A nurse is providing teaching about relapse prevention to a client who has schizophrenia. Which of the following statements by the client indicates an understanding of the teaching?

Indicates potential Improvement a. Hygiene b. Food intake c. Rapid change in mood

Indicates potential worsening a. Giving away car b. Condition of skin on right hand

Choice A: Giving away car

This could be a sign of the client’s worsening condition. Giving away possessions can sometimes be a sign of suicidal ideation. It’s important to monitor this behavior and report it to the healthcare provider.

Choice B: Hygiene

The client showered without prompting on the third day, which is an improvement from the first day when they declined to shower. Improved personal hygiene can be a sign of improvement in a client with obsessive-compulsive disorder.

Choice C: Food intake

The client ate 75% of their meals on the third day, which is an improvement from the first day when they refused to eat. Increased food intake can indicate an improvement in the client’s condition2.

Choice D: Condition of skin on right hand

The client’s hands remain reddened with a 1 cm x 1 cm area of peeling skin noted on the center of the right palm. This could indicate a worsening condition, as it may be a result of excessive handwashing, a common compulsion in OCD.

Choice E: Rapid change in mood

The client’s affect rapidly changed throughout the afternoon and early evening; the client is now talkative and appears content. This could indicate an improvement in the client’s condition, as they are engaging more with others and showing more positive emotions.

Choice A reason: An altered level of consciousness is not typically associated with Alzheimer's disease. Patients with Alzheimer's may experience confusion or disorientation, but changes in consciousness, such as stupor or coma, are not characteristic symptoms of the disease.

Choice B reason: Failure to recognize familiar objects, known as agnosia, is a common finding in Alzheimer's disease. As the disease progresses, the ability to recognize objects, faces, and even sounds can be impaired, which is a direct result of the deterioration of brain areas involved in processing sensory information.

Choice C reason: Excessive motor activity is not a common finding in Alzheimer's disease. While patients may experience restlessness, the disease often leads to a decrease in overall activity levels due to cognitive decline and the eventual difficulty with coordination and motor functions.

Choice D reason: Rapid mood swings can occur in Alzheimer's disease, but they are not as prominent as other cognitive symptoms. Mood changes in Alzheimer's are usually a result of the frustration and confusion experienced by the patient rather than a direct symptom of the disease itself.