Which of the following is true for withdrawn patients diagnosed with schizophrenia?
They are usually violent toward caregivers
They usually fear sexual involvement with therapists
They avoid relationships because they become anxious with emotional closeness
They exhibit a high degree of hostility as evidenced by rejecting behaviour.
The Correct Answer is C
Choice A reason: Most patients with schizophrenia are not inherently violent. Withdrawn patients, specifically, tend to move away from others rather than toward them aggressively. Violence is more often associated with untreated positive symptoms like command hallucinations or paranoid delusions rather than the negative symptom of social withdrawal.
Choice B reason: While social and interpersonal dysfunction is a hallmark of schizophrenia, fearing sexual involvement with therapists is a specific, narrow concern that does not describe the general underlying mechanism of social withdrawal. It does not capture the pervasive interpersonal anxiety characteristic of the disorder.
Choice C reason: Social withdrawal in schizophrenia is often a protective mechanism against the overwhelming stimuli of social interaction. These patients frequently experience "interpersonal anxiety" where emotional closeness feels threatening or disorganized, leading them to isolate themselves to maintain a sense of psychological safety and equilibrium.
Choice D reason: Although rejecting behavior may be perceived as hostility by others, it is usually a defensive maneuver rather than an expression of anger. The primary driver is often an inability to process social cues or a fear of being overwhelmed by the presence of others.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Anorexia nervosa is characterized by significant weight loss (42 kg is very low for an adult), a preoccupation with food (cooking gourmet meals for others), and attempts to hide the body (wearing layered, loose clothing). These behaviors are classic indicators of the intense fear of weight gain seen in this disorder.
Choice B reason: Eating disorder not otherwise specified (now often categorized as OSFED) is used when a patient's symptoms cause significant distress but do not meet the full, strict criteria for Anorexia or Bulimia. This patient’s dramatic weight loss and specific behavioral patterns fit the primary diagnostic criteria for Anorexia Nervosa.
Choice C reason: Major Depressive Disorder can cause weight loss due to anorexia (loss of appetite). However, the specific behaviors of cooking elaborate meals for others while restricting one's own intake and wearing layered clothing to hide weight loss are specific to the psychopathology of an eating disorder rather than depression.
Choice D reason: Bulimia Nervosa involves episodes of binge eating followed by compensatory behaviors like purging. Patients with bulimia usually maintain a weight that is within or slightly above the normal range. The patient's extremely low weight of 42 kg and restrictive eating habits point toward the restrictive type of Anorexia.
Correct Answer is D
Explanation
Choice A reason: Although 10 hours of sleep might seem positive, it may actually represent hypersomnia, which is a symptom of depression. Furthermore, the patient’s verbalization that they are a "failure" indicates that their cognitive distortions and low self-esteem remain unchanged, suggesting that the treatment has not yet effectively addressed the core depressive thoughts.
Choice B reason: Sleeping 7 hours is a normal physiological finding, but the patient remains "preoccupied" with thoughts of inadequacy. Effective treatment for depression should result in a reduction of ruminative negative thinking and an improvement in self-image. This documentation shows that the psychological symptoms of the depressive episode are still very much active.
Choice C reason: This choice indicates only marginal improvement. Sleeping only 5 hours with interruptions and requiring assistance for basic hygiene suggests significant lingering psychomotor retardation and sleep disturbance. A weight loss of 1 pound shows that the vegetative symptoms of depression, such as poor appetite, have not yet been resolved.
Choice D reason: This documentation shows improvement across multiple domains: sleep is stabilizing, the patient is actively participating in social activities (singing), and most importantly, they are demonstrating "future orientation" by anticipating a visit. Looking forward to future events is a significant clinical indicator that the pervasive hopelessness of depression is lifting.
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