A nurse is teaching about sources of psychological stress to a group of newly licensed nurses. The nurse should identify which of the following qualifies as a source of psychological distress?

A. Use touch to calm the client during periods of anxiety:

Individuals with paranoid schizophrenia may have heightened sensitivity to touch, and it can potentially exacerbate their anxiety or paranoia. This intervention may not be appropriate as it could escalate the client's distress.

B. Check the client's mouth after the client takes medication:

This is the best choice. People with paranoid schizophrenia may be prone to hoarding or pocketing medications. Checking the client's mouth ensures that the medication has been swallowed, promoting medication adherence and preventing potential harm.

C. Rotate the staff assignments for this client:

Consistency in caregivers is generally preferred for clients with schizophrenia to build trust and a therapeutic relationship. Constantly changing staff assignments can lead to increased anxiety and mistrust.

D. Assign an assistive personnel to feed the client at meal times:

While assistance with feeding may be needed, assigning an assistive personnel without direct supervision for a client with paranoid schizophrenia may not be the best approach. It's important to ensure the client's safety and monitor their behavior during meals.

A. Axons: Axons are nerve cell processes that transmit signals away from the cell body. While axons are essential for communication between nerve cells, their structure or function is not directly implicated in the altered behavior associated with schizophrenia.

B. Neurotransmitters: This is the correct answer. In schizophrenia, there is evidence of dysregulation in neurotransmitter systems, particularly dopamine. Dopamine dysregulation is associated with both positive and negative symptoms of schizophrenia. In the case of negative symptoms, such as social withdrawal and reduced emotional expression, hypoactivity in dopamine pathways may play a role.

C. Dendrites: Dendrites are nerve cell processes that receive signals from other neurons. Similar to axons, dendrites are crucial for communication between nerve cells, but their structure or function is not specifically implicated in the altered behavior associated with schizophrenia.

D. Synapses: Synapses are the junctions between nerve cells where neurotransmitters are released to transmit signals. While synapses play a critical role in neurotransmission, the altered behavior in schizophrenia is more closely linked to the dysregulation of neurotransmitters, particularly dopamine, than to structural changes in synapses.