A nurse is assessing a client diagnosed with schizophrenia. The client believes that an alien invasion is imminent and has barricaded themselves in their room to protect against the perceived threat. The client becomes agitated when approached and insists on the necessity of the barricade. Which intervention by the nurse is most appropriate?
A) Administering an antipsychotic medication immediately
B) Confronting the client about the irrational belief
C) Removing the barricade to encourage social interaction
D) Reassuring the client that the belief is unrealistic
E) Allowing the client to maintain the barricade while ensuring safety
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Rationale: Option E demonstrates the best approach by respecting the client’s perception while ensuring their safety. Schizophrenic clients often experience delusions that are real to them, and abruptly challenging these beliefs can escalate agitation and undermine trust. Safety remains the priority while respecting the client’s autonomy.
A client with schizophrenia is prescribed haloperidol (Haldol). The nurse monitors the client for which potential adverse effect specific to this medication?
A) Weight gain
B) Hypertension
C) Extrapyramidal symptoms
D) Sedation
E) Dry mouth
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Rationale: Haloperidol, a typical antipsychotic, is associated with extrapyramidal symptoms (EPS) such as dystonia, akathisia, and Parkinsonism. Monitoring for these adverse effects is crucial as they can affect the client’s motor function and overall well-being.
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During a group therapy session for clients with schizophrenia, one member suddenly begins to loudly chant and interrupt others, becoming increasingly agitated. What is the nurse’s initial action?
A) Remove the client from the group session
B) Verbally reprimand the client for disruptive behavior
C) Ignore the behavior to avoid reinforcing it
D) Redirect the client’s behavior using a calm voice and gentle touch
E) Immediately call for security assistance to restrain the client
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Rationale: When a client with schizophrenia displays disruptive behavior during a group session, redirecting their behavior with a calm approach helps to de-escalate the situation. Removal or reprimanding may worsen agitation, while ignoring the behavior can lead to a lack of intervention. Using redirection techniques can help the client regain focus and decrease agitation in a therapeutic manner.
Understanding Schizophrenia: NCLEX Priority Questions
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A nurse is assessing a client diagnosed with schizophrenia who has been prescribed clozapine (Clozaril). The client reports experiencing fever, sore throat, and malaise. Which action should the nurse prioritize?
A) Administering an antipyretic medication
B) Suspending the clozapine dosage immediately
C) Initiating isolation precautions for the client
D) Contacting the healthcare provider promptly
E) Encouraging increased fluid intake
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Rationale: Clozapine can cause agranulocytosis, presenting as fever and sore throat. Given the potential severity of this adverse effect, it’s crucial to promptly involve the healthcare provider for further evaluation and potential discontinuation of the medication to prevent worsening hematological complications.Understanding Schizophrenia: Causes and Symptoms
Question 2: Vignette: A client with schizophrenia has been prescribed risperidone (Risperdal). The nurse educates the client and family about potential adverse effects. Which statement by the client indicates understanding of a common side effect of this medication?
A) “I should watch out for excessive weight gain.”
B) “I might experience low blood pressure.”
C) “I could have difficulty sleeping.”
D) “I may develop hand tremors.”
E) “I might have increased sweating.”
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Rationale: Risperidone, an atypical antipsychotic, commonly causes extrapyramidal symptoms like hand tremors. Educating the client and family about these potential side effects helps in monitoring and managing the medication’s adverse effects effectively.
NCLEX Focus Exploring Schizophrenia: Causes and Diagnosis
A client with schizophrenia has been prescribed risperidone (Risperdal). The nurse educates the client and family about potential adverse effects. Which statement by the client indicates understanding of a common side effect of this medication?
A) Administering a benzodiazepine
B) Providing a quiet and calm environment
C) Initiating physical restraints for safety
D) Encouraging the client to express feelings
E) Administering a dose of antipsychotic medication
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Rationale: Clients experiencing acute psychosis benefit from a calm and quiet environment to minimize stimuli and reduce agitation. This intervention aims to create a safe space while avoiding further escalation of the client’s distress.
NCLEX Questions: Focus on Medications for Schizophrenia
A client with schizophrenia is being discharged and will continue with outpatient therapy. The nurse emphasizes the importance of medication adherence. Which statement by the client indicates a need for further education?
A) “I will take my medication daily as prescribed.”
B) “I’ll skip doses if I feel better to avoid side effects.”
C) “I’ll monitor for any changes and report them to my doctor.”
D) “I understand that stopping medication suddenly can worsen my symptoms.”
E) “I’ll consult my doctor before taking any other medications.”
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Rationale: Stopping medication abruptly or skipping doses can lead to relapse in clients with schizophrenia. It’s crucial to emphasize the importance of consistent medication adherence to maintain stability and prevent exacerbation of symptoms.
A nurse is assessing a client diagnosed with schizophrenia. The client presents with an absence of emotional expression, reduced social engagement, and minimal speech. Which category of symptoms is the client predominantly displaying?
A) Cognitive symptoms
B) Positive symptoms
C) Affective symptoms
D) Negative symptoms
E) Psychomotor symptoms
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Rationale: Negative symptoms of schizophrenia involve a decrease or absence of normal behaviors or emotions. This vignette describes characteristics such as flat affect, social withdrawal, and reduced speech, which are indicative of negative symptoms commonly seen in schizophrenia.
NCLEX Questions Critical Thinking: Schizophrenia Symptoms
A client diagnosed with schizophrenia experiences auditory hallucinations, paranoid delusions, and disorganized speech. These symptoms are categorized as:
A) Positive symptoms
B) Negative symptoms
C) Affective symptoms
D) Psychomotor symptoms
E) Cognitive symptoms
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Rationale: Positive symptoms of schizophrenia involve the presence of abnormal behaviors or experiences not typically seen in healthy individuals. Auditory hallucinations, paranoid delusions, and disorganized speech are examples of positive symptoms characterized by an excess or distortion of normal functions.
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NCLEX Review: Schizophrenia Treatments
A client with schizophrenia demonstrates a lack of motivation, reduced ability to experience pleasure, and decreased interest in social interactions. These symptoms are most consistent with:
A) Negative symptoms
B) Positive symptoms
C) Affective symptoms
D) Cognitive symptoms
E) Psychomotor symptoms
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Rationale: Negative symptoms in schizophrenia encompass diminished emotional expression, avolition, and social withdrawal. The client’s lack of motivation, reduced pleasure, and decreased interest in social interactions align with the characteristics of negative symptoms associated with schizophrenia.
