While conducting a health history, the nurse notes that the patient is demonstrating positive signs of schizophrenia. What did the nurse assess in this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply
1. Disorganized sentence structure
2. Kicking the nurse
3. Not responding to questions
4. Difficulty following instructions
5. Stating that God wants the patient to go home
1,2,5
Rationale 1: Disorganized speech is a positive symptom of schizophrenia.
Rationale 2: Combativeness is a positive symptom of schizophrenia.
Rationale 3: Lack of responsiveness is a negative symptom of schizophrenia.
Rationale 4: Difficulty following instructions is not a positive symptom of schizophrenia.
Rationale 5: A delusion is a positive symptom of schizophrenia.
Global Rationale: Disorganized speech, combativeness, and delusions are positive symptoms of schizophrenia. Lack of responsiveness is a negative symptom of schizophrenia. Difficulty following instructions is not a positive symptom of schizophrenia.
You might also like to view...
A 22-year-old nurse is working with a seriously ill 23-year-old patient who is recovering from a motor vehicle accident. The nurse recognizes having difficulty maintaining professional boundaries based on their similar ages
Which action should the nurse take initially? a. Seek guidance from another experienced nurse or the unit manager. b. Provide excellent care, but keep conversation and contact to a minimum. c. Arrange to have ancillary staff complete as much care as possible within their scope of practice. d. Discuss with the nursing supervisor the possibility of having another nurse assume this patient assignment.
An elderly client who has had a colostomy states, "I understand how to take care of my colostomy, but what is that other bag for that you used?" This statement indicates a(an)
A) Incongruent relationship B) Congruent relationship C) Non-therapeutic relationship D) Evaluative relationship
An ER nurse is completing an assessment on a patient that is alert but struggles to answer questions. When she attempts to talk, she slurs her speech and appears very frightened. What additional clinical manifestation does the nurse expect to find if nacy's sysmptoms have been caused by a brain attack (stroke)?
A. A carotid bruit B. A hypotensive blood pressure C. hyperreflexic deep tendon relexes. D. Decreased bowel sounds
According to the Joint Commission's Official "Do Not Use" List of Medical Abbreviations, how should the commonly used abbreviation Q.D. now be written?