Is it Schizophrenia?
A nurse is teaching a group of students about disorders within the schizophrenia spectrum. Which disorder is characterized by one or more delusions lasting at least one month, but does NOT include hallucinations, disorganized speech, or major functional impairment?
A. Brief psychotic disorder
B. Delusional disorder
C. Schizoaffective disorder
D. Substance‑induced psychotic disorder
B. Delusional disorder
Delusional disorder involves persistent delusions for at least one month with otherwise normal functioning and no other psychotic symptoms.
Which of the following is considered a positive (+) symptom of schizophrenia?
a-flat affect
b-disorganized speech
c-poor eye contact
d-impaired hygiene
b-disorganized speech
A patient states, “I was born with special powers, and I’m destined to save the entire world.” What type of delusion is this?
A. Persecution
B. Grandeur
C. Reference
D. Fixed
B. Grandiose delusion
Grandiose delusions involve an exaggerated sense of self‑importance, power, knowledge, or identity.
A patient’s family reports that over the past year, the patient has become increasingly withdrawn, stopped attending school, and shows a decline in hygiene. The nurse recognizes these changes as part of which phase of schizophrenia?
A. Maintenance phase
B. Prodromal phase
C. Acute phase
D. Stabilization phase
B. Prodromal phase-The prodromal phase includes gradual changes in functioning, social withdrawal, and subtle behavioral decline before psychosis appears.
acute phase- includes the most severe symptoms such as hallucinations, delusions, and disorganized thinking.
stabilization phase, symptoms lessen and the patient begins to regain functioning.
Maintenance-The pt is stable, improving, and focused on long‑term recovery and relapse prevention. New baseline established.
A nurse is reviewing antipsychotic medications with a nursing student. Which of the following are second‑generation (atypical) antipsychotics? Select all that apply.
A. Haloperidol
B. Ziprasidone
C. Pimozide
D. Clozapine
E. Risperidone
F. Quetiapine
G. Olanzapine
H. Chlorpromazine
I. Paliperidone
J. Lurasidone
K. Aripiprazole
B. Ziprasidone
D. Clozapine
E. Risperidone (Comes in Long-term injection)
F. Quetiapine
G. Olanzapine (Comes in Long-term injection)
I. Paliperidone (Comes in Long-term injection)
J. Lurasidone
Gen 1 Haloperidol (Comes in Long-term injection)
Gen 3 Aripiprazole (Comes in Long-term injection)
A patient suddenly develops hallucinations and disorganized behavior after a severe stressor. Symptoms last less than one month, and the patient returns to baseline functioning. Which schizophrenia‑spectrum disorder does this describe?
A. Brief psychotic disorder
B. Schizoaffective disorder
C. Delusional disorder
D. Substance‑induced psychotic disorder
A. Brief psychotic disorder
Brief psychotic disorder involves sudden onset of psychotic symptoms that last at least one day but less than one month, followed by full recovery.
If a pt with schizophrenia persistently repeats the same ideas over and over, this pattern of speech would be documented as?
A. Echolalia
B. Clang association
C. Word salad
D. Neologisms
correct answer is A. Echolalia-repetition of another’s words
B. Clang association -sounds like rhyming
C. Word salad -jumble of words meaningless to a listener is a form of Looseness of association -use of statements and topics unconnected
D. Neologisms Nee-All-O-Gisms- made up words that make sense only to the patient think little mermaid and the fork called a “dinglehopper”
A patient tells the nurse, “I know the hospital staff replaced my real sister with an identical impostor. Nothing you say will change my mind.” What type of delusion is this?
A. Persecution
B. Grandeur
C. Reference
D. Fixed
D. Fixed
A fixed delusion is a firmly held false belief that remains unchanged despite clear evidence, logical explanations, or reassurance. The belief persists even when confronted with facts that contradict it.
A nursing instructor is reviewing key epidemiologic features & risk factors of schizophrenia with a group of students. Which statements about schizophrenia are supported by current evidence? Select all that apply.
A. Schizophrenia affects about 1% of the population
B. It is characterized by psychosis
C. Most individuals (about 75%) develop symptoms gradually between ages 15 and 25
D. Child‑onset and late‑onset schizophrenia are rare
E. It is more commonly diagnosed among males
F. Higher rates are seen in individuals living in urban areas
G. Winter Births
H. Trauma
I. Prenatal risk factors like Pregnancy and delivery complications (sub abuse, flu & iron deficiency
ALL ARE CORRECT
A nurse is comparing second‑generation (atypical) antipsychotics with the third‑generation antipsychotic aripiprazole. Which statements accurately describe aripiprazole when compared with second‑generation antipsychotics? Select all that apply.
A. It may improve both positive and negative symptoms of schizophrenia
B. It is especially helpful for hard‑to‑treat negative symptoms
C. It has little risk of EPS or tardive dyskinesia
D. It has a higher risk of akathisia than many second‑generation antipsychotics
E. It carries a higher risk of metabolic syndrome than second‑generation antipsychotics
Correct Answers: A, B, C, D
E. Aripiprazole has a lower metabolic risk than many second‑generation antipsychotics (e.g., Olanzapine, Clozapine).
A patient arrives in the emergency department with new‑onset hallucinations and paranoia. The nurse learns the patient recently used methamphetamine. Which schizophrenia‑spectrum disorder is most likely?
A. Schizoaffective disorder
B. Delusional disorder
C. Substance‑induced psychotic disorder
D. Brief psychotic disorder
C. Substance‑induced psychotic disorder
Substance‑induced psychotic disorder occurs when hallucinations or delusions develop during or soon after substance use.
A patient with schizophrenia repeatedly states, “The government implanted a chip in my brain.” This is an example of which type of symptom?
A. Positive symptom
B. Negative symptom
C. Cognitive symptom
D. Mood symptom
Correct Answer: A. Positive symptom
-Delusions are positive symptoms because they reflect an added, false belief not based in reality.
If a pt with schizophrenia is having delusions and believes that the government is sending assassins to kill him or her an appropriate response is?
A. It must be hard to be so scared, but you are safe here
B. You are having a delusion. The government is not sending assassins
C. Look around. This is a safe place you don’t need to worry
D. We have security guards that will protect you from the assassins
A. It must be hard to be so scared, but you are safe here.
-Do not argue or contradict. This is their delusion and they believe it is real. To tell them its not only breaks trust and will cause a breakdown in the therapeutic relationship.
A pt is experiencing severe psychosis with delusions & hallucinations. The priority in the care of the pt is?
A. Developing a therapeutic relationship
B. Using therapeutic communication
C. Ensuring the safety of the patient and others
D. Using strategies for delusions and hallucinations
C. Ensuring the safety of the patient and others
A nurse is teaching a patient about second‑generation (atypical) antipsychotics such as risperidone, olanzapine, and quetiapine. Which statements about these medications are accurate? Select all that apply.
A. They treat both positive and negative symptoms of schizophrenia
B. They cause minimal to no extrapyramidal side effects (EPS) or tardive dyskinesia
C. They have a lower risk of metabolic syndrome compared to first‑generation antipsychotics
D. They may cause significant weight gain
E. They carry a risk for metabolic syndrome
F. They are less effective than first‑generation antipsychotics for positive symptoms
Correct Answers: A, B, D, E
A nurse is reviewing the DSM‑5 criteria for schizophrenia while assessing a patient with suspected psychosis. Which set of findings would best support a diagnosis of schizophrenia?
A. Recurrent panic attacks, compulsive rituals, and intrusive thoughts that cause distress
B. Delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, negative symptoms, and functional impairment
C. Mood swings, pressured speech, and periods of elevated energy lasting at least one week
D. Memory loss, wandering behavior, and difficulty recognizing familiar people
Correct Answer: B
The DSM‑5 identifies five core symptom domains of schizophrenia: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms. These symptoms must cause functional impairment in work, relationships, or self‑care.
A diagnosis requires at least two symptoms, with at least one being delusions, hallucinations, or disorganized speech.
A pt with schizophrenia exhibits negative and positive symptoms. Examples of negative symptoms are (select all that apply)?
A. Alogia
B. Akithesia
C. Apathy
D. Anhedonia
E. Affective Blunting
F. Asociality
G. Avolition
H. Auditory Hallucinations
Things that aren't there you are negative for them but should be!
Negative (-) symptoms take away:
All (As)
Anhedonia-no pleasure or enjoyment
Avolition-no motivation
Asociality-don’t want to be around others
Affective blunting
Apathy- don’t care
Alogia-poverty of speech
A pt who believes that other people are constantly talking about him or laughing at him is likely experiencing delusions of?
A. Persecution
B. Grandeur
C. Reference
D. Fixed
Correct answer is C. Reference-pt believes almost everything refers to them (newspapers, tv sending coded messages).
A. Persecution-Others intend to harm them being recorded or watched by FBI or CIA.
B. Grandeur-believes exceptional power or knowledge, "I am the Queen or God."
D. Fixed- does not go away despite all the proof. Ex. Ms Julie believes she is married to Johnny Depp. Even if I showed her her real marriage license and introduced her to her actual spouse the fixed delusion will not go away.
A pt with schizophrenia is very agitated and is experiencing auditory hallucinations that make the pt suspicious and fearful of others. The nurses response that is most indicated is to?
A. Talk to the pt and maintain eye contact
B. Try to engage the pt in activities
C. Isolate the pt in a locked room
D. Ensure that the pt has adequate personal space
D. Ensure that the pt has adequate personal space
A nurse is teaching a patient about first‑generation (typical) antipsychotics such as haloperidol and chlorpromazine. Which statements about these medications are accurate? Select all that apply.
A. They primarily target the positive symptoms of schizophrenia
B. They are generally less expensive than second‑generation antipsychotics
C. They have a lower risk of extrapyramidal side effects (EPS) compared to second‑generation antipsychotics
D. They may cause anticholinergic side effects, such as dry mouth and constipation
E. They carry a risk of tardive dyskinesia
F. They may cause weight gain, polydipsia and sexual dysfunction
Correct Answers: A, B, D, E, F
A nurse is reviewing a patient’s history to help differentiate schizophrenia from schizoaffective disorder. Which finding is most consistent with schizoaffective disorder rather than schizophrenia?
A. The patient has experienced delusions, hallucinations, and disorganized speech for at least six months with significant functional impairment
B. The patient has psychotic symptoms that occur exclusively during episodes of major mood disturbance
C. The patient has psychotic symptoms for at least two weeks in the absence of a major mood episode, along with periods where mood symptoms are present
D. The patient demonstrates negative symptoms such as flat affect and avolition without any mood symptoms
Correct answer is C.
Schizoaffective disorder includes both psychotic symptoms and major mood episodes, but the key feature is that the person also has at least two weeks of psychosis when no mood symptoms are present.
This separates it from:
Mood disorders with psychotic features(e.g., major depressive disorder with psychotic features or bipolar disorder with psychotic features), where psychosis happens only during mood episodes (Option B).
Schizophrenia, which does not require major mood episodes and often includes negative symptoms and long‑term impairment (Options A and D).
Which of the following are considered abnormal speech patterns associated with schizophrenia or other psychotic disorders?
A. Symbolic speech
B. Circumstantiality
C. Tangential speech
D. Flight of ideas
E. Pressured speech
Correct Answer: A, B, C, D, E (positive s/s)
All listed patterns reflect disruptions in thought organization, pacing, or clarity and are commonly seen in schizophrenia spectrum or mood disorders with psychosis.
-Symbolic speech uses metaphorical or symbolic language instead of direct communication (e.g., saying “the crown watches me” to mean “the police watch me”).
-Circumstantiality = overly detailed, may go off topic but eventually answers
-Tangential speech = starts to answer but veers off and never returns to the original question.
-Flight of ideas = rapid shifting between loosely connected thoughts
-Pressured speech = fast, hard‑to‑interrupt speech
All are abnormal speech patterns associated with psychotic or manic states
A patient says, “the FBI are tracking me through my phone." They won’t stop until they arrest me.” What type of delusion is this?
A. Persecution
B. Grandeur
C. Reference
D. Fixed
A. Persecution
This reflects a false belief of being monitored or targeted by authorities.
A nurse is caring for a patient with schizophrenia who refuses medication, stating, “There is nothing wrong with me. I don’t have any illness, and I don’t need treatment.” The nurse recognizes this behavior as:
A. Delusional thinking
B. Noncompliance
C. Anosognosia
D. Manipulative behavior
C. Anosognosia
Anosognosia is a lack of awareness of one’s own illness. The patient truly does not recognize they have a disorder, so refusal of treatment is not intentional defiance. This is common in schizophrenia and affects insight and engagement in care.
A nurse is developing a plan of care for a patient newly admitted with schizophrenia who is experiencing hallucinations, social withdrawal, and difficulty communicating. Which nursing diagnoses are appropriate for this patient? Select all that apply.
A. Risk for self‑directed or other‑directed violence
B. Social isolation
C. Chronic low self‑esteem
D. Disturbed sensory perception
E. Impaired verbal communication
F. Risk for impaired skin integrity
Correct Answers: A, B, C, D, E
A. Risk for self‑directed or other‑directed violence Patients with hallucinations, delusions, or impaired judgment may be at increased risk for harming themselves or others.
B. Social isolation Withdrawal, reduced social engagement, and difficulty connecting with others are common in schizophrenia.
C. Chronic low self‑esteem Negative symptoms, stigma, and impaired functioning can contribute to long‑term self‑esteem challenges.
D. Disturbed sensory perception Hallucinations (auditory, visual, tactile) reflect altered sensory perception and are a core symptom.
E. Impaired verbal communication Disorganized speech, thought blocking, or difficulty expressing ideas can interfere with communication.F. Risk for impaired skin integrity Not typically associated with schizophrenia unless another condition is present, so this is not an appropriate diagnosis here.