NURS 222: Schizophrenia & Psychotic Disorders Comprehensive Quiz
(2026/2027) WCU
1. A client is experiencing the dopamine hypothesis of schizophrenia. Which
neuroanatomical area is most associated with the positive symptoms caused by
excess dopamine?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The mesolimbic pathway is associated with reward and pleasure; overactivity
of dopamine in this area is believed to cause positive symptoms like hallucinations and
delusions.
2. A patient with schizophrenia states, ‘The FBI is monitoring my thoughts
through the microwave.’ This is an example of which type of delusion?
A. Persecutory delusion
B. Somatic delusion
C. Grandiose delusion
D. Erotomanic delusion
Answer: A
Rationale: Persecutory delusions involve the belief that one is being singled out for harm,
followed, or conspired against by others or organizations.
,3. The nurse is assessing a client for negative symptoms of schizophrenia. Which
of the following should the nurse document as a negative symptom?
A. Echolalia
B. Ideas of reference
C. Loose associations
D. Avolition
Answer: D
Rationale: Avolition (lack of motivation) is a negative symptom, representing a loss of
normal function. Echolalia and loose associations are positive symptoms/disorganized
behavior.
4. A client is prescribed Clozapine (Clozaril). Which laboratory value is the
priority for the nurse to monitor to ensure safety?
A. Absolute Neutrophil Count (ANC)
B. Serum glucose levels
C. Liver function tests
D. Blood Urea Nitrogen (BUN)
Answer: A
Rationale: Clozapine carries a black box warning for agranulocytosis. The ANC must be
monitored weekly or bi-weekly to prevent life-threatening infections.
5. During an assessment, a patient remains in a fixed position for several hours
and allows the nurse to move their arm into an awkward position without
moving it back. This is known as:
A. Akathisia
B. Echopraxia
C. Waxy flexibility
D. Dystonia
Answer: C
, Rationale: Waxy flexibility is a feature of catatonia where a patient maintains a posture or
position into which they are placed by someone else.
6. A client tells the nurse, ‘The voices are telling me to hurt my roommate.’
What is the nurse’s priority intervention?
A. Ask the client what the voices are saying exactly.
B. Provide a quiet environment with low stimulation.
C. Implement one-to-one observation for safety.
D. Administer a PRN dose of anxiolytics immediately.
Answer: C
Rationale: Command hallucinations that involve harm to self or others require immediate
safety interventions, such as increased supervision (1:1 observation).
7. Which second-generation antipsychotic is most likely to cause significant
weight gain and metabolic syndrome?
A. Olanzapine
B. Aripiprazole
C. Ziprasidone
D. Lurasidone
Answer: A
Rationale: Olanzapine (Zyprexa) is known for having a very high risk of weight gain,
dyslipidemia, and altered glucose metabolism compared to other atypicals.
8. A client on Haloperidol presents with high fever, muscle ‘lead-pipe’ rigidity,
and autonomic instability. What condition should the nurse suspect?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin syndrome
C. Extrapyramidal symptoms (EPS)
D. Anticholinergic toxicity
Answer: A
(2026/2027) WCU
1. A client is experiencing the dopamine hypothesis of schizophrenia. Which
neuroanatomical area is most associated with the positive symptoms caused by
excess dopamine?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The mesolimbic pathway is associated with reward and pleasure; overactivity
of dopamine in this area is believed to cause positive symptoms like hallucinations and
delusions.
2. A patient with schizophrenia states, ‘The FBI is monitoring my thoughts
through the microwave.’ This is an example of which type of delusion?
A. Persecutory delusion
B. Somatic delusion
C. Grandiose delusion
D. Erotomanic delusion
Answer: A
Rationale: Persecutory delusions involve the belief that one is being singled out for harm,
followed, or conspired against by others or organizations.
,3. The nurse is assessing a client for negative symptoms of schizophrenia. Which
of the following should the nurse document as a negative symptom?
A. Echolalia
B. Ideas of reference
C. Loose associations
D. Avolition
Answer: D
Rationale: Avolition (lack of motivation) is a negative symptom, representing a loss of
normal function. Echolalia and loose associations are positive symptoms/disorganized
behavior.
4. A client is prescribed Clozapine (Clozaril). Which laboratory value is the
priority for the nurse to monitor to ensure safety?
A. Absolute Neutrophil Count (ANC)
B. Serum glucose levels
C. Liver function tests
D. Blood Urea Nitrogen (BUN)
Answer: A
Rationale: Clozapine carries a black box warning for agranulocytosis. The ANC must be
monitored weekly or bi-weekly to prevent life-threatening infections.
5. During an assessment, a patient remains in a fixed position for several hours
and allows the nurse to move their arm into an awkward position without
moving it back. This is known as:
A. Akathisia
B. Echopraxia
C. Waxy flexibility
D. Dystonia
Answer: C
, Rationale: Waxy flexibility is a feature of catatonia where a patient maintains a posture or
position into which they are placed by someone else.
6. A client tells the nurse, ‘The voices are telling me to hurt my roommate.’
What is the nurse’s priority intervention?
A. Ask the client what the voices are saying exactly.
B. Provide a quiet environment with low stimulation.
C. Implement one-to-one observation for safety.
D. Administer a PRN dose of anxiolytics immediately.
Answer: C
Rationale: Command hallucinations that involve harm to self or others require immediate
safety interventions, such as increased supervision (1:1 observation).
7. Which second-generation antipsychotic is most likely to cause significant
weight gain and metabolic syndrome?
A. Olanzapine
B. Aripiprazole
C. Ziprasidone
D. Lurasidone
Answer: A
Rationale: Olanzapine (Zyprexa) is known for having a very high risk of weight gain,
dyslipidemia, and altered glucose metabolism compared to other atypicals.
8. A client on Haloperidol presents with high fever, muscle ‘lead-pipe’ rigidity,
and autonomic instability. What condition should the nurse suspect?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin syndrome
C. Extrapyramidal symptoms (EPS)
D. Anticholinergic toxicity
Answer: A
