T2 - Schizophrenia (Josh)

Question 1

Bleuler’s Four ‘A’s’ of Schizophrenia.

Answer 1

• Affect
• Associative Looseness
• Autism
• Ambivalence

Question 2

Negative Symptoms include –

Answer 2

Affect (ex: inappropriate)

Volition (ex: deteriorated appearance)

Interpersonal Functioning (ex: social isolation)

Psychomotor Behavior (ex: anergia)

Assoc. Features (ex: andedonia)

Question 3

— reinforce hallucinations.

Answer 3

DO NOT

• let the client know you do not share the perceptions
• call them ‘voices’ not ‘they’ or ‘them’

Question 4

Types of Hallucinations:

Answer 4

• Auditory
• Visual
• Tactile
• Gustatory
• Olfactory

Question 5

A nurse is completing an admission assessment for a client who has schizo. Which of the following findings should the nurse document as positive symptoms? (SATA)

a) Auditory hallucination
b) Lack of motivation
c) Use of clang associations
d) Delusion of persecution
e) Constantly waving arms
f) Flat affect

Answer 5

a) Auditory hallucination
c) Use of clang associations
d) Delusion of persecution
e) Constantly waving arms

Question 6

Interventions for a client who IS hallucinating.

Answer 6

• observe for OBJECTIVE S/S
• AVOID TOUCHING client
• ASSESS CONTENT ONCE A DAY
• DO NOT REINFORCE hallucination
• help client make CONNECTION BETWEEN HALLUCINATION and ANXIETY
• DISTRACTION METHODS – discuss ways of helping people cope

Question 7

— are fixed, false beliefs.

Answer 7

Delusions

Question 8

In — —, the the HCP can use praise and other positive reinforcements to help the client w/ schizo reduce the frequency of maladaptive behaviors.

Answer 8

Behavior Therapy

Question 9

— has been shown to be effective when combined w/ drug treatment for schizophrenics.

Answer 9

Group Therapy

Question 10

What is echolalia?

Answer 10

repeating words they hear

• it is an attempt to identify w/ the person speaking

Question 11

Negative S/S of Schizophrenia:

Answer 11

• AFFECTIVE FLATTENING,
• ALOGIA (POVERTY OF SPEECH),
• AVOLITION/APATHY,
• ANHEDONIA,
• SOCIAL ISOLATION

Question 12

Can schizophrenia be inherited?

Answer 12

Yes

Question 13

Positive Symptoms are those that are —

Answer 13

exaggerated

• you can observe them

Question 14

A nurse is caring for a client who has schizoaffective disorder. Which of the following statements indicates the client is experiencing depersonalization?

a) I am a superhero, I am immortal
b) I am no one and everyone is me
c) I feel monsters pinching me all over
d) I know that you are stealing my thoughts

Answer 14

b) I am no one and everyone is me

Question 15

Hallucinations have to do with —–

Answer 15

your 5 senses

Question 16

— — stresses a client’s rights to goals and to have freedom of movement and informal relationship w/ staff.

Answer 16

Milieu Therapy

Question 17

To be classified as Schizo, the signs of disturbance must persist at least –

Answer 17

6 mths

Question 18

Which of the following would the nurse want to use benztropine?

a) client’s level of agitation has increased
b) client complains of a sore throat
c) client’s skin has yellowish cast
d) client develops tremors and a shuffling gait

Answer 18

d) client develops tremors and a shuffling gait

Question 19

Examples of Conventional Antipsychotics (for positive symptoms)

ATI

Answer 19

Haloperidol

Loxapine

Chlorpromazine

Fluphenazine

Question 20

Positive S/S of Schizophrenia:

Answer 20

• HALLUCINATIONS,
• DELUSIONS,
• DISORGANIZED THINKING/SPEECH,
• DISORGANIZED BEHAVIOR

(Must have 3 of these)

Question 21

A nurse is caring for a client who has substance-induced psychotic disorder and is experiencing auditory hallucinations. The client states, ‘The voices want leave me alone!’

Which of the following is an appropriate statement? (SATA)

a) When did you start hearing the voices?
b) The voices are not real, or else we would both be hearing them.
c) It must be scary to hear voices
d) Are they voices telling you to hurt yourself?
e) Why are the voices talking only to you?

Answer 21

a) When did you start hearing the voices?
c) It must be scary to hear voices
d) Are they voices telling you to hurt yourself?

Question 22

Schizophrenia is — multiple personalities.

Answer 22

NOT

Question 23

Interventions for a patient w/ delusions.

Answer 23

• convey ACCEPTANCE
• do NOT ARGUE
• focus on REALITY - BASED activities
• DISCOURAGE DISCUSSIONS about delusions
• use SAME STAFF if suspicious
• DON’T TOUCH, LAUGH, WHISPER if suspicious
• give food in SEALED CONTAINERS
• discuss way of HELPING COPE with disturbing thoughts

Question 24

Positive Symptoms include —

Answer 24

Content of thought (ex: delusion)

Form of thought (ex: neologism)

Perception (ex: illusion)

Sense of self (ex: echolalia)

Question 25

Example of Antidepressant (ATI)

Answer 25

Paroxetine

Question 26

Diagnostic criteria for Schizo..

Answer 26

2 or more of: - Delusions - Hallucinations - Disorganized Speech - Grossly disorganized/catatonic behavior - Negative symptoms

Question 27

When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first? a) Provide large motor activities to relieve the client's pent-up tension b) Administer a dose of prn chlorpromazine to keep the client calm c) Call for sufficient help to control the situation safely d) Convey to the client that his behavior is not acceptable and will not be tolerated

Answer 27

c) Call for sufficient help to control the situation safely

Question 28

Phases of Schizophrenia.

Answer 28

1) Premorbid Phase 2) Prodromal Phase 3) Schizophrenia 4) Residual

Question 29

The nurse is caring for a client w/ schizo. Order include 100 mg chlorpromazine IM STAT and then 50 mg PO bid. Why is chlorpromazine used? a) reduce EPS symptoms b) prevent NMS c) decrease psychotic symptoms d) induce sleep

Answer 29

c) decrease psychotic symptoms

Question 30

Examples of Atypical Antidepressants (ATI)

Answer 30

Risperidone Olanzapine Quetiapine Ziprasidone Apriprazole Clozapine

Question 31

Purposefully imitating the movements of others

Answer 31

Echopraxia

Question 32

How is social-skill therapy typically taught to schizo clients?

Answer 32

role-play using scenarios that they would face in every-day life

Question 33

A nurse is caring for a client who reports hearing voices that are telling him to 'kill your doctor.' Which of the following is the priority action? a) Use therapeutic communication to discuss the hallucination w/ the client b) Initiate one-to-one observation of the client c) Focus the client on reality d) Notify the provider of the client's statement

Answer 33

b) Initiate one-to-one observation of the client

Question 34

When talking to a schizophrenic, use ---, not ---

Answer 34

'the voices' 'they'

Question 35

--- came up w/ the term 'schizophrenia'

Answer 35

Dr. Eugene Bleuler

Question 36

A nurse is speaking w/ a client who has schizo when he suddenly seems to stop focusing on the nurse's questions and begins looking at the ceiling and talking to himself. Which of the following actions should the nurse take? a) Stop the interview at this point, and resume later when the client is better able to concentrate b) Ask the client "Are you seeing something on the ceiling?' c) Tell the client, 'You seem to be looking at something on the ceiling. I see something there too.' d) Continue the interview without comment on the client's behavior

Answer 36

b) Ask the client "Are you seeing something on the ceiling?'

Question 37

When the emotional tone is weak, the affect is --

Answer 37

bland

Question 38

Does schizophrenia mean 'split personality'?

Answer 38

No