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Chapter 4 Psychosis and schizophrenia
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Chapter 4 Psychosis and schizophrenia
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Chapter 4 Psychosis and schizophreniaMULTIPLE CHOICE
1. A newly admitted patient has the diagnosis of catatonic schizophrenia. Which
behavior observed in the patient supports that diagnosis?
a. Uses a rhyming form of speech
b. Refuses to eat any unwrapped foods
c. Laughs when watching a sad movie
d. Maintains an immobilized state for hours
ANS: D
Catatonic schizophrenia is characterized by extremes of psychomotor activity ranging
from frenzied behavior to immobilization and may include echopraxia and posturing.
Paranoid thinking is characteristic of paranoid schizophrenia. Inappropriate affect and
clanging are seen in disorganized schizophrenia.
2. What would be an appropriate short-term outcome for a patient diagnosed with
residual schizophrenia who exhibits ambivalence?
a. Decide their own daily schedule.
b. Decide which unit groups they will attend.
c. Choose which clinic staff member to work with.
d. Choose between two outfits to wear each morning.
ANS: D
An early step would be to make choices about nonthreatening matters when presented
with limited alternatives. The remaining options represent decisions that are too
complicated for the patient to make initially.
3. What is the priority nursing diagnosis for a catatonic patient?
a. Ineffective coping
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, b. Impaired physical mobility
c. Impaired social interaction
d. Risk for deficient fluid volume
ANS: D
The highest priority for the patient is maintenance of basic physiologic needs, such as
hydration. Mobility is of lesser physiological importance than fluid volume. The
remaining options do not have priority over a physiological need.
4. Which nursing diagnosis is appropriate for a patient who insists being called Your
Highness and demonstrates loosely associated thoughts?
a. Risk for violence
b. Defensive coping
c. Impaired memory
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, d. Disturbed thought processes
ANS: D
Delusions and loose associations suggest disturbed thought processes. The other
options are not supported by data in the scenario.
5. Which initial short-term outcome would be appropriate for a patient who was
admitted expressing delusional thoughts?
a. Accept that delusion is illogical.
b. Distinguish external boundaries.
c. Explain the basis for the delusions.
d. Engage in reality-oriented conversation.
ANS: D
Delusions are not reality oriented; thus an appropriate outcome would be that patient
will engage in reality-oriented conversation rather than discussing delusional beliefs.
Delusions are fixed, false beliefs. Patients rarely accept anyone using logic to dispute
them. Data are not present to suggest boundary disturbance. Explaining the delusion is
not progress; it suggests the patient still holds to the belief.
6. Which of the following interventions should the nurse plan to use to reduce patient
focus on delusional thinking?
a. Confronting the delusion
b. Refuting the delusion with logic
c. Exploring reasons the patient has the delusion
d. Focusing on feelings suggested by the delusion
ANS: D
Focusing on feelings suggested by the delusion will help meet patient needs and help
the patient stay based in reality. This technique fosters rapport and trust while
discouraging the belief without challenging or refuting it.
7. Which assessment observation supports a patients diagnosis of disorganized
schizophrenia?
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