A client recently diagnosed with schizophrenia is brought to the mental health clinic by the identical twin sibling for the first follow-up visit after hospitalization. The client’s sibling says to the nurse, "I read that schizophrenia runs in families. I guess I'm doomed." Which is the best response by the nurse?
"At the moment, I would worry more about how your sibling is doing."
"You are at risk for the disease. However, there are other factors that contribute to the development of schizophrenia."
"Would you like to talk to a health care provider about this?"
"The odds are about 50-50 that you will come down with the disease as well."
The Correct Answer is B
Choice A reason: Redirecting the sibling’s concern to the patient minimizes and dismisses the sibling’s anxiety. This is not therapeutic.
Choice B reason: Schizophrenia has a genetic component, especially in identical twins, but environment and other factors also play roles. This response provides accurate information while reducing unnecessary fear.
Choice C reason: Offering referral may be helpful later, but it does not immediately address the sibling’s expressed concern or provide reassurance.
Choice D reason: Saying there is a 50-50 chance is inaccurate and unnecessarily alarming. The risk is higher in identical twins but not absolute.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Choice A reason: Focusing only on medications neglects the interpersonal development central to Peplau’s model. The orientation phase emphasizes relationship building, not task-centered care.
Choice B reason: Allowing expression without structure or guidance does not fulfill the orientation phase, which requires the nurse to actively build trust and clarify roles.
Choice C reason: Excessive distance prevents rapport, which is essential in the orientation phase where the foundation for a therapeutic relationship must be established.
Choice D reason: Establishing trust, being consistent, and clarifying client expectations define the orientation phase of Peplau’s theory. This phase sets the groundwork for collaboration and progress in treatment.
Correct Answer is C
Explanation
Choice A reason: Schizophrenia rarely presents in early childhood; cases in preschoolers are extremely uncommon and considered childhood-onset schizophrenia.
Choice B reason: While symptoms may persist into later life, new-onset schizophrenia is unusual in older adults and should prompt investigation for other causes such as dementia or medical illness.
Choice C reason: Schizophrenia most commonly develops in late adolescence to early adulthood, with men typically diagnosed in their late teens to early 20s and women in their late 20s to early 30s.
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