A client with schizophrenia walks up to the nurse with his arm ...

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A client with schizophrenia walks up to the nurse with his arm outstretched and says, My arm went away. Dog, dog, dog. How should the nurse respond?
 
  A) Ignore the comments and redirect the client's attention.
  B) Ask the client if he is trying to say that something is wrong with his arm.
  C) Ask the client if he is having visual hallucinations.
  D) Tell the client that he or she can see the arm, and no dogs are around.

Question 2

The nurse is evaluating the plan of care for a client with schizophrenia. Which of the following observations best suggests that the plan has been effective?
 
  A) The client believes that she no longer requires medication and has begun to taper down her doses.
  B) The client has resumed employment and has been attending social functions.
  C) The client is able to describe her hallucinations in considerable detail.
  D) The client seeks opportunities to teach other clients who have schizophrenia.

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Answer to Question 1

Ans: B
Feedback:
The client's illogical, symbolic, and disorganized speech often holds a message that he or she cannot express clearly. The nurse listens for themes and reflects back to the client the meaning that the nurse has deciphered. The nurse does not dismiss the client's verbal and nonverbal behaviors as meaningless or nonsense. In effect, the nurse tries to decode the communication that the client offers and validate its meaning.

Answer to Question 2

Ans: B
Feedback:
Major goals for the care of a client with schizophrenia are to experience improved thought processes and fewer psychotic symptoms, to not engage in violent behavior, to acquire improved social skills and engage in satisfying social interaction, and to gain knowledge about the disease process and treatment. A belief that medications are unnecessary is an ominous sign. Seeking to teach other and describing hallucinations do not necessarily signal improvement in symptom management and functioning.