Which of the following groups of characteristics would the nurse expect to see in the client with schizophrenia?
A. Loose associations, grandiose delusions, and auditory hallucinations
B. Periods of hyperactivity and irritability alternating with depression
C. Delusions of jealousy and persecution, paranoia, and mistrust
D. Sadness, apathy, feelings of worthlessness, anorexia, and weight loss
Correct Answer: A. Loose associations, grandiose delusions, and auditory hallucinations
Loose associations, grandiose delusions, and auditory hallucinations are all characteristic of the classic schizophrenic client. These clients aren’t able to care for their physical appearance. They frequently hear voices telling them to do something either to themselves or to others. Additionally, they verbally ramble from one topic to the next. In the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), Two or more of the following symptoms must be present for a significant portion of time during a one-month period: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, or negative symptoms.
Option B: Periods of hyperactivity and irritability alternating with depression are characteristic of bipolar or manic disease. The defining characteristics of mania are increased talkativeness, rapid speech, decreased the need for sleep (unlike depression or anxiety in which the need for sleep exists, but there is an inability to sleep), racing thoughts, distractibility, increase in goal-directed activity, and psychomotor agitation. Some other hallmarks of mania are an elevated or expansive mood, mood lability, impulsivity, irritability, and grandiosity.
Option C: Delusions of jealousy and persecution, paranoia, and mistrust are characteristics of paranoid disorders. Often, these patients think that others have greatly and irreversibly injured them. They are hypervigilant for potential insults, slights, threats, and disloyalty and look for hidden meanings in remarks and actions. They closely scrutinize others for evidence to support their suspicions. For example, they may misinterpret an offer of help as implication that they are unable to do the task on their own. If they think that they have been insulted or injured in any way, they do not forgive the person who injured them. They tend to counterattack or to become angry in response to these perceived injuries. Because they distrust others, they feel a need to be autonomous and in control.
Option D: Sadness, apathy, feelings of worthlessness, anorexia, and weight loss are characteristics of depression. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. The common features of all the depressive disorders are sadness, emptiness, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function.