SCHIZOPHRENIC question

BabyLady, BSN, RN · Jan 11, 2009

yup.. I'm going with #4... if the voices are telling him/her to harm themselves or others.

Gotta be careful on this one!!!!

They warn us all the time to not read too much into the question.

Nowhere in #4 did it say that the patient was going to harm themselves.

Hearing voices telling the client what to do???

We have no idea of what the voices are saying.

BabyLady, BSN, RN · Jan 11, 2009

waoh thanks everyone, i guess am wrong then, cause i chose the no.3 since answer no 4 is expected in a client with this kind of diagnosis. It is a review book i saw in the library(prentice hall's i think) today and because this question has been bothering me i had to post it. Thanks once aga

I understand your reasoning that #4 is expected, but #3 is not expected in a schizophrenic patient, and may not have anything to do with schizophrenia at all.

Ever noticed how NCLEX patients only tend to have one disorder at a time?

There are many different types of schizophrenia...they all don't see things or hear things that isn't there.

Another reason why #4 is correct is if you had a patient that was Dx with schizophrenia..this could actually be a new symptom that did not appear before in the client, therefore, you would need to find out "what the voices were saying"...are the voices internal or external, what is the patient hearing, does the patient know they are real vs not real (there is a monumental difference between the two).

Hope that helps.

choco901 · Jan 11, 2009

i think #4 is the best answer~

Atheos · Jan 11, 2009

So... what was the answer in the book????

Psyched Out RN · Jan 11, 2009

Yes, all the answers are statements we could expect from someone w/schizophrenia, but the point of the question is to pick the answer that you would be most concerned about investigating further for the possibility of risk/danger to the patient. Does that make sense?

Keenay99 · Jan 12, 2009

I will go with # 4 too, because #4 needs follows up. You have to find out what is the voice is telling the patient to do. #4 final answer:yeah:. Please let us know what is the right answer.

ANH_RN · Jan 12, 2009

I would say #4 ... what exactly ARE those voices telling you? We already know he may be paranoid (1).

Mr Ian · Jan 12, 2009

I would say #4 ... what exactly ARE those voices telling you? We already know he may be paranoid (1).

I'm not sure the first comment reveals paranoia -

1. "The Govt is under me"

Can be taken as a statement of grandiosity or narcissism - as he is suggesting he is above the govt.

Unless of course, the rest of the sentence was meant to read:

1. "The Govt is under me... bed"

:)

Mr Ian · Jan 12, 2009

Nowhere in #4 did it say that the patient was going to harm themselves.
Hearing voices telling the client what to do???

I think that was the point iceyspots was making - the need to clarify if the voices were talking of harming self or others.

And you are absolutely right - never read in to the question.

Command hallucinations are not necessarily about harm - can often be encouraging ritualistic behaviour - like turn the TV off and on; don't shower before breakfast; buy the nurses chocolate....

mlandingin177 · Jan 16, 2009

That question was on my NCLEX-PN that I took 2 days ago. i chose number 4

Nana Cilla · Jan 16, 2009

my best choice is #4 safety first. If you have voices that tell you what to do, that is dangerous........the first thing that comes to mind is SUICIDE.....so safety first. :banghead:

LadySnyper · Jan 16, 2009

Please can someone help me get an the answer to this question?,
what statement if made by a schizophrenic patient needs follow up? If the client states.....
1. "The Govt is under me"
2 "I can read the mind of every one here"
3. "I don't feel anyone of you here can help me"
4. " I have voices that tell me what to do"

I think its number four. safety is the prioirty here...i think. THe voices might tell the patient to hust himself/others so the nurse has to assess further...and intervene appropriately...