Nclex-Rn Practice Questions-Care Of The Psychiatric Client - Schizophrenic & Delusional Disorders
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Question 1 |
A client with schizophrenia reports that her hallucinations have decreased in frequency. What is the most appropriate nursing intervention to address the client’s problem with social isolation?
A | Have the client join in a group game. |
B | Name the client as the leader of the client support group. |
C | Have the client play solitaire. |
D | Ask the client to participate in a group sing-along. |
Question 2 |
Which action by a client with stable schizophrenia is most important for preventing relapse?
A | Attending group therapy sessions |
B | Participating in family support meetings |
C | Attending social skills training sessions |
D | Consistently taking prescribed medications |
Question 3 |
A client approaches the nurse and points at the sky, showing her where the men would be coming from to get him. What is the best response by the nurse?
A | “Why do you think the men are coming here?” |
B | “You’re safe here; we won’t let them harm you.” |
C | “It seems like the world is pretty scary for you, but you’re safe here.” |
D | “There are no bad men in the sky because no one lives that close to earth.” |
Question 4 |
A client is brought to the crisis response center by his family. During evaluation, he reports being depressed for the last month and complains about voices constantly whispering to him. Which diagnosis is the most likely?
A | Catatonic schizophrenia |
B | Disorganized schizophrenia |
C | Paranoid schizophrenia |
D | Schizoaffective disorder |
Question 5 |
What is the most appropriate nursing intervention for a nurse to implement when caring for a client with paranoid schizophrenia?
A | Defend yourself when the client is verbally hostile toward you. |
B | Provide a warm approach by touching the client. |
C | Explain everything you’re doing before you do it. |
D | Clarify the content of the client’s delusions. |
Question 6 |
The nurse is interviewing a client with a delusional disorder. Which of the following conditions would the nurse expect from this client?
A | Bizarre behavior |
B | Agitation |
C | Impaired short-term memory |
D | Apparently normal functioning |
Question 7 |
A client is admitted to a psychiatric unit for a delusional disorder. He explains to a nurse that he made a contract with God to be the best minister on earth. Now that he has achieved the goal, most of his friends have stopped seeing him out of envy. On mental status examination, there is little impairment in psychosocial functioning. Which condition is expected?
A | Nonbizarre delusions |
B | Fragmentary delusions |
C | Regressive behavior |
D | Regressive delusions |
Question 8 |
As a nurse approaches the nursing station, a client with the diagnosis of delusional disorder raises his voice and says, “You’re following me. What do you want?” What is the best response by the nurse?
A | “Are you frightened?” |
B | “You know I’m not following you.” |
C | “You’ll have to go into seclusion if you continue to threaten me.” |
D | “I’m sorry if I frightened you. I was returning to the nursing station after going out for lunch.” |
Question 9 |
A client who is taking antipsychotic medications becomes agitated, fearful, and panicky that people are staring at him. He paces with his neck twisted to one side, and his eyes forcefully drawn upward toward the ceiling. The nurse recognizes the need for intervention. What is the most appropriate medication for the nurse to administer?
A | I.M. benztropine (Cogentin) |
B | Haloperidol (Haldol) |
C | Paliperidone (Invega) |
D | Diazepam (Valium) |
Question 10 |
The nurse is teaching the family of a client with schizophrenia about symptoms of remission. Which of the following responses would be the most accurate?
A | The disease is in the prodromal phase. |
B | The client no longer has prominent psychotic symptoms. |
C | The client is free from all signs of illness and is no longer on medication. |
D | The client is free from all signs of illness whether or not he’s on medication. |
Question 11 |
A client tells a nurse voices are telling him to do “terrible things.” What is the best response by the nurse?
A | Find out what the voices are telling him. |
B | Let him go to his room to decrease his anxiety. |
C | Begin talking to the client about an unrelated topic. |
D | Tell the client the voices aren’t real. |
Question 12 |
A client is preoccupied with his belief that the CIA has been planning to take him away to save the agency from his influence. These delusions are a defense against which underlying feeling?
A | Aggression |
B | Guilt |
C | Inferiority |
D | Persecution |
Question 13 |
A client has started taking haloperidol (Haldol). What is the most important instruction for the nurse to give the client?
A | “You should report feelings of restlessness or agitation at once.” |
B | “Use a sunscreen outdoors on a year-round basis.” |
C | “Be aware you’ll feel increased energy taking this drug.” |
D | “This drug will indirectly control essential hypertension.” |
Question 14 |
Which symptom indicates that schizophrenia is a thought disorder?
A | Faulty logic |
B | Distorted but organized thinking |
C | Organized but disruptive thoughts |
D | Appropriate perception but difficulty responding appropriately to people and events |
Question 15 |
A client with schizophrenia tells the nurse that the President consults with him before making major decisions. What is the best response by the nurse?
A | “How long have you known the President?” |
B | “You’re fortunate to know the President.” |
C | “How will you speak with the President from the hospital?” |
D | “You must feel important. Now let’s make your bed.” |
Question 16 |
A client is admitted after being found on a highway, hitting at cars and yelling at motorists. When approached by the nurse, the client shouts, “You’re the one who stole my husband from me!” The nurse interprets the behavior as:
A | hallucinatory experience. |
B | delusional experience. |
C | disorientation to the environment. |
D | phobic experience. |
Question 17 |
In preparation for discharge, a client diagnosed with schizophrenia was taught symptom self-management as part of a relapse prevention program. Which statement indicates to the nurse that the client understands symptom monitoring?
A | “When I hear voices, I become afraid I’ll relapse.” |
B | “My parents aren’t involved enough to be aware if I begin to relapse.” |
C | “My family is more protected from stress if I keep them out of my illness process.” |
D | “When I’m feeling stressed, I go to a quiet room by myself and do imagery.” |
Question 18 |
A client with schizophrenia is huddled on the floor and appears to be interacting with someone underneath the bed. The nurse notes that the client appears afraid. Which assessment by the nurse is most likely correct?
A | The client is having hallucinations. |
B | The client is having suicidal ideations. |
C | The client is having nightmares. |
D | The client is having delusions. |
Question 19 |
While talking to a client with schizophrenia, a nurse notes the client frequently uses unrecognizable words with no common meaning. The nurse identifies this as which of the following?
A | Echolalia |
B | Clang association |
C | Neologisms |
D | Word salad |
Question 20 |
While caring for a hospitalized client diagnosed with schizophrenia, a nurse observes the client watching television. The client tells the nurse the television is speaking directly to him. Which term describes this belief?
A | Autistic thinking |
B | Concrete thinking |
C | Paranoid thinking |
D | Referential thinking |
Question 21 |
A nurse is talking with the family of a client diagnosed with schizophrenia. The mother asks, “What causes this disorder?” What is the best response by the nurse?
A | Prenatal or postpartum central nervous system damage |
B | Bacterial infections in the mother during pregnancy or delivery |
C | A biological predisposition exacerbated by environmental stressors |
D | Lack of bonding and attachment during infancy, which leads to depression in later life |
Question 22 |
What is the most appropriate action for a nurse to implement when caring for a client who is having a delusion?
A | Ask the client to describe his delusion. |
B | Explain to the client that the delusion isn’t real. |
C | Act as if the delusion is real to reduce the client’s anxiety. |
D | Engage the client in an organized activity. |
Question 23 |
During the initial interview, a schizophrenic client states to the nurse, “I don’t enjoy things anymore. I used to love to read mystery books but even that isn’t enjoyable now.” The nurse determines the client is experiencing which of the following?
A | Avolition |
B | Anhedonia |
C | Alogia |
D | Flat affect |
Question 24 |
A nurse on an inpatient unit is having a discussion with a client diagnosed with schizophrenia about his schedule for the day. The client comments that he was highly active at home and then explains the volunteer job he held. The nurse interprets the client’s response as reflecting which of the following?
A | Circumstantiality |
B | Loose associations |
C | Referential |
D | Tangentiality |
Question 25 |
A client diagnosed with schizophrenia has been taking haloperidol (Haldol) for 1 week when a nurse observes that the client’s eyeball is fixated on the ceiling. Which specific condition is the client exhibiting?
A | Akathisia |
B | Neuroleptic malignant syndrome |
C | Oculogyric crisis |
D | Tardive dyskinesia |
Question 26 |
A 20-year-old client has been diagnosed with schizophrenia. He presently lives by himself; doesn’t bathe or dress himself; and is erratic with eating, drinking, and taking prescribed medications. Which nursing diagnosis for this client has priority?
A | Ineffective role performance related to isolation |
B | Activity intolerance related to perceptual distortions |
C | Ineffective coping |
D | Imbalanced nutrition: Less than body requirements related to symptoms of schizophrenia |
Question 27 |
A single 24-year-old client is admitted with acute schizophrenic reaction. The nurse anticipates that which of the following is the most appropriate therapy for the client?
A | Counseling to produce insight into behavior |
B | Biofeedback to reduce agitation associated with schizophrenia |
C | Drug therapy to reduce symptoms associated with acute schizophrenia |
D | Electroconvulsive therapy to treat the mood component of schizophrenia |
Question 28 |
A 45-year-old client experiencing delusions has been admitted to the crisis center. When assessing the content of the delusions, the nurse should look for which aspect of the delusions?
A | Logic |
B | Religious beliefs |
C | Themes |
D | True experiences |
Question 29 |
A 50-year-old schizophrenic client becomes agitated and confronts the nurse with clenched fists. What is the most appropriate intervention by the nurse?
A | Take the client by the hand and lead him to the activity room for cards. |
B | Step up to the client and tell him his behavior is inappropriate. |
C | Call for security to take him to a seclusion room. |
D | Speak to him in a quiet voice and offer him medication to help him calm down. |
Question 30 |
The nurse is caring for a 58-year-old male client diagnosed with paranoid schizophrenia. The client says, “The earth and the roof of the house rule the political structure with particles of rain.” The nurse interprets this statement as which of the following?
A | Tangentiality |
B | Perseveration |
C | Loose association |
D | Thought blocking |
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