a nurse is assessing a client who has been diagnosed with paranoid schizophrenia which of the following findings should the nurse expect

ATI RN

ATI Mental Health Practice B

1. A healthcare professional is assessing a client diagnosed with paranoid schizophrenia. Which of the following findings should the healthcare professional expect?

A. Auditory hallucinations
B. Delusions of grandeur
C. A flat affect
D. Disorganized speech

Correct answer: B

Rationale: The correct answer is B: Delusions of grandeur. Clients with paranoid schizophrenia often experience delusions of grandeur or persecution, auditory hallucinations, and a flat affect. However, the most characteristic finding for paranoid schizophrenia is the presence of delusions, which are fixed false beliefs that are not based in reality. Delusions of grandeur, where individuals believe they are exceptionally powerful or important, are commonly seen in paranoid schizophrenia. Choice A, auditory hallucinations, are more commonly associated with other types of schizophrenia such as paranoid or disorganized schizophrenia. Choice C, a flat affect, is a symptom that can be seen across various types of schizophrenia. Choice D, disorganized speech, is more indicative of disorganized schizophrenia.

2. A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?

A. The client is experiencing severe distress and is at risk for physical and psychological illness.
B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
D. The client may view these losses as challenges and perceive them as opportunities.

Correct answer: C

Rationale: The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a client's life. However, susceptibility to stress-related physical or psychological illness cannot be accurately estimated without considering the individual's coping resources and available support systems. Positive coping mechanisms and strong social support can mitigate the risk of stress-related illnesses even in the face of significant life changes and losses. Choice A is incorrect because it makes a definitive statement about the client's state without considering individual coping mechanisms and support. Choice B is incorrect because a score of 110 does not necessarily mean no threat of stress-related illness, as individual factors play a crucial role. Choice D is incorrect as it assumes a positive outlook without acknowledging the potential impact of the experienced losses on stress levels.

3. A client diagnosed with paranoid schizophrenia states, 'The FBI is watching me. I see their agents everywhere.' Which is the nurse's most appropriate response?

A. You shouldn't worry about that. It's not real.
B. I don't see any FBI agents, but it sounds like you're feeling frightened.
C. Let's talk about something else to take your mind off of it.
D. Why do you think the FBI is watching you?

Correct answer: B

Rationale: Validating the client's feelings without reinforcing the delusion is important. This response acknowledges the client's fear without agreeing with the delusion. It shows empathy and understanding towards the client's emotions while not validating the delusional belief.

4. How do psychiatrists determine which diagnosis to give a patient?

A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
B. Hospital policy dictates how psychiatrists diagnose mental disorders.
C. Psychiatrists assess the patient and identify diagnoses based on the patient's symptoms and contributing factors.
D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

Correct answer: A

Rationale: Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine which diagnosis to give a patient. The DSM-5 is a comprehensive manual published by the American Psychiatric Association (APA) that outlines specific criteria for diagnosing mental disorders. It aims to ensure accurate and consistent diagnosis and treatment. Choices B and D provide inaccurate information. Hospital policy does not dictate psychiatric diagnoses, and the American Medical Association does not provide diagnostic labels for mental disorders. Choice C, although mentioning the assessment of patients, does not highlight the specific criteria and guidelines provided by the DSM-5 that psychiatrists use to assign diagnoses.

5. Which of the following is an uncommon symptom of schizophrenia?

A. Delusions
B. Fatigue
C. Disorganized speech
D. Catatonia

Correct answer: B

Rationale: Common symptoms of schizophrenia include delusions, hallucinations, disorganized speech, and catatonia. Fatigue is not typically considered a direct symptom of schizophrenia. It is important to focus on symptoms directly related to the disorder when identifying schizophrenia.