A male client has schizotypal personality disorder. A female ...

[jrubin]

A male client has schizotypal personality disorder. A female client compliments him on his style of dressing, and he interprets this as her caring deeply for him and desiring to date him. What is the client experiencing?
 
  a. Paranoia
  b. Ideas of reference
  c. Inappropriate affect
  d. Delusions of grandeur

Question 2

The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating.
 
  He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called volmers hiding in the warehouse where he works and undoing his work each night. This information most likely suggests: a. medication nonadherence.
  b. a need for psychoeducation.
  c. the chronic nature of his illness.
  d. relapse of his schizophrenia.

[Benayers]

Answer to Question 1

B
Ideas of reference are incorrect perceptions of casual events as having great or significant meaning and are frequently seen in clients with schizotypal personality disorder. Paranoia refers to individuals who assume that everyone is out to harm, deceive, or exploit them; inappropriate affect refers to inappropriate emotional expressions; and delusions of grandeur are irrational grandiose thoughts, but they differ from ideas of reference in that an interaction is not necessary to cause the delusions of grandeur.

Answer to Question 2

D
Signs of potential relapse include feeling tense, difficulty concentrating, trouble sleeping, increased withdrawal, increased bizarre or magical thinking, and a general worsening of the patient's residual symptoms or a return of previous symptoms. The patient is more symptomatic, and medication nonadherence may be a contributing factor, but there is no information to indicate that the patient has been nonadherent (relapse can occur even when the patient is taking medication regularly). A lack of understanding of one's illness and treatment would not itself lead to the presentation described here, and psychoeducation is better delivered when the patient's symptoms are stable. In this case, the symptoms have worsened and/or new symptoms have been added; this suggests a change is occurring rather than the continued presentation of chronic symptoms.

[jrubin]

TYSM

[diana chang]

Excellent