The patient tells the nurse, The world will end tonight at ...

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The patient tells the nurse, The world will end tonight at midnight. Armageddon is upon us This statement indicates the patient is experiencing which type of delusion?
 
  1. Religious
  2. Grandiose
  3. Nihilistic
  4. Persecutory

Question 2

The nurse caring for a patient with schizophrenia spectrum disorder knows that the risk of disease increases according to which neurochemical explanations? Select all that apply.
 
  1. Use of drugs that increase dopaminergic activity
  2. A decrease in dopaminergic activity in the brain
  3. An increase in gray matter in the anterior cingulate and hippocampus
  4. A reduction in the structural gray matter of the bilateral frontal lobe and amygdala
  5. Mitochondrial reduction of density and volume, including defective mitochondrial energy production

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Answer to Question 1

Answer: 3
Explanation: Nihilistic delusions involve a belief that part of the individual (or world) is dead or does not exist. Persecutory delusions involve the belief that others intend to harm or kill the patient. Grandiose delusions involve beliefs that the patient is famous or powerful. Religious delusions involve specific references to religion.

Answer to Question 2

Answer: 1, 4, 5
Explanation: There are a number of neurochemical explanations for schizophrenia spectrum disorder (SSD). The most common is the dopamine hypothesis, which states that the most effective antipsychotic medications may have antagonistic actions on the dopamine type 2 (D2) receptor in the brain. Therefore, drugs that increase (not decrease) dopaminergic activity would produce a condition that resembles psychosis. Another explanation lies with neuropathology, which suggests that SSDs are composed of structural defects in multiple areas with a reduction (not increase) of gray matter in the anterior cingulate, bilateral frontal lobe, hippocampus, and amygdala. A study on brain metabolism dysfunction posits that there is a presence of mitochondrial dysfunction in patients with SSD that results in reduced mitochondrial density and volume, as well as defective mitochondrial energy production.