunction in schizophrenia typically involves impaired memory, attention, and formal thought disorder. This is due to the underlying neurobiological and neurocognitive deficits associated with the disorder. Choices A, B, and C are incorrect because they primarily align with emotional and affective symptoms commonly seen in schizophrenia, not specifically cognitive dysfunction. Symptoms such as anxiety, fear, agitation, aggression, anger, hostility, violence, blunted affect, or inappropriate affective responses are more related to the emotional and behavioral aspects of schizophrenia, rather than cognitive deficits.

Question 5 of 5

A patient diagnosed with schizophrenia has been rehospitalized after a relapse. A priority intervention in designing a discharge plan to prevent relapses will be:

Correct Answer: D

Rationale: The correct answer is D because early identification of signs of impending relapse and coping strategies are crucial in preventing relapses in schizophrenia. By recognizing early warning signs, the patient can receive timely intervention and support to prevent further deterioration. This proactive approach enables healthcare providers to adjust treatment plans and provide necessary resources, ultimately reducing the likelihood of rehospitalization. Choice A is incorrect because developing tolerance for cognitive symptoms may be beneficial but not a priority in preventing relapses. Choice B is incorrect as family support is important but solely relying on family for structure may not address all factors contributing to relapse. Choice C is incorrect as working on self-concept may be helpful but not directly related to preventing relapses.

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