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101 Cards in this Set
- Front
- Back
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Schizophrenia is a disease entity that results from ___ cause(s)
a) a single cause b) two causes c) three or more causes d) multiple causes |
d) multiple causes
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What is a major concern among patienst with schizophrenia?
a) suicide b) depression c) homelessness d) inadequate mental health assistance |
a) suicide: 10% of patient with schizophrenia die by suicide
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True or False: Borderline personality disorder is characterized by disturbances in thought processes, perception, and affect invariably result is a severe deterioration of social and occupational functioning.
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False: That describes schizophrenia.
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What happens during Phase I: The Schizoid Personality, during the development of schizophrenia?
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The person does not enjoy close relationships and appear to be a loner.
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What happens during Phase: II: The Prodromal Phase?
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The person becomes socially withdrawn and lacks initiative, interest, or energy.
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What happens during Phase III: Schizophrenia?
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This is the active phase in which the psychotic symptoms are prominent.
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How is the course of schizophrenia characterized?
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By periods of remission and exacerbation.
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The nurse knows that the Phase IV: Residual Phase is most similar to what earlier phase of schizophrenia?
a) Phase I b) Phase II c) Phase III d) Phase IV |
b) Phase II in which the patient has flat affect and impairment in role functioning.
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Does schizophrenia have a familian pattern?
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Yes.
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True or false: identical twins reared apart have the same rate of development of the illness as do those reared together.
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True!
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What is the dopamine hypothesis?
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A theory that suggests that schizophrenia may be caused by an excess of dopamine-dependent neuronal activity in the brain.
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What do neuroleptics do?
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Lower the level of dopamine by blocking dopamine receptors.
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There is a high incidence of schizophrenia after prenatal exposure to:
a) cocaine b) heroine c) influenza d) german measles |
c) influenza
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What brain changes can be observed in patients with schizophrenia?
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enlarged ventricles and sulci as well as cerebellar atrophy
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What is the downward drift hypothesis?
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This hypothesis relates the schizophrenic's move into, or failure to move out of, the low socioeconomic group..
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What happens during Phase III: Schizophrenia?
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This is the active phase in which the psychotic symptoms are prominent.
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How is the course of schizophrenia characterized?
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By periods of remission and exacerbation.
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The nurse knows that the Phase IV: Residual Phase is most similar to what earlier phase of schizophrenia?
a) Phase I b) Phase II c) Phase III d) Phase IV |
b) Phase II in which the patient has flat affect and impairment in role functioning.
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Does schizophrenia have a familian pattern?
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Yes.
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True or false: identical twins reared apart have the same rate of development of the illness as do those reared together.
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True!
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What is the dopamine hypothesis?
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A theory that suggests that schizophrenia may be caused by an excess of dopamine-dependent neuronal activity in the brain.
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What do neuroleptics do?
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Lower the level of dopamine by blocking dopamine receptors.
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There is a high incidence of schizophrenia after prenatal exposure to:
a) cocaine b) heroine c) influenza d) german measles |
c) influenza
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What brain changes can be observed in patients with schizophrenia?
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enlarged ventricles and sulci as well as cerebellar atrophy
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What is the downward drift hypothesis?
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This hypothesis relates the schizophrenic's move into, or failure to move out of, the low socioeconomic group..
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What type of schizophrenia is characterized by flat affect or grossly inappropriate affect with a concurrent poor contact with reality?
a) Catatonic b) Paranoid c) Residual d) Brief e) Disorganized |
e) Disorganized
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What type of schizophrenia is characterized by the presence of delusions of persecution or grandeur and auditory hallucinations related to a single theme?
a) Catatonic b) Paranoid c) Residual d) Brief e) Disorganized |
b) Paranoid
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What type of schizophrenia is characterized by marked abnormalities in motor behavior and may be manifested in the form of stupor or excitement?
a) Catatonic b) Paranoid c) Residual d) Brief e) Disorganized |
a) Catatonic
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What is residual schizophrenia?
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When there is continuing evidence of the illness although there are no prominent psychotic symptoms. This is the state of residual schizophrenia that follows an acute episode.
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How is schizoaffective disorder different from schizophrenia?
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It has similar characteristics as schizophrenia but there is a strong element of symptomatology associated with depression or mania.
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In a catatonic schizophrenic, ___ is manifested by a state of extreme psychomotor agitation.
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catatonic excitement: The movements are frenzied and purposeless, and are usually accompanied by continuous incoherent verbalizations and shouting.
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With brief psychotic disorder, does the person have a full return to the premorbid level of functioning?
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Yes! The essential feature of this disorder is the sudden onset of psychotic symptoms that may or may not be preceded by a severe psychosocial stressor. These symptoms last as least 1 day but less than 1 month, and there is an eventual full return to the premorbid level of functioning.
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How is schizophreniform disorder different from schizophrenia?
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Schizophreniform disorder lasts less than 6 months. The diagnosis is changed to schizophrenia if the clinical picture persists beyond 6 months
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The presence of one or more nonbizarre delusions that persist for at least 1 month is the essential feature of ____.
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Delusional disorder.
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What happens with erotomanic type delusional disorder?
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The patient believes that someone, usually of a higher status, is in love with him or her.
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What happens with grandiose type delusional disorder?
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The patient have irrational ideas regarding their own worth, talent, knowledge, or power.
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What happens with jealous type delusional disorder?
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The patient centers on the idea that the person's sexual partner is unfaithful. (Um, maybe this isn't a delusion???)
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What happens with persecutory type delusional disorder?
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The patient believe they are being malevolently treated in some way.
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What happens with somatic type delusional disorder?
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The patient believes that they have some physical defect, disorder, or disease.
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What happens with shared psychotic disorder?
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The person with the primary delusional disorder is usually the dominant person in the relationship, and the delusional thinking is gradually imposed on the more passive partner.
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____ is characterized by a disturbance of consciousness and a change in cognition that develop rapidly over a short period.
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Delirium
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What is the difference between primary and secondary dementias?
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Primary are those such as Alzheimer's disease, in which the dementia itself is the major sign of some organic brain disease. Secondary dementias are caused by or related to another disease or condition such as HIV or cerebral trauma.
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How might the personality of a person with dementia change?
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They may experience an alteration or accentuation of premorbid coharacteristics. For example, an individual who was previously very socially active may become apathetic and socially isolated.
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Dementia that occurs as a result of stroke, depression, side effects of certain medications, vitamin or nutritional deficiencies(especially B12 or folate) is:
a) reversible b) irreversible c) none of the above |
a) reversible
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The inability to carry out motor activities despite intact motor function is termed ___.
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Apraxia
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Describe stage 1 of dementia of the alzheimer's type.
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No apparent symptoms
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Describe Stage 2 of dementia of the alzheimer's type.
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Forgetfulness
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Describe Stage 3 of dementia of the alzheimer's type.
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Mild cognitive decline
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Describe Stage 4 of dementia of the Alzheimer's type.
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Mild to moderate cognitive decline.
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Describe Stage 5 of dementia of the Alzheimer's type.
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Moderate cognitive decline.
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During what stage of dementia of the Alzheimer's type does urinary and fecal incontinence begin?
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Stage 6
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Describe stage 7 of dementia of the alzheimer's type.
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Severe cognitive decline
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It is very important to monitor people with dementia for:
a) pressure ulcers b) cognitive decline c) memory loss d) recognition of family members |
a) pressure ulcers
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How are early onset and late onset dementia classified?
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Early onset is when the first symptoms begin before age 65 and late onset is when the symptoms begin after age 65
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Research has indicated that in the brains of Alzheimer's clients, the enzyme required to produce ______ is dramatically reduced.
a) GABA b) dopamine c) epinephrine d) acetylcholine |
d) acetylcholine
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What appears in the brains of individuals with Alzheimer's disease?
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plaques and tangles
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What are plaques in the brains of Alzheimer's disease made up of?
a) calcium b) beta amyloid c) fragmented fat emboli d) hemmolated protein |
b) beta amyloid
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Can head trauma cause Alzheimer's disease?
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Yes
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Is there a familial patterns with Alzheimer's disease?
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Yes
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What type of dementia is caused by significant cerebrovascular disease?
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Vascular dementia
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What is thought to be one of the most significant factors in the etiology of multiple small strokes or cerebral infarcts causing vascular dementia?
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High blood pressure
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What is the difference between amnesia and dementia in terms of impairment in abstract thinking or judgment.
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Dementia has impairment in abstract thinking and judgment while amnesia has no impairment in abstract thinking or judgment
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What is confabulation?
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The creation of imaginary events to fill in memory gaps. People with amnesia may do this.
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What is substance-induced persisting amnestic disorder?
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When findings indicate memory impairment related to the persisting effects of substance use. The symptoms exist long after the effects of substance intoxication or withdrawal have subsided.
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What is the first step in the treatment of delirium?
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Determining and correcting the underlying causes.
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Why is a full medical and neurological workup conducted once a diagnosis of dementia is established?
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To make sure that it is not really delirium, in which there is a potentially reversible treatment that can prevent permanent brain damage.
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Why are newer antipsychotic medications such as Risperdal, Zyprexa, Seroquel and Geodon favored?
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Because they have a lessened chance of causing extrapyramidal side effects.
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What do the following conditions represent: confusion, blurred vision, constipation, dry mouth, dizziness, and difficulty urinating?
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They are anticholinergic side effects.
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Why are Valium, Librium, Xanax, Ativan and Serax preferred over diazepam-like medications?
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They have shorter half lives and have a lower risk of oversedations and falls.
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_____ is characterized by a disturbance of consciousness and a change in cognition that develop rapidly.
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Delirium
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What is the usually duration of delirium?
a) less than 1 year b) less than 6 months c) less than 3 months d) less than 1 month |
d) less than 1 month: Generally days-2 weeks
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True or False: Toxins reported to cause dementia include organophosphate (anticholinesterase), insecticides, carbon monoxide, and volatile substances such as fuel or organic solvents.
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False: These are toxins reported to cause DELIRIUM
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What is the difference between primary and secondary dementia?
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Primary dementias are those such as Alzheimer's disease in which the dementia itself is the major sign of disease, as opposed to secondary dementias in which the dementia is caused by another disease or condition such as HIV or cerebral trauma.
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Describe the personality changes that are common in dementia.
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Personality changes involve accentuation of premorbid characteristics or opposition of previous characteristics.
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Is there such a thing as reversible dementia?
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Yes, dementia can occur as a result of stroke, depression, side effects of certain medications, vitamin or nutritional deficiencies(especially B12 or folate), and metabolic disorders.
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_____, a symptom of dementia, involves the inability to carry out motor activities despite intact motor function.
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Apraxia
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Which stage of dementia involves no apparent decline in memory?
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Stage I
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Which stage of dementia involves an inability for the individual to recognize family members and possible decubiti and contractures?
a) Stage I b) Stage III c) Stage IV d) Stage VII |
d) Stage VII
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Which stage of dementia involves forgetfulness?
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Stage II
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What is confabulation?
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Creating imaginary events to fill memory gaps.
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During which stage of dementia does urinary and fecal incontinence usually start?
a) Stage I b) Stage II c) Stage III d) Stage IV e) Stage V f) Stage VI g) Stage VII |
f) Stage VI
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At what stage is institutional care usually required for the patient with dementia?
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Stage VI
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Early onset dementia of the Alzheimer's Type occurs at age ___ or younger.
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65
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Late onset dementia of the Alzheimer's Type occurs at age ___ or older.
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66
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When speaking to a patient with schizophrenia who tells you that he hears voices, what is the best way not to reinforce the hallucination?
a) Tell him "they" cant get to you in the hospital b) Tell him "they" may seem real to him, but you cannot hear them speaking c) Tell him he is experiencing a psychotic break in reality and that he can trust you. d) Tell him "Even though I realize the voices are real to you, I do not hear any voices" |
d) Tell him "Even though I realize the voices are real to you, I do not hear any voices"
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A female schizophrenic patient with disturbed though processes argues that a man is always watching her go to the bathroom. How do you approach the delusion?
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Use "reasonable doubt" as a therapeutic technique: "I understand that you believe that to be true, but I personally find it hard to believe" Do not argue or deny the belief.
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If a schizophrenic patient is highly suspicious what should you as the nurse avoid? CATA
a) developing a close relationship with them b) rotating staff members whenever possible c) physical contact d) laughing, whispering or talking quietly where the patient can see but cannot hear what is being said e) canned food |
b) rotating staff members- having the same nurse will promote a trusting relationship
c) physical contact- they dont like being touched d) laughing, whispering or talking quietly where the patient can see but cannot hear what is being said- They will assume you are talking about them -Also avoid family style foods as they might be suspicious of it being poisoned |
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What are common psychomotor behaviors of the client with schizophrenia?
a) volition b) posturing c) waxy flexibility d) rocking |
d) rocking (and pacing) are common psychomotor behaviors of this client
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The schizophrenic patient who has anergia would:
a) wake up at 3 am to start getting ready for the day b) allow their body to be posed in unnatural positions, and maintain it, until manually removed c) not be able to wash himself because he is too tired d) be unable to experience pleasure |
c) not be able to wash himself because he is too tired: anergia is a deficiency of energy
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What is a risk for a schizophrenic patient experiencing anhedonia?
a) CNS over stimulation b) suicide c) life-threatening tachycardia d) refusing to take prescribed medication due to suspicion |
b) suicide: anhedonia is the inability to experience pleasure
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The inability to chose a logical course of action in a given situation is termed:
a) anhedonia b) anergia c) emotional ambivalence d) autism e) volition |
d) volition has to do with impairment in the ability to initiate goal-directed activity
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What is the term given to the schizophrenic patient who creates their own inner fantasy world while distorting or excluding the external environment?
a) anhedonia b) anergia c) emotional ambivalence d) autism e) volition |
d) autism
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When the patient repeats words that they hear, this is termed:
a) nihilistism b) echolalia c) echopraxia d) neologisms e) associative looseness |
b) echolalia
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When the patient imitates movements made by others, this is termed:
a) nihilistism b) echolalia c) echopraxia d) neologisms e) associative looseness |
c) echopraxia
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When the patient invents new words, this is termed:
a) nihilistism b) echolalia c) echopraxia d) neologisms e) associative looseness |
d) neologisms
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What is the term given to when the patient shifts from one unrelated subject to another, such as: "We wanted to take the bus, but the airport took all the traffic and driving is the ticket when you want to get somewhere"?
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This is termed associative looseness: The individual is unaware that the topics are unconnected.
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What would person with clang associations say?
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It is very cold. I am cold and bold. Give me some laundry I can fold: Their choice of words is governed by by sounds.
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What might a person using a word salad say?
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"Most forward actions growls life double plays circle uniform" This is a group of words put together randomly, without any logical connections.
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What type of hallucination are most dangerous?
a) auditory b) command c) visual d) tactile |
b) command: These type of hallucinations may place the individual or others in a potentially dangerous situation as voices that issue commands for violence to self or others may or may not be heeded by the psychotic person
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What might a patient with tactile hallucination think?
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That bugs are crawling under their skin, or feel a false sensation that someone or something is touching them.
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