The nurse is evaluating several clients with a diagnosis of schizophrenia. Which client will be assessed as having the worst potential outcomes?
An adolescent client with alogia, anhedonia, and a flat or blunted affect.
A client who has a first cousin with bipolar I disorder.
A client with an exacerbation of hallucinations and delusions 2 years after diagnosis.
An older adult client with an onset of positive symptoms at age 35.
The Correct Answer is A
Choice A reason: This client presents with negative symptoms of schizophrenia, which are often associated with a poorer prognosis. Negative symptoms like alogia and anhedonia indicate a diminished emotional response and lack of motivation, which can severely impact the client's ability to function and respond to treatment.

Choice B reason: Having a first cousin with bipolar I disorder may suggest a genetic predisposition to mood disorders but does not directly influence the prognosis of a client already diagnosed with schizophrenia.
Choice C reason: While an exacerbation of hallucinations and delusions indicates a worsening of symptoms, it is the positive symptoms of schizophrenia that are often more responsive to treatment. Therefore, this client may not necessarily have the worst outcomes.
Choice D reason: An older adult with a late onset of schizophrenia typically has a better prognosis than those with an earlier onset. Late-onset schizophrenia is often less severe and may respond better to treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Bulimia Nervosa often involves behaviors such as excessive laxative use, which can lead to severe electrolyte imbalances, potentially causing unconsciousness.
Choice B reason: While a sudden cardiac event is possible, it is less likely to be directly related to the history of Bulimia Nervosa and laxative use.
Choice C reason: There is no indication that an accidental fall occurred, and it would not be directly related to the history of laxative use.
Choice D reason: Without further information, it is speculative to attribute the unconsciousness to a reaction to another medication.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A reason: While it’s important to assess access to lethal means, this question is too specific and assumes the client owns a gun. A more appropriate question might be, “Do you have access to any means to harm yourself?”
Choice B reason: Inquiring about thoughts of self-harm or harming others is a direct question that assesses suicidal ideation and intent, which is essential for determining immediate risk.
Choice C reason: Understanding if the client has specific plans for self-harm can help gauge the immediacy and seriousness of the suicide risk.
Choice D reason: Discussing feelings about dying can provide insight into the client's emotional state and potential risk for suicide.
Choice E reason: This question is important but it should not replace direct questions about the client’s current thoughts and feelings. It’s possible for a client to deny feelings of suicidality to their psychiatrist while still experiencing them.
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