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A)

B)
C)
D)

A client
diagnosed with
schizophrenia is
laughing and
talking while
1.
sitting alone.
Which of the
following is the
best response
by the nurse?
Can you share
your joke with
me?
Sit with the
client quietly
until the client is
ready to talk
Tell me what's
happening.
You look lonely
here. Let's join
the others in the

day room.

A)

A college
freshman is
admitted to the
hospital with a
diagnosis of
schizophrenia.
Friends reported
that she had
been in her
2.
room for 2 days
in a trance-like
state, not eating
or speaking to
anyone. Which
of the following
is the highest
priority for this
client?
Assessing fluid
intake and

B)

C)
D)

output
Completing an
assessment of
mental status
Obtaining more
data about her
college
experiences
Providing for
adequate rest
3. A suspicious
client has been
placed in a room
with a
roommate. The
night nurse
reports that this
client has been
awake for the
past 3 nights.

A)

B)

C)

D)

The likely
explanation for
his wakefulness
is which of the
following?
He is fearful of
what his
roommate might
do to him while
he sleeps.
He is a light
sleeper and
unaccustomed
to a roommate.
He is watching
for an
opportunity to
escape.
He is worrying
about his family
problems.

A)
B)

The nurse is
working with a
client with
schizophrenia,
disorganized
type. It is time
for the client to
get up and eat
4. breakfast. Which
of the following
statements by
the nurse would
be most
effective in
helping the
client prepare
for breakfast?
I'll expect you
in the dining
room in 20
minutes.
It's time to put

C)

D)

A)

your dress on
now.
Stay right there
and I'll get your
clothes for you.
Why don't you
stay here and I'll
get your tray for
you.
A client with
schizophrenia is
reluctant to take
his prescribed
oral medication.
5.
The most
therapeutic
response by the
nurse to this
refusal is,
I can see that

B)

C)

D)

you're
uncomfortable
now, so we can
wait until
tomorrow.
If you refuse
these pills, you'll
have to get an
injection.
What is it about
the medicine
that you don't
like?
You know you
have to take this
medicine for
your own good.
6. The nurse
observes a
client with

A)
B)
C)

schizophrenia
sitting alone,
laughing
occasionally,
and turning his
head as if
listening to
another person.
The nurse
assesses this
behavior to
indicate that the
client is
experiencing
auditory
hallucinations
and says,
Are you hearing
something?
It's a beautiful
day, isn't it?
Would you like
to go to your

D)

A)

room to talk?
Would you like
to take some of
your PRN
medication?
A client with
schizophrenia is
admitted to the
inpatient unit.
He does not
speak when
spoken to but
7.
has been
observed talking
to himself on
occasion. At this
time, the priority
goal for this
client is to
Establish a

B)
C)
D)

trusting
relationship with
the nurse
Express his
feelings freely
Increase his
socialization
with others
Increase his
reality
orientation
8. The nurse
enters the room
of a client with
schizophrenia
the day after he
has been
admitted to an
inpatient setting
and says, I

A)

B)
C)

would like to
spend some
time talking with
you. The client
stares straight
ahead and
remains silent.
The best
response by the
nurse would be,
I can see you
want to be
alone. I'll come
back another
time.
You don't need
to talk right now.
I'll just sit here
for a few
minutes.
I've got some
other things I
can do now. I

D)

hope you'll feel


like talking
later.
You would feel
better if you
would tell me
what you're
thinking.
9. One evening, a
client with
schizophrenia
leaves his room
and begins
marching in the
hall. When
approached by
the nurse, the
client says, God
says I'm
supposed to
guard the area.

A)

B)

C)

Which of the
following
responses would
be best?
I understand
you hear a
voice. You and I
are the only
ones in the hall,
and I don't hear
a voice.
The voices are
part of your
illness, and they
will leave in
time.
This guarding
responsibility
can make you
tired. You rest
for now, and I'll
guard a while.

D)

A)
B)

You are just


imagining these
things. Do not
pay any
attention to the
voices.
The client with
schizophrenia
tells the nurse
that rats have
10. started to eat
his brain. The
best response
by the nurse
would be,
Have you
discussed this
with your
physician?
How could that

C)
D)

A)
B)
C)
D)

be possible?
You cannot
have rats in
your brain.
You look OK to
me.
A client is
repeating every
word that the
nurse says. This
11. would be
correctly
documented as
which of the
following?
Word salad
Clang
association
Neologisms
Echolalia

A)

B)
C)

The most
commonly
supported
neurochemical
theory
12.
explaining the
etiology of
schizophrenia
suggest which of
the following?
Excessive
amounts of
dopamine and
serotonin in the
brain
Ineffective
ability of the
brain to use
dopamine and
serotonin
Insufficient

D)

amounts of
dopamine in the
brain
Decreased brain
tissue in the
frontal and
temporal
regions of the
brain
13. The nurse is
assessing for
negative
symptoms of
schizophrenia in
a newly
admitted
patient. The
nurse would
note which
behavior as
indicative of a

A)

B)

C)

D)

negative
symptom?
Difficulty staying
on subject when
responding to
assessment
questions
Belief of owning
a transportation
device allowing
for travel to the
center of the
Earth
Hesitant to
answer the
nurses
questions during
the assesment
interview
Mimicking the
postural
changes made

by the nurse
during the
assessment
interview

A)
B)
C)
D)

The patient with


schizophrenia
believes the
student nurses
are there to spy
14. on the patients.
The patient is
suffering from
which of the
following
symptoms?
Hallucinations
Delusions
Anhedonia
Ideas of
reference

A)
B)
C)

The patient with


schizophrenia
makes the
following
statement, I
just dont know
how to count.
The sky turned
15.
to fire. I have a
ball in my
head. The
nurse
documents this
entire statement
as an example
of:
Flight of ideas
Ideas of
reference
Delusional
thinking

D)

A)
B)
C)
D)

Associative
looseness
A person
suffering from
schizophrenia
has little
emotional
expression when
16. interacting with
others. The
nurse would
document the
patients affect
as which of the
following?
Flat
Blunt
Bright
Inappropriate

A)
B)
C)
D)

A schizophrenic
patient having a
conversation
with the nurse
suddenly stops
talking in the
17. middle of a
sentence. The
patient is
experiencing
which type of
thought
disruption
Thought
withdrawal
Thought
insertion
Thought
blocking
Thought
broadcasting

A)

During the
nursing
assessment a
patient
describes
constantly
hearing voices
mumbling in the
background. The
patient denies
18.
that the voices
are telling him
to do anything
harmful. The
nurse
documents that
the patient is
experiencing
which of the
following?
Command

B)
C)
D)

hallucinations
Auditory
hallucinations
Olfactory
hallucinations
Gustatory
hallucinations
19. A patient with
schizophrenia
reads the advice
column in the
newspaper daily.
When asked
why the patient
is so interested
in the advice
column, the
patient replies,
This person is
my guide and

A)
B)
C)
D)

tells me what I
must do every
day. The nurse
would best
describe this
type of thinking
as which of the
following?
Referential
delusion
Grandiose
delusion
Thought
insertion
Personalization
20. The nurse is
preparing a
patient with
schizophrenia
for discharge.

A)
B)
C)
D)

The nurse asks


the patient,
How are you
going to care for
yourself at
home? The
purpose of the
nurses question
is to assess the
patients:
self concept.
judgment.
insight.
social support
system.
21. All of the
following are
nursing
diagnoses
indentified for a

A)
B)
C)
D)

patient with
schizophrenia.
Which diagnosis
will resolve
when the
patients
negative
symptoms
improve?
Impaired Verbal
Communication
Risk for OtherDirected
Violence
Disturbed
Thought
Processes
Social Isolation
22. All of the
following are

A)
B)
C)
D)

included in the
plan of care for
a patient with
schizophrenia.
Which nursing
intervention
should the nurse
perform first
when caring for
this patient?
Observe for
signs of fear or
agitation
Maintain reality
through
frequent contact
Encourage to
participate in
treatment milieu
Assess
community
support systems

A)

A patient with
schizophrenia is
seen sitting
alone and
talking out loud.
Suddenly the
patient stops
and turns as if
listening to
23. someone. The
nurse
approaches and
sits down beside
the patient.
Which of the
following is the
best initial
response by the
nurse?
Are you hearing
voices right

B)
C)

D)

A)
B)

now?
Stop and look
at me.
I can tell you
are hearing
voices, but they
are not real.
Would you like
to play a card
game with me?
A patient states,
I am dead. I
have come back
24. from the dead.
An appropriate
response by the
nurse is:
What is it like
to feel dead?
No you did not

C)

D)

die. People dont


come back from
the dead.
Show me what
you did in art
therapy this
morning.
Ill get your
medicine and
youll feel
better.
25. When
performing
discharge
planning with a
schizophrenic
patient, the
nurse
anticipates
barriers to

A)
B)
C)

adhering to the
medication
regimen. The
nurse assesses
which of the
following as
improving the
likelihood that
the patient will
follow the
prescribed
medication
regimen? (Select
all that apply)
Short term
memory intact
History of
missing
appointments
Receives
monthly
disability checks

D)

E)

Walking is
primary mode of
transportation
States location
of pharmacy
nearest his
residence
26. A schizophrenic
patient is
attending a
follow-up
appointment at
the community
mental health
clinic. The
patient reports
to the nurse, I
stopped taking
the
antipsychotic
medication

A)

B)

because I cant
get it on with
my girlfriend
anymore.
Which of the
following should
the nurse
recommend to
enhance the
patients wellbeing?
It sounds like
that is a
problem for
you.
Sexual
dysfunction is a
temporary side
effect and
should subside
once your body
is used to the
medication.

C)

D)

You should
avoid having sex
with your
girlfriend
anyway. Do you
really want her
to get
pregnant?
It is important
for you to take
an antipsychotic
medication.
Lets consider a
different type
that will be less
likely to affect
your sexual
functioning.
27. A patient with
schizophrenia
has returned to

A)

the clinic
because of an
increase in
symptoms. The
patient reports
he stopped
taking his meds
because he
didnt like the
side effects. The
nurse educates
the patient
about managing
uncomfortable
side effects.
Which of the
following is
included in the
teaching plan?
(Select all that
apply)
Suck on hard
candy as

B)

C)
D)

E)

desired
Spend at least
30 minutes
outside in the
sun daily
Use stool
softeners as
needed
Decrease the
amount of daily
fluid intake
Maintain a
balanced
caloriecontrolled diet
28. The family of a
young adult
schizophrenic
male asks how
they can

A)
B)
C)
D)
E)

recognize when
their son is
beginning to
relapse. The
nurse teaches
the family to
look for the
following:
(Select all that
apply)
Excessive
sleeping
Fatigue
Irritability
Increased
inhibition
Negativity
29. A patient asks
the nurse upon
discharge,

A)

B)

C)
D)

What should I
do if I forget to
take my
medicine? The
nurse should
explain to the
patient which of
the following?
Just double the
dose next time
it is scheduled.
Skip that dose
and resume
your regular
with the next
dose.
Dont miss
doses, or you
will not maintain
therapeutic drug
levels.
If you

remember
within 3-4 hours
then take it.
Otherwise skip
it.
A student nurse,
having her first
experience in an
inpatient
psychiatric unit,
is frightened by
the behaviors of
the patients
30.
with
schizophrenia.
The student
should take
which of the
following actions
to deal with her
fear?

A)
B)
C)

D)

Express her fear


to the
psychiatrist
during rounds
Pretend that she
is not afraid
Stay in an open
area while
talking with the
patients
Do additional
reading to
better
understand the
symptoms of
schizophrenia

Answer Key
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

C
A
A
B
C
A
D
B
A
A
D
A
C
B
D
B
C
B
A
C

21.
22.
23.
24.
25.
26.
27.
28.
29.
30.

D
A
B
A
A, C, E
D
A, C, E
B, C, E
D
C