A nurse is caring for a client who has schizophrenia.

Exhibits

Select the "3" findings that should indicate to the nurse the client is experiencing negative symptoms related to their schizophrenia.

Blood pressure

Lack of motivation

Change in behavior

Lack of energy

Withdrawn

Answer and Explanation

Correct Answer : B,D,E

A. Blood pressure: A blood pressure reading (especially an isolated one) is not a psychiatric symptom and not related to schizophrenia symptomatology unless associated with medication side effects.
B. Lack of motivation: Also known as avolition, this is a hallmark negative symptom—reflected in the client's refusal to eat, drink, or attend therapy.
C. Change in behavior: This is too vague. While behavior changes are characteristic of schizophrenia, they could reflect either positive or negative symptoms and require clarification.
D. Lack of energy: Also referred to as anergia, it’s seen in the client's desire to sleep instead of engaging in activities and their slowed movements.
E. Withdrawn: Social withdrawal and isolation are common negative symptoms. The client avoids conversation and stays in bed, demonstrating a diminished interest in social interaction.

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Correct Answer is D

Explanation

A. A semi-private room with a roommate who has a similar diagnosis is not the best choice. While it may seem appropriate to place the client with someone who has a similar diagnosis, the manic phase of bipolar disorder often involves excessive energy, impulsivity, and possible aggression. This could be disruptive to a roommate and may lead to safety concerns.
B. A seclusion room until the client's activity level becomes more subdued should not be the first step. Seclusion is typically used as a last resort for safety when the client is an imminent danger to themselves or others. It should not be used as a routine intervention for clients in the manic phase of bipolar disorder, as it can be traumatic and isolating.
C. A private room in a quiet location on the unit is not ideal because clients in the manic phase may feel more isolated and their agitation could worsen in a quiet, remote environment. They also need monitoring to prevent any potential safety risks.
D. A private room close to the nursing station is the best choice. A private room allows the client to have a safe space while minimizing distractions from other patients. Being close to the nursing station ensures that the client is easily monitored, which is important in the manic phase where there is often a high level of activity and potential for risky behaviors. Additionally, proximity to the nursing station allows the staff to intervene quickly if needed.

A. Intention tremors B. Hyperpigmentation C. Purple striations D. Hirsutism

Correct Answer is B

Explanation

A. Intention tremors are not associated with Addison's disease. They are typically seen in neurological conditions such as multiple sclerosis or cerebellar disorders.
B. Hyperpigmentation is a classic and expected finding in clients with Addison's disease, especially in primary adrenal insufficiency. It results from increased secretion of adrenocorticotropic hormone (ACTH), which stimulates melanocytes to produce more melanin, leading to darkening of the skin, particularly in areas exposed to friction such as elbows, knuckles, and mucous membranes.
C. Purple striations are more commonly seen in Cushing's syndrome, which involves excessive cortisol, the opposite of Addison’s disease (which involves cortisol deficiency).
D. Hirsutism (excessive hair growth) is also more characteristic of Cushing’s syndrome, due to increased androgen levels. It is not a typical finding in Addison’s disease.

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A nurse is caring for a client who has schizophrenia. Exhibits Select the "3" findings that should indicate to the nurse the client is experiencing negative symptoms related to their schizophrenia.

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A nurse is caring for a client who has schizophrenia.

Exhibits

Select the "3" findings that should indicate to the nurse the client is experiencing negative symptoms related to their schizophrenia.