After being in the hospital for one month, a client with schizophrenia states that voices are telling them they will die tonight. The client asks the nurse if this is true. The client’s statement and question indicate that they:

Have a poor prognosis.

Are not improving and may be getting worse.

Are questioning the hallucination and want reassurance from the nurse.

Will begin to enter the manic phase of their illness.

Answer and Explanation

The Correct Answer is C

Choice A Reason: Have a poor prognosis

A poor prognosis in schizophrenia is typically associated with persistent and severe symptoms, lack of response to treatment, and significant functional impairment. While the client’s statement about hearing voices is concerning, it does not necessarily indicate a poor prognosis on its own. Prognosis in schizophrenia is multifactorial and depends on various factors, including the duration of untreated psychosis, adherence to treatment, and the presence of supportive social networks.

Choice B Reason: Are not improving and may be getting worse

This choice suggests that the client’s condition is deteriorating. While the presence of hallucinations can indicate a lack of improvement, it is important to consider the context. The client’s ability to question the hallucination and seek reassurance from the nurse suggests a level of insight that is often associated with better outcomes. Insight into one’s condition is a positive prognostic factor in schizophrenia.

Choice C Reason: Are questioning the hallucination and want reassurance from the nurse

This is the correct answer. The client’s question indicates that they are aware that the voices might not be real and are seeking reassurance from the nurse. This level of insight is crucial in managing schizophrenia, as it can lead to better adherence to treatment and improved outcomes. Insight into the nature of hallucinations and delusions is often a sign of a more favorable prognosis.

Choice D Reason: Will begin to enter the manic phase of their illness

Mania is characterized by elevated mood, increased activity, and other symptoms such as decreased need for sleep and grandiosity. It is more commonly associated with bipolar disorder than schizophrenia. The client’s statement about hearing voices predicting their death does not align with the typical presentation of mania. Therefore, this choice is not applicable in this context.

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Free Nursing Study Resources

Correct Answer is ["A","C","D"]

Explanation

Choices A, C, and D: Changes to behavior and personality, Impaired judgment, Muscle stiffness and shuffling gait.

Choice A Reason:

Changes to behavior and personality are hallmark symptoms of frontotemporal dementia (FTD). This condition primarily affects the frontal and temporal lobes of the brain, which are responsible for behavior, personality, and language. Patients often exhibit socially inappropriate behaviors, apathy, and a decline in personal hygiene. These changes are among the earliest and most noticeable symptoms of FTD.

Choice B Reason:

While a past history of head trauma can be a risk factor for various types of dementia, it is not specifically associated with frontotemporal dementia. FTD is more commonly linked to genetic factors and specific protein abnormalities in the brain. Therefore, a history of head trauma is not a typical aspect of the medical history for FTD patients.

Choice C Reason:

Impaired judgment is a common symptom of frontotemporal dementia. The degeneration of the frontal lobes affects executive functions, including decision-making, problem-solving, and judgment. Patients may make poor decisions, exhibit risky behaviors, and have difficulty understanding the consequences of their actions.

Choice D Reason:

Muscle stiffness and a shuffling gait can occur in some forms of frontotemporal dementia, particularly in cases where the condition overlaps with motor neuron disease or Parkinsonism. These physical symptoms are less common than behavioral and cognitive symptoms but can still be present in some patients.

Choice E Reason:

A diagnosis of hypertension is not specifically related to frontotemporal dementia. While hypertension is a common condition that can coexist with any form of dementia, it is not a characteristic feature of FTD. The primary symptoms of FTD are related to changes in behavior, personality, and cognitive functions rather than vascular issues.

A. Clonazepam is to be used for long-term therapy in conjunction with buspirone. B. Clonazepam is to be used short-term until the buspirone takes full effect. C. Buspirone should be taken as needed until clonazepam takes full effect. D. Tolerance could result with long-term use of buspirone.

Correct Answer is B

Explanation

Choice A Reason:

Clonazepam is to be used for long-term therapy in conjunction with buspirone.

This statement is incorrect. Clonazepam, a benzodiazepine, is typically used for short-term relief of anxiety symptoms due to its potential for dependence and tolerance1. Long-term use of benzodiazepines is generally avoided in favor of medications like buspirone, which do not carry the same risks of dependence.

Choice B Reason:

Clonazepam is to be used short-term until the buspirone takes full effect.

This is the correct response. Buspirone takes several weeks to achieve its full therapeutic effect. During this period, clonazepam may be used to manage acute anxiety symptoms. Once buspirone reaches its full effect, clonazepam can be tapered off to avoid long-term use and potential dependence.

Choice C Reason:

Buspirone should be taken as needed until clonazepam takes full effect.

This statement is incorrect. Buspirone is not intended for as-needed use; it must be taken consistently to maintain stable blood levels and achieve its therapeutic effect. Clonazepam, on the other hand, is used for short-term relief and should not be relied upon for long-term management of anxiety.

Choice D Reason:

Tolerance could result with long-term use of buspirone.

This statement is incorrect. Unlike benzodiazepines, buspirone does not typically cause tolerance or dependence with long-term use. It is considered a safer option for chronic management of anxiety disorders.

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After being in the hospital for one month, a client with schizophrenia states that voices are telling them they will die tonight. The client asks the nurse if this is true. The client’s statement and question indicate that they:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is admitted to an inpatient unit with a diagnosis of frontotemporal dementia. Which of the following aspects of a medical history would the nurse expect to see with this client? (Select All that Apply.)

Correct Answer is ["A","C","D"]

Explanation

A client diagnosed with generalized anxiety disorder (GAD) is started on buspirone. Which statement made by the client indicates teaching has been effective? The client verbalizes that:

Correct Answer is B

Explanation

The nurse notices a client wandering in the hospital hall giggling, with bizarre behavior that is annoying and frightening other clients. A priority in caring for her is to:

Which of the following interventions would a nurse use when caring for an inpatient client who expresses anger inappropriately?

A client diagnosed with Obsessive-Compulsive Disorder has developed a number of compulsive washing rituals over the years. The nurse recognizes that these behavioral rituals serve which purpose?

The nurse must prepare an oral contrast solution in 850 mL of apple juice. There are 6-ounce containers of apple juice in the pantry. What is the minimum number of containers of juice to make 850 mL? (Round the answer to the nearest whole container)

A client with a diagnosis of schizophrenia says to the student nurse, “The mazurkas are coming. The mazurkas are coming.” The client’s use of the word ‘mazurka’ is most likely a/an:

A nurse is caring for a client who is diagnosed with Functional Neurologic Symptom Disorder (conversion disorder). What action should the nurse include in the plan of care?

An IV infusion of 125 mL of a GI prokinetic agent is ordered to be given over 1 hour. The nurse will use a microdrip infusion set (60 gtts/mL). How many drops per minute will the drug infuse at the proper rate? Use a preceding zero if necessary. Do not use trailing zeros.