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","C","D","E"]
Explanation
Choice A reason: Children's natural activity levels and spontaneity can mimic the hyperactivity of bipolar mania, making it challenging to differentiate between typical behavior and symptoms of a mood disorder.
Choice B reason: This statement is incorrect; bipolar disorder can be diagnosed before the age of 18. Early-onset bipolar disorder is recognized and can be diagnosed in children and adolescents.
Choice C reason: ADHD and bipolar disorder share common symptoms such as impulsivity and inattention, which can complicate the differential diagnosis, especially in younger populations.
Choice D reason: Neurotransmitter levels do indeed vary with age, which can affect mood and behavior, thereby complicating the diagnosis of bipolar disorder in young individuals.
Choice E reason: While genetic predisposition plays a role in bipolar disorder, it alone is not a definitive diagnostic determinant due to the complex interplay of genetic and environmental factors.
Correct Answer is B
Explanation
Choice A reason: This statement shows that the client is willing to ground their decisions in reality, which is a key step in managing paranoid personality disorder.
Choice B reason: Trusting others is important, but it does not indicate that the client has learned to validate their ideas before acting.
Choice C reason: Differentiating true suspicions is part of managing the disorder, but it does not demonstrate an understanding of the need to validate ideas with others.
Choice D reason: Understanding the origins of paranoid thinking is insightful, but it does not show that the client has learned to validate their ideas before taking action.
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