A nurse is collecting data from a client who has a new diagnosis of schizophrenia.
Which of the following client statements supports this diagnosis?
"I just need a couple of hours of sleep each night.”.
"Remembering where I put things has become difficult.”.
"I won't eat because I know that the food has been poisoned.”.
"Counting stairs helps me feel more in control.”.
The Correct Answer is C
Choice A rationale
A need for only a couple of hours of sleep each night could suggest mania, a symptom associated with bipolar disorder, rather than schizophrenia. Individuals with schizophrenia often experience sleep disturbances, but this specific statement is more indicative of a manic episode.
Choice B rationale
Difficulty remembering where things are placed can be a symptom of various conditions, including normal aging, stress, depression, or cognitive impairments. While cognitive deficits can occur in schizophrenia, this statement alone is not a strong indicator of the disorder's core features.
Choice C rationale
The statement "I won't eat because I know that the food has been poisoned" is a paranoid delusion, a positive symptom commonly seen in schizophrenia. Delusions are fixed, false beliefs that are not based in reality and are a hallmark feature of psychotic disorders like schizophrenia.
Choice D rationale
Counting stairs to feel more in control could be a mild compulsion or a coping mechanism for anxiety. While anxiety can co-occur with schizophrenia, this behavior itself is not a primary diagnostic criterion for the disorder.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Repeated school absences are a common finding in conduct disorder and indicate a disregard for rules and obligations. While important to address, it does not represent an immediate safety risk compared to threats of harm.
Choice B rationale
Threats of injury to others indicate a potential for violence and pose an immediate safety risk to others. This requires the nurse's immediate attention to assess the situation, ensure safety, and implement appropriate interventions to prevent harm.
Choice C rationale
Lack of empathy for others is a core characteristic of conduct disorder, reflecting a difficulty in understanding or sharing the feelings of others. While significant for long-term management, it does not present an immediate safety concern.
Choice D rationale
A history of shoplifting indicates a pattern of rule-breaking and disregard for the rights of others, which is characteristic of conduct disorder. However, it does not represent an immediate threat of harm compared to threats of injury.
Correct Answer is A
Explanation
Choice A rationale
Liver function tests, such as alanine aminotransferase (ALT) with a normal range of 7 to 56 U/L for females and 10 to 70 U/L for males, and aspartate aminotransferase (AST) with a normal range of 5 to 40 U/L for both sexes, should be reviewed before administering valproic acid. Valproic acid can cause hepatotoxicity, and pre-existing liver dysfunction is a contraindication or requires careful monitoring.
Choice B rationale
A chest x-ray is primarily used to assess the lungs and heart. It is not directly relevant to the potential side effects or contraindications of valproic acid therapy.
Choice C rationale
A prostate-specific antigen (PSA) test is used to screen for prostate cancer in men. It is not related to the potential adverse effects of valproic acid. The normal range for PSA is generally less than 4 ng/mL, but this can vary with age.
Choice D rationale
A urine culture is used to detect urinary tract infections. While important for overall health assessment, it does not directly assess for contraindications or potential organ-specific side effects associated with valproic acid administration. .
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