A nurse is planning care for a client who has paranoid schizophrenia. Which of the following interventions should be included in the plan of care?
Assign an assistive personnel to feed the client at mealtimes.
Use touch to calm the client during periods of anxiety.
Rotate staff assignments for this client.
Check the client’s mouth after the client takes medication.
The Correct Answer is D
Choice A reason:
Assigning assistive personnel to feed the client at mealtimes is not typically necessary for clients with paranoid schizophrenia unless there are specific physical limitations. This intervention does not address the unique needs of managing paranoia and ensuring medication adherence.
Choice B reason:
Using touch to calm the client during periods of anxiety is not recommended for clients with paranoid schizophrenia. These clients may misinterpret touch as a threat, exacerbating their paranoia and anxiety.
Choice C reason:
Rotating staff assignments for this client can increase anxiety and paranoia. Consistency in caregivers helps build trust and reduces the client’s suspicion and anxiety.
Choice D reason:
Checking the client’s mouth after the client takes medication is crucial to ensure that the client has swallowed the medication. Clients with paranoid schizophrenia may hide or refuse medication due to their distrust, so this intervention helps ensure they receive their prescribed treatment.
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Correct Answer is C
Explanation
Choice A reason:
Bizarre behavior is considered a positive symptom of schizophrenia. Positive symptoms are those that add abnormal experiences, such as hallucinations, delusions, and disorganized behavior. Bizarre behavior falls into this category as it represents an addition to normal behavior patterns.
Choice B reason:
Somatic delusions are also positive symptoms of schizophrenia. These delusions involve false beliefs about the body, such as believing one has a serious illness despite medical evidence to the contrary. Positive symptoms are characterized by the presence of abnormal thoughts or behaviors.
Choice C reason:
Affective flattening is a negative symptom of schizophrenia. Negative symptoms are characterized by the absence or reduction of normal functions, such as emotional expression, motivation, and social interaction. Affective flattening refers to a lack of emotional expression, where the individual shows little to no facial expressions or emotional responses.
Choice D reason:
Illogicality, or disorganized thinking, is considered a positive symptom of schizophrenia. It involves incoherent or nonsensical speech and thought patterns. Positive symptoms are those that reflect an excess or distortion of normal functions.
Correct Answer is D
Explanation
Choice A reason:
Developmental theories focus on the progression of human growth and development through various stages of life. While these theories are important in understanding patient behavior and needs, they do not directly relate to the implementation of a privilege system in an inpatient unit. Privilege systems are more aligned with behavioral theories, which emphasize the modification of behavior through reinforcement and consequences.
Choice B reason:
Humanistic theories emphasize the individual’s capacity for self-actualization and personal growth. These theories focus on the holistic development of the person and the importance of empathy and unconditional positive regard in therapeutic relationships. Although humanistic approaches are valuable in mental health care, they do not specifically address the structured reinforcement strategies used in privilege systems.
Choice C reason:
Cognitive theories focus on the role of thought processes in influencing emotions and behaviors. These theories are crucial in understanding and treating mental health conditions, particularly through cognitive-behavioral therapy (CBT). However, the privilege system, which relies on tangible rewards and consequences to shape behavior, is more closely related to behavioral theories rather than cognitive ones.
Choice D reason:
Behavioral theories are directly related to the use of a privilege system. These theories emphasize the use of reinforcement and punishment to modify behavior. In an inpatient setting, a privilege system is used to encourage desirable behaviors by providing rewards (privileges) and discouraging undesirable behaviors through the removal of privileges. This approach is grounded in the principles of operant conditioning, a key concept in behavioral theories.