A client with schizophrenia has received standard antipsychotics for a year. His hallucinations are less intrusive, but the client remains apathetic, has poverty of thought, cannot work, and is socially isolated.

To address these symptoms, the nurse might expect the psychiatrist to prescribe which medication?

A) Correct. Schizoaffective disorder is characterized by a combination of symptoms of schizophrenia (such as delusions and hallucinations) and mood disorders (such as depression or mania).

B) Incorrect. Waxy flexibility and catatonic excitement are more commonly associated with catatonic schizophrenia, not schizoaffective disorder.

C) Incorrect. Bizarre mannerisms and hostility may be seen in various psychiatric disorders but are not specific to schizoaffective disorder.

D) Incorrect. While agitation and ideas of reference can occur in schizoaffective disorder, they are not the defining features of this diagnosis.

A. A schizophrenic episode Schizophrenic episodes are characterized by a complex interplay of symptoms including delusions, hallucinations, disorganized thinking, and altered perceptions. While the client is experiencing altered perceptions, the sudden onset and specific description are more indicative of hallucinogen ingestion.

B. Hallucinogen ingestion The client's description of altered perception, feeling outside of their own body, and visual distortions are indicative of hallucinogen ingestion. This class of substances can cause profound alterations in perception, leading to hallucinations and distorted sensory experiences. The slightly elevated vital signs may be a physiological response to the effects of the hallucinogen.

C. Opium intoxication Opium is an opioid and its effects are characterized by sedation, respiratory depression, and miosis (pupil constriction). The client's description of altered perception and feeling outside of their body are not typical of opium intoxication.

D. Cocaine overdose Cocaine is a stimulant and its effects are characterized by increased heart rate, blood pressure, and hyperarousal. The client's description of altered perception and feeling outside of their body are not typical of cocaine overdose.