Which client best exhibits the characteristics that are typical of the prodromal period of schizophrenia?

A 25-year-old woman who is not experiencing symptoms of delusions and hallucinations.

A 20-year-old man who is exhibiting a decrease in his ability to concentrate and function in daily activities.

A 30-year-old man who is experiencing an exacerbation of symptoms after stopping his antipsychotic.

A 28-year-old woman who is exhibiting bizarre and disruptive behavior.

Answer and Explanation

The Correct Answer is B

Choice A reason: Absence of symptoms does not indicate the prodromal phase of schizophrenia, which involves subtle cognitive and functional declines driven by early dopamine dysregulation in the prefrontal cortex. This woman shows no signs of prodromal neural changes, making this choice incorrect.

Choice B reason: The prodromal phase of schizophrenia includes decreased concentration and functioning, reflecting early dopamine and glutamate dysregulation in the prefrontal cortex and hippocampus. These subtle neurocognitive changes precede overt psychosis, accurately describing the 20-year-old’s symptoms as prodromal.

Choice C reason: Exacerbation after stopping antipsychotics indicates active schizophrenia, not the prodromal phase. Dopamine receptor hypersensitivity from medication withdrawal causes symptom relapse, not the subtle, pre-psychotic cognitive decline characteristic of the prodromal period, making this incorrect.

Choice D reason: Bizarre and disruptive behavior indicates active schizophrenia, not the prodromal phase. Overt psychosis reflects advanced mesolimbic dopamine hyperactivity, unlike the prodromal period’s subtle cognitive and functional impairments driven by early prefrontal and hippocampal changes.

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Correct Answer is A

Explanation

Choice A reason: Suicide in depression is linked to low serotonin, impairing prefrontal cortex regulation and increasing impulsivity. SSRIs increase serotonin, stabilizing amygdala-prefrontal circuits, reducing suicidal ideation by enhancing mood regulation and impulse control, making them the first-line treatment.

Choice B reason: Atypical antipsychotics target dopamine and serotonin receptors for psychosis or mania, not primary suicide risk. Depression-related suicide stems from serotonin deficits, and antipsychotics are less effective for this neurochemical profile, making them inappropriate as first-line treatment.

Choice C reason: Mood stabilizers like lithium address bipolar mood swings, not primary depression-related suicide. Serotonin dysregulation drives suicidal behavior in depression, and stabilizers lack direct serotonin enhancement, making them less effective than SSRIs for this indication.

Choice D reason: Tricyclic antidepressants increase serotonin and norepinephrine but have higher side effect risks, like cardiotoxicity, compared to SSRIs. Serotonin deficits drive suicide risk, and SSRIs are safer and more effective for targeting this neurochemical imbalance in depression.

A. Notify the provider for a restraint order and assessment. B. Advise the cafeteria staff of plastic utensils that can be used as weapons. C. Ask staff members how the patient was able to acquire the utensil. D. Notify the house supervisor for further direction.

Correct Answer is A

Explanation

Choice A reason: Notifying the provider ensures legal and medical oversight for restraints, addressing self-harm risk driven by serotonin deficits and amygdala hyperactivity. This prioritizes patient safety and evaluates underlying psychiatric causes, ensuring appropriate intervention to stabilize neural dysregulation.

Choice B reason: Advising cafeteria staff is a preventive measure but not the priority during acute self-harm. Serotonin-driven impulsivity requires immediate medical assessment, and addressing utensil access is secondary to stabilizing the patient’s acute neurochemical crisis.

Choice C reason: Investigating utensil acquisition is important for future prevention but not urgent. The patient’s self-harm, driven by serotonin deficits and amygdala hyperactivity, requires immediate medical intervention to ensure safety and address acute psychiatric needs first.

Choice D reason: Notifying the house supervisor is administrative, not clinical, and delays direct intervention. Self-harm reflects serotonin dysregulation and amygdala-driven impulsivity, requiring immediate provider assessment for restraints and psychiatric evaluation, making this less urgent.

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Which client best exhibits the characteristics that are typical of the prodromal period of schizophrenia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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