A nurse is caring for a client who has schizophrenia.
Nurses' Notes: Day 1 1030: A 35-year-old client who has schizophrenia is admitted.
Diagnosed 15 years ago.
Brought in by partner and states client has remained in room for the last several days and movements are delayed.
Day 1 1730: Client refuses to eat or drink.
Client appears withdrawn and does not engage in conversation.
Client has flat affect.
Does not want to go to therapy session and wants to sleep.
Client's movements are slow.
Vital Signs: Day 1 1030: Temperature 37° C (98.6° F). Heart rate 72/min.
Respiratory rate 20/min.
Blood pressure 132/38 mm Hg. Oxygen saturation: 99% on room air.
Select the "3" findings that should indicate to the nurse the client is experiencing negative symptoms related to their schizophrenia:.
Withdrawn.
Lack of energy.
Change in behavior.
Lack of motivation.
Blood pressure.
Correct Answer : A,B,D
Choice A rationale:
Being withdrawn is a negative symptom of schizophrenia. It refers to the lack of social engagement and reduced interest in others.
Choice B rationale:
Lack of energy, or avolition, is a negative symptom of schizophrenia. It refers to a decrease in the initiation and persistence of goal-directed activities.
Choice C rationale:
Change in behavior is too broad to be considered a specific negative symptom of schizophrenia. Both positive and negative symptoms of schizophrenia can lead to changes in behavior.
Choice D rationale:
Lack of motivation, or avolition, is a negative symptom of schizophrenia. It refers to a decrease in the initiation and persistence of goal-directed activities.
Choice E rationale:
Blood pressure is not a symptom of schizophrenia. It is a physiological measurement and does not reflect the psychological symptoms of schizophrenia.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Weight gain is not typically associated with acute mania in bipolar disorder.
Choice B rationale:
Disorganized speech can be a symptom of acute mania, which is characterized by increased energy, feelings of euphoria, racing thoughts, risky behaviors, and an inflated self-image.
Choice C rationale:
While hallucinations can occur in severe bipolar episodes, the client reporting that voices are telling him to write a novel is not specifically indicative of acute mania.
Choice D rationale:
Dressing in all black is not a specific symptom of acute mania.
Correct Answer is A
Explanation
Choice A rationale:
Assigning a staff member to stay with the client at all times is the priority action when a client declines to make a safety contract. This is because the immediate safety of the client is the primary concern in such situations.
Choice B rationale:
Locking the doors to the unit and securing windows so they cannot be opened might be considered a safety measure, but it is not the priority. The focus should be on direct supervision to ensure safety.
Choice C rationale:
Removing any objects from the client’s environment that could be used for self-harm is important, but it is not the priority. The immediate safety of the client through constant supervision is the priority.
Choice D rationale:
Providing the client with plastic eating utensils for meals is a safety measure, but it is not the priority. The immediate safety of the client through constant supervision is the priority.
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