RN Nursing · Psychiatric Assessment · Practice question
A nurse is performing a mental status examination for a client who has schizophrenia. The nurse should recognize that which of the following actions requires the client to think abstractly?
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Count by adding sevens consecutively.
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✓
Determine the meaning of a proverb.
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Name the last three presidents of the United States of America,
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Explain what to do if he misses the bus.
Answer & explanation
Correct: Determine the meaning of a proverb.
Abstract thinking is the cognitive ability to understand concepts that are not tied to concrete, literal, or tangible experiences — it involves interpreting metaphors, recognizing patterns, or grasping symbolic meaning. Asking a client to interpret a proverb, such as 'a rolling stone gathers no moss,' requires the person to move beyond the literal words and understand the figurative meaning, making it a direct test of abstract reasoning. In clients with schizophrenia, concrete thinking is common, meaning they may interpret proverbs literally rather than symbolically, which is a key finding assessed during the mental status examination. Counting by adding sevens consecutively is a test of concentration and working memory, not abstract thinking. Naming the last three presidents tests remote memory and orientation. Explaining what to do if one misses the bus is a practical problem-solving question that assesses judgment and insight but involves concrete, real-world reasoning rather than abstract symbolic thought. The proverb interpretation task is the classic and universally recognized method for formally evaluating abstract thinking in a mental status examination, and impairment in this domain is clinically significant in schizophrenia.
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