A patient diagnosed with schizophrenia has been stable for a year; however, the family now reports the patient is tense, sleeps 3 to 4 hours per night, and has difficulty concentrating. The patient says. "My computer is sending out infected radiation beams." The nurse can correctly assess this information as an Indication of

chronic deterioration.

medication nonadherence.

the need for psychoeducation.

relapse.

Answer and Explanation

The Correct Answer is D

A. Chronic deterioration refers to a gradual, long-term decline in functioning, not the sudden emergence of new or worsening psychotic symptoms.

B. While relapse can sometimes be related to nonadherence, there is no direct evidence here that the patient has stopped taking medication, so this cannot be assumed.

C. Psychoeducation may be helpful, but the immediate concern is the reemergence of psychotic symptoms, not just a lack of understanding about the illness.

D. The patient is displaying insomnia, tension, difficulty concentrating, and paranoid delusions, which are early warning signs of a psychotic relapse in schizophrenia. Prompt intervention is necessary to prevent full exacerbation.

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Correct Answer is A

Explanation

A. Using silence allows the patient time to process thoughts and feelings, encourages introspection, and can facilitate deeper communication during interviews.

B. While prolonged silence can sometimes make patients uncomfortable, its intentional and therapeutic use is beneficial when appropriately timed.

C. Reflecting or paraphrasing communicates understanding; silence alone does not confirm comprehension.

D. In therapeutic communication, the nurse does not have to immediately fill silence; allowing moments of quiet can be purposeful.

A. Aripiprazole (Abilify) B. Olanzapine (Zyprexa) C. Clozapine (Clozaril) D. Ziprasidone (Geodon)

Correct Answer is A

Explanation

A. Aripiprazole is an atypical antipsychotic with a lower risk of weight gain, metabolic syndrome, and hypertension compared with olanzapine or clozapine, making it suitable for a patient who is overweight and hypertensive. It effectively treats positive symptoms such as auditory hallucinations and may improve social functioning.

B. Olanzapine is effective for schizophrenia but is associated with significant weight gain, hyperlipidemia, and worsening hypertension, making it less appropriate for this patient.

C. Clozapine is reserved for treatment-resistant schizophrenia due to risks of agranulocytosis, myocarditis, and metabolic side effects; it is not first-line for this patient.

D. Ziprasidone has a lower risk of metabolic side effects than olanzapine or clozapine, but it carries a risk of QT prolongation, which may be concerning in hypertensive patients with potential cardiac risks.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which principle should guide the nurse in determining the extent of silence to use during patient interview sessions?

Correct Answer is A

Explanation

A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social function. The patient is also overweight and hypertensive. Which drug should the nurse advocate?

Correct Answer is A

Explanation

Which statement shows a nurse has empathy for a patient who made a suicide attempt?

A nurse is caring for a client who has major depressive disorder and is scheduled for electroconvulsive therapy (ECT). The client's spouse asks the nurse about the possible side effects of the ECT. Which of the following responses should the nurse make?

A patient undergoing diagnostic tests says. "Nothing is wrong with me except a stubborn chest cold." The spouse reports the patient smokes, coughs daily. lost 15 pounds and is easily fatigued. Which defense mechanism is the patient using?

Which nursing intervention has the highest priority for a patient who is diagnosed with anorexia nervosa and has begun to gain weight?

Which measure would be considered a form of primary prevention for suicide?

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client al t about the use of this medication?

Two weeks ago, a soldier returned to the United States from active duty in a combat zone. The soldier was diagnosed with post-traumatic stress disorder (PTSD). Which comment by the soldier requires the nurse's immediate attention?

A hospitalized client diagnosed with alcohol use disorder believes spiders are spinning webs in the room to entrap him. The patient is fearful, agitated, and diaphoretic. Which nursing intervention is indicated?