A nurse is caring for a client who has schizophrenia who consistently does the opposite of what the nurse asks of him. The nurse recognizes this as which of the following alterations in behavior?
Automatic obedience.
Active negativism.
Impaired impulse control.
Waxy flexibility.
The Correct Answer is B
Choice A reason: Automatic obedience involves unthinkingly following instructions, often seen in catatonia. The client’s oppositional behavior is the opposite, making this an incorrect choice.
Choice B reason: Active negativism, common in schizophrenia, involves deliberately doing the opposite of what is requested, reflecting resistance or opposition. The client’s behavior matches this description.
Choice C reason: Impaired impulse control involves acting on urges without restraint, such as aggression or impulsivity. The client’s deliberate opposition is not impulsive but purposeful, so this is incorrect.
Choice D reason: Waxy flexibility involves maintaining imposed postures, typically in catatonia. The client’s oppositional behavior does not involve physical posturing, making this incorrect.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Pseudoparkinsonism causes symptoms such as tremors, rigidity, bradykinesia, and shuffling gait. It is not associated with fever, blood pressure changes, or diaphoresis.
Choice B reason: Tardive dyskinesia develops gradually after prolonged antipsychotic use and presents with involuntary movements like lip smacking, tongue protrusion, or grimacing. It does not cause acute systemic symptoms such as hyperpyrexia or autonomic instability.
Choice C reason: Neuroleptic malignant syndrome (NMS) is a life-threatening emergency associated with antipsychotics. It manifests with hyperpyrexia, autonomic instability (blood pressure changes, diaphoresis), severe muscle rigidity, and altered mental status. The client’s presentation matches NMS.
Choice D reason: Acute dystonia involves sudden muscle contractions affecting the face, neck, or back (e.g., torticollis, oculogyric crisis). It does not present with systemic symptoms like fever or blood pressure fluctuations.
Correct Answer is D
Explanation
Choice A reason: This statement reflects derealization, which is the experience that the external environment feels unreal or changed, not depersonalization.
Choice B reason: This describes auditory hallucinations, a common symptom of schizophrenia, but not depersonalization.
Choice C reason: This indicates persecutory delusions, not depersonalization.
Choice D reason: This confirms depersonalization, which involves altered perception of one’s own body or sense of self, such as believing body parts are distorted in size or shape.
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