Schizo
Which of the following is an example of a positive symptom of schizophrenia?
A. Flat affect
B. Anhedonia
C. Auditory hallucinations
D. Social withdrawal
Answer: C. Auditory hallucinations
Rationale: Positive symptoms add to normal function (hallucinations, delusions), while negative symptoms take away (flat affect, anhedonia).
What is the primary characteristic of bipolar I disorder?
A. Recurrent depressive episodes
B. Hypomanic episodes only
C. At least one manic episode
D. Rapid cycling mood swings
Answer: C. At least one manic episode
Rationale: Bipolar I requires at least one manic episode, while Bipolar II involves hypomania and depression.
Which class of medications is most commonly used to treat schizophrenia?
A. Selective serotonin reuptake inhibitors (SSRIs)
B. Antipsychotics
C. Mood stabilizers
D. Benzodiazepines
Answer: B. Antipsychotics
Rationale: Antipsychotic medications are the primary treatment for schizophrenia. SSRIs treat depression, and mood stabilizers are used for bipolar disorder.
Which medication is considered a first-line mood stabilizer for bipolar disorder?
A. Fluoxetine
B. Lithium
C. Haloperidol
D. Alprazolam
Answer: B. Lithium
Rationale: Lithium is the gold standard for bipolar disorder treatment, particularly in mania prevention.
Which of the following is a hallmark symptom of attention-deficit/hyperactivity disorder (ADHD)?
A. Increased need for sleep
B. Impulsivity and difficulty focusing
C. Repetitive hand movements
D. Depressed mood and anhedonia
Answer: B. Impulsivity and difficulty focusing
Rationale: ADHD is characterized by hyperactivity, impulsivity, and inattention.
A nurse is caring for a client with schizophrenia who believes the FBI is watching them through the TV. This is an example of:
A. A hallucination
B. A delusion
C. Paranoia
D. Depersonalization
Answer: B. A delusion
Rationale: Delusions are false fixed beliefs. Paranoia involves mistrust, but delusions are broader and more rigid.
Which behavior is characteristic of mania?
A. Slowed movements
B. Hyperverbal speech
C. Increased sleep
D. Poor concentration due to low energy
Answer: B. Hyperverbal speech
Rationale: Mania includes pressured speech, euphoria, and risk-taking behavior.
A client taking haloperidol develops muscle rigidity, a high fever, and altered mental status. What is the priority action?
A. Administer diphenhydramine
B. Stop the medication and notify the provider
C. Encourage fluids and rest
D. Give a lower dose of haloperidol
Answer: B. Stop the medication and notify the provider
Rationale: The client is experiencing neuroleptic malignant syndrome (NMS), a life-threatening reaction requiring immediate discontinuation of the antipsychotic.
A nurse is educating a client taking lithium. Which statement indicates understanding?
A. “I will limit my sodium intake to prevent side effects.”
B. “I will drink at least 2-3 liters of water per day.”
C. “I will stop my lithium if I feel better.”
D. “I will take lithium only when I feel manic.”
Answer: B. “I will drink at least 2-3 liters of water per day.”
Rationale: Dehydration and low sodium can cause lithium toxicity, so maintaining hydration and stable sodium intake is critical.
A nurse is educating the parent of a child with autism spectrum disorder (ASD). Which intervention should be recommended?
A. Encouraging a structured routine
B. Placing the child in a large group setting
C. Using multiple caregivers to improve adaptability
D. Encouraging unstructured playtime
Answer: A. Encouraging a structured routine
Rationale: Children with ASD benefit from structured routines and minimal environmental changes to reduce anxiety.
(Moderate) A client with schizophrenia has poor hygiene, monotone speech, and social withdrawal. These are examples of:
A. Cognitive symptoms
B. Affective symptoms
C. Negative symptoms
D. Disorganized symptoms
Answer: C. Negative symptoms
Rationale: Negative symptoms involve diminished emotions, motivation, and engagement.
A nurse is caring for a client in a manic episode. Which dietary intervention is most appropriate?
A. Regular three-course meals
B. Finger foods high in calories
C. Low-fat, low-calorie meals
D. Restricting caffeine intake only
Answer: B. Finger foods high in calories
Rationale: Manic clients struggle to sit down for meals, so high-calorie portable foods are best.
Which side effect is unique to clozapine, requiring frequent lab monitoring?
A. Weight gain
B. Agranulocytosis
C. Tardive dyskinesia
D. Hyperprolactinemia
Answer: B. Agranulocytosis
Rationale: Clozapine can cause severe neutropenia (agranulocytosis), increasing infection risk. Regular WBC monitoring is required.
A client on valproate (Depakote) should have which labs monitored regularly? (Select all that apply.)
A. Liver function tests (LFTs)
B. White blood cell count (WBC)
C. Platelet count
D. Creatinine
E. Serum sodium
Answer: A, C
Rationale: Valproate can cause hepatotoxicity (LFTs) and thrombocytopenia (low platelets), requiring frequent monitoring.
Which statement by a parent suggests an understanding of treatment for oppositional defiant disorder (ODD)?
A. “I should establish clear, consistent rules and consequences.”
B. “I should let my child vent anger without setting limits.”
C. “Strict punishment will help my child behave better.”
D. “This disorder will resolve on its own with time.”
Answer: A. “I should establish clear, consistent rules and consequences.”
Rationale: ODD is best managed with consistent structure, behavioral therapy, and positive reinforcement.
A client diagnosed with schizophrenia states, “The cat speaks in riddles, and the television whispers my name.” Which term describes this speech pattern?
A. Clang associations
B. Word salad
C. Loose associations
D. Flight of ideas
Answer: C. Loose associations
Rationale: Loose associations occur when thoughts lack logical connection. Clang associations involve rhyming, and word salad is completely disorganized speech.
Which of the following is a risk associated with untreated mania?
A. Worsening depressive symptoms
B. Sleep disturbances
C. Increased risk of psychosis
D. All of the above
Answer: D. All of the above
Rationale: Untreated mania can worsen the disorder and lead to severe functional impairment.
Which symptom is most associated with tardive dyskinesia caused by long-term antipsychotic use?
A. Tremors and bradykinesia
B. Lip-smacking and tongue protrusion
C. Muscle rigidity and fever
D. Oculogyric crisis
Answer: B. Lip-smacking and tongue protrusion
Rationale: Tardive dyskinesia involves involuntary movements, particularly oral-facial (e.g., lip-smacking, tongue protrusion, blinking).
Which medication is an anticonvulsant mood stabilizer used to treat bipolar disorder?
A. Buspirone
B. Carbamazepine
C. Lorazepam
D. Sertraline
Answer: B. Carbamazepine
Rationale: Carbamazepine is an anticonvulsant used as a mood stabilizer, particularly for bipolar disorder with rapid cycling.
A child diagnosed with conduct disorder is most likely to exhibit which behavior?
A. Avoidance of social interaction
B. Repetitive hand-wringing
C. Aggression toward others and rule violations
D. Excessive worrying about the future
Answer: C. Aggression toward others and rule violations
Rationale: Conduct disorder involves aggressive and antisocial behavior, including property destruction and cruelty.
Which neurotransmitter is most implicated in schizophrenia?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Answer: A. Dopamine
Rationale: Excess dopamine is linked to positive symptoms, while a deficiency in certain areas contributes to negative symptoms.
Which feature is unique to Bipolar II Disorder compared to Bipolar I?
A. No full manic episodes
B. Psychotic features
C. Increased hospitalization rates
D. Higher suicide risk
Answer: A. No full manic episodes
Rationale: Bipolar II is defined by hypomania, which is less severe than full-blown mania.
A nurse is administering risperidone. Which finding requires immediate intervention?
A. Drowsiness
B. Gynecomastia
C. Drooling and muscle stiffness
D. Increased appetite
Answer: C. Drooling and muscle stiffness
Rationale: Drooling and stiffness suggest extrapyramidal symptoms (EPS), which may progress to acute dystonia or other movement disorders.
Which symptom is an early sign of lithium toxicity?
A. Seizures
B. Coarse tremors
C. Mild nausea and fine hand tremors
D. Coma
Answer: C. Mild nausea and fine hand tremors
Rationale: Early toxicity signs include GI distress, mild tremors, and polyuria. Severe toxicity leads to coarse tremors, seizures, and coma.
A child with Tourette syndrome is prescribed a medication for tic suppression. Which medication is most likely to be used?
A. Methylphenidate
B. Risperidone
C. Sertraline
D. Atomoxetine
Answer: B. Risperidone
Rationale: Atypical antipsychotics like risperidone are used for tic suppression in Tourette syndrome.
A client with schizophrenia is seen standing still for hours in an awkward posture. The nurse recognizes this as:
A. Catatonia
B. Echopraxia
C. Waxy flexibility
D. Depersonalization
Answer: C. Waxy flexibility
Rationale: Waxy flexibility occurs when a person’s limbs remain in a position until moved. Catatonia involves extreme psychomotor disturbances, but waxy flexibility is a specific subtype.
A client with bipolar disorder states they feel "amazing, unstoppable, and chosen by the universe." This is an example of:
A. Grandiosity
B. Tangential thinking
C. Paranoia
D. Anhedonia
Answer: A. Grandiosity
Rationale: Grandiosity is a common manic symptom, where clients believe they have exceptional abilities or power.
A client on fluphenazine reports severe restlessness, inability to sit still, and agitation. The nurse recognizes this as:
A. Tardive dyskinesia
B. Akathisia
C. Neuroleptic malignant syndrome
D. Dystonia
Answer: B. Akathisia
Rationale: Akathisia is a movement disorder causing inner restlessness and constant motion, often seen with high-potency antipsychotics.
A nurse is teaching a client about lamotrigine (Lamictal). Which side effect requires immediate medical attention?
A. Mild headache
B. Skin rash
C. Weight gain
D. Increased appetite
Answer: B. Skin rash
Rationale: Lamotrigine can cause Stevens-Johnson syndrome (SJS), a life-threatening rash requiring immediate discontinuation.
A child with reactive attachment disorder (RAD) is likely to exhibit:
A. Excessive dependence on caregivers
B. Avoidance of all social interactions, including with caregivers
C. Frequent hallucinations and delusions
D. A strong preference for interacting with strangers over parents
Answer: B. Avoidance of all social interactions, including with caregivers
Rationale: Children with RAD develop severe emotional detachment, even from caregivers, due to early neglect or trauma.
Which of the following symptoms is NOT commonly associated with schizophrenia?
A. Tangentiality
B. Thought blocking
C. Confabulation
D. Anhedonia
Answer: C. Confabulation
Rationale: Confabulation (filling in memory gaps with fabricated details) is more associated with dementia and amnesia than schizophrenia.
A nurse is evaluating a client taking lithium for bipolar disorder. Which lab value requires immediate intervention?
A. Lithium level 1.0 mEq/L
B. Sodium 132 mEq/L
C. Potassium 4.2 mEq/L
D. Blood glucose 100 mg/dL
Answer: B. Sodium 132 mEq/L
Rationale: Low sodium increases lithium toxicity risk since lithium and sodium compete for excretion in the kidneys.
Which neurotransmitter pathway is targeted by first-generation (typical) antipsychotics to reduce positive symptoms of schizophrenia?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: A. Mesolimbic pathway
Rationale: Typical antipsychotics block dopamine (D2) receptors in the mesolimbic pathway, reducing positive symptoms like hallucinations and delusions.
Which electrolyte imbalance increases the risk of lithium toxicity?
A. Hypokalemia
B. Hypermagnesemia
C. Hyponatremia
D. Hypercalcemia
Answer: C. Hyponatremia
Rationale: Low sodium (hyponatremia) increases lithium reabsorption in the kidneys, leading to toxicity.
Which disorder is most strongly associated with enuresis (bedwetting) past the age of 5?
A. Generalized anxiety disorder
B. Autism spectrum disorder
C. Attention-deficit/hyperactivity disorder (ADHD)
D. Oppositional defiant disorder (ODD)
Answer: C. Attention-deficit/hyperactivity disorder (ADHD)
Rationale: Enuresis is commonly comorbid with ADHD, possibly due to impulsivity and inattentiveness interfering with bladder control.