Schizophrenia Q 37
A client with paranoid schizophrenia is admitted to the psychiatric unit of a hospital. Nursing assessment should include careful observation of the client’s:
A. Thinking, perceiving, and decision-making skills
B. Verbal and nonverbal communication processes
C. Affect and behavior
D. Psychomotor activity
Correct Answer: A. Thinking, perceiving, and decision-making skills
Nursing assessment of a psychotic client should include careful inquiry about and observation of the client’s thinking, perceiving, symbolizing, and decision-making skills and abilities. Assessment of such a client typically reveals alterations in thought content and process, perception, affect, and psychomotor behavior; changes in personality, coping, and sense of self; lack of self-motivation; presence of psychosocial stressors; and degeneration of adaptive functioning.
Option B: Assess if incoherence in speech is chronic or if it is more sudden, as in an exacerbation of symptoms. Establishing a baseline facilitates the establishment of realistic goals, the foundation for planning effective care. Keep the environment calm, quiet and as free of stimuli as possible. Keep anxiety from escalating and increasing confusion and hallucinations/delusions.
Option C: Identify with client symptoms he experiences when he or she begins to feel anxious around others. Increased anxiety can intensify agitation, aggressiveness, and suspiciousness. Assess if the medication has reached therapeutic levels. Many of the positive symptoms of schizophrenia (hallucinations, delusions, racing thoughts) will subside with medications, which will facilitate interactions.
Option D: Although assessing communication processes, affect, behavior, and psychomotor activity would reveal important information about the client’s condition, the nurse should concentrate on determining whether the client is hallucinating by assessing thought processes and decision-making ability.