A client displays disorganized thinking, difficult-to-follow ...

[torybrooks]

A client displays disorganized thinking, difficult-to-follow speech, and silly, inappropriate affect. The client isolates himself from other clients and staff, ignores unit activities, and often seems to be listening and responding to unseen stimuli.
 
  This client's behavior most closely conforms to the characteristic behavior of:
  1. Residual schizophrenia
  2. Schizoaffective disorder
  3. Paranoid schizophrenia
  4. Disorganized schizophrenia

Question 2

A client tried to gouge out his eye in response to auditory hallucinations commanding, If thine eye offend thee, pluck it out. The nurse would analyze this behavior as indicating:
 
  1. Impaired impulse control
  2. Inability to manage anger
  3. Derealization
  4. Inappropriate affect

[welcom1000]

Answer to Question 1

ANS: 4
The presence of disorganization and inappropriate affect identifies this disorder as disorganized schizophrenia. 1. The symptoms are too florid to be residual schizophrenia. 2. Schizoaffective disorder presents with severe mood disorder along with symptoms of schizophrenia. 3. Paranoid schizophrenia is characterized by persecutory or grandiose delusions.

Answer to Question 2

ANS: 1
Command hallucinations may be so intense that the client cannot control the impulse to do what the hallucination tells him to do; thus the client has impaired impulse control. 2. This is not an anger management problem. 3. Derealization is a feeling that the environment is distorted or un-real and not suggested in the scenario. 4. No evidence of inappropriate affect is given.