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d. Teaching to limit caffeine intake

ANS: C

Ziprasidone is a second-generation antipsychotic medication. The incidence of weight gain, diabetes, and high cholesterol is high with second-generation antipsychotic medications. The patient is overweight now, so weight management will be especially important. The other interventions may occur in time, but do not have the priority of weight management.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Pages 12-53, 84 (Table 12-5) TOP: Nursing Process: Planning

MSC: Client Needs: Physiological Integrity a. Neologism b. Idea of reference c. Thought broadcasting d. Associative looseness

25. A patient diagnosed with schizophrenia says, “It’s beat. Time to eat. No room for the cat.” What type of verbalization is evident?

ANS: D

Looseness of association refers to jumbled thoughts incoherently expressed to the listener. Neologisms are newly coined words. Ideas of reference are a type of delusion. Thought broadcasting is the belief that others can hear one’s thoughts.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Pages 12-18, 46, 47 TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity a. Haloperidol b. Olanzapine c. Chlorpromazine d. Diphenhydramine

26. A patient diagnosed with schizophrenia has taken a conventional antipsychotic medication for a year. Hallucinations are less intrusive, but the patient continues to have apathy, poverty of thought, and social isolation. The nurse would expect a change to which medication?

ANS: B

Olanzapine is a second-generation atypical antipsychotic that targets both positive and negative symptoms of schizophrenia. Haloperidol and chlorpromazine are conventional antipsychotics that target only positive symptoms. Diphenhydramine is an antihistamine. See relationship to audience response question.

PTS: 1

DIF: Cognitive Level: Analyze (Analysis)

REF: Pages 12-33 (Case Study and Nursing Care Plan: Schizophrenia), 52

TOP: Nursing Process: Planning

MSC: Client Needs: Physiological Integrity a. Psychoeducational b. Psychoanalytic c. Transactional d. Family

27. The family of a patient diagnosed with schizophrenia is unfamiliar with the illness and family’s role in recovery. Which type of therapy should the nurse recommend?

ANS: A

A psychoeducational group explores the causes of schizophrenia, the role of medication, the importance of medication compliance, support for the ill member, and hints for living with a person with schizophrenia. Such a group can be of immeasurable practical assistance to the family. The other types of therapy do not focus on psychoeducation.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 12-30, 31, 43, 44, 93 (Box 12-2) | Page 221

TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

28. 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 a. the need for psychoeducation. b. medication nonadherence. c. chronic deterioration. d. relapse.

ANS: D

Signs of potential relapse include feeling tense, difficulty concentrating, trouble sleeping, increased withdrawal, and increased bizarre or magical thinking. Medication nonadherence may not be implicated. Relapse can occur even when the patient is taking medication regularly. Psychoeducation is more effective when the patient’s symptoms are stable. Chronic deterioration is not the best explanation.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Pages 12-32, 33, 93 (Box 12-2) TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity

29. A patient diagnosed with schizophrenia begins to talks about “macnabs” hiding in the warehouse at work. The term “macnabs” should be documented as a. a neologism. b. concrete thinking. c. thought insertion. d. an idea of reference.

ANS: A

A neologism is a newly coined word having special meaning to the patient. “Macnabs” is not a known common word. Concrete thinking refers to the inability to think abstractly. Thought insertion refers to thoughts of others are implanted in one’s mind. Ideas of reference are a type of delusion in which trivial events are given personal significance.