ATI Mental Health: Schizophrenia and Psychotic Disorders Exam 4
Practice 2026 |Questions |Answers |Rationales
1. A nurse is assessing a client who has schizophrenia and is taking clozapine.
Which of the following laboratory results should the nurse monitor most
closely?
A. White blood cell (WBC) count
B. Serum creatinine
C. Thyroid-stimulating hormone
D. Serum potassium
Answer: A
Rationale: Clozapine can cause agranulocytosis, a life-threatening decrease in WBC count.
Clients require baseline and weekly monitoring of WBC and ANC.
2. A client with schizophrenia reports hearing voices telling them to ‘hurt the
person in the lobby.’ Which of the following is the priority nursing action?
A. Ask the client if they have a plan to carry out the command
B. Document the client’s statement in the medical record
C. Tell the client that the voices are not real
D. Administer an extra dose of antipsychotic medication
Answer: A
Rationale: Safety is the priority. Command hallucinations can lead to violent behavior, and
the nurse must assess the risk of harm and the client’s intent to follow the command.
,3. A nurse is caring for a client who is experiencing a first-episode psychotic
break. Which of the following is considered a ‘positive symptom’ of
schizophrenia?
A. Social withdrawal
B. Lack of motivation
C. Auditory hallucinations
D. Flat affect
Answer: C
Rationale: Positive symptoms are manifestations of things that are ‘added’ to personality,
such as hallucinations, delusions, and disorganized speech.
4. A client who has schizophrenia uses words that rhyme but have no logical
connection. The nurse should document this as which of the following?
A. Clang association
B. Word salad
C. Echolalia
D. Neologism
Answer: A
Rationale: Clang association is the choice of words based on their sound (rhyming) rather
than their meaning.
5. A nurse observes a client with schizophrenia standing in a fixed position for
hours, resisting any movement. This behavior is known as:
A. Waxy flexibility
B. Akathisia
C. Dystonia
D. Echopraxia
Answer: A
, Rationale: Waxy flexibility is a symptom of catatonia where the client remains in a fixed
position for long periods.
6. Which of the following findings should the nurse identify as a negative
symptom of schizophrenia?
A. Delusions
B. Anhedonia
C. Bizarre behavior
D. Flight of ideas
Answer: B
Rationale: Negative symptoms are the absence of normal behaviors, such as anhedonia
(lack of pleasure), alogia, and avolition.
7. A client is prescribed haloperidol. The nurse should monitor for which of the
following extrapyramidal symptoms (EPS) characterized by physical
restlessness?
A. Tardive dyskinesia
B. Akathisia
C. Pseudoparkinsonism
D. Acute dystonia
Answer: B
Rationale: Akathisia is an inner feeling of restlessness that causes the client to pace or be
unable to sit still.
Practice 2026 |Questions |Answers |Rationales
1. A nurse is assessing a client who has schizophrenia and is taking clozapine.
Which of the following laboratory results should the nurse monitor most
closely?
A. White blood cell (WBC) count
B. Serum creatinine
C. Thyroid-stimulating hormone
D. Serum potassium
Answer: A
Rationale: Clozapine can cause agranulocytosis, a life-threatening decrease in WBC count.
Clients require baseline and weekly monitoring of WBC and ANC.
2. A client with schizophrenia reports hearing voices telling them to ‘hurt the
person in the lobby.’ Which of the following is the priority nursing action?
A. Ask the client if they have a plan to carry out the command
B. Document the client’s statement in the medical record
C. Tell the client that the voices are not real
D. Administer an extra dose of antipsychotic medication
Answer: A
Rationale: Safety is the priority. Command hallucinations can lead to violent behavior, and
the nurse must assess the risk of harm and the client’s intent to follow the command.
,3. A nurse is caring for a client who is experiencing a first-episode psychotic
break. Which of the following is considered a ‘positive symptom’ of
schizophrenia?
A. Social withdrawal
B. Lack of motivation
C. Auditory hallucinations
D. Flat affect
Answer: C
Rationale: Positive symptoms are manifestations of things that are ‘added’ to personality,
such as hallucinations, delusions, and disorganized speech.
4. A client who has schizophrenia uses words that rhyme but have no logical
connection. The nurse should document this as which of the following?
A. Clang association
B. Word salad
C. Echolalia
D. Neologism
Answer: A
Rationale: Clang association is the choice of words based on their sound (rhyming) rather
than their meaning.
5. A nurse observes a client with schizophrenia standing in a fixed position for
hours, resisting any movement. This behavior is known as:
A. Waxy flexibility
B. Akathisia
C. Dystonia
D. Echopraxia
Answer: A
, Rationale: Waxy flexibility is a symptom of catatonia where the client remains in a fixed
position for long periods.
6. Which of the following findings should the nurse identify as a negative
symptom of schizophrenia?
A. Delusions
B. Anhedonia
C. Bizarre behavior
D. Flight of ideas
Answer: B
Rationale: Negative symptoms are the absence of normal behaviors, such as anhedonia
(lack of pleasure), alogia, and avolition.
7. A client is prescribed haloperidol. The nurse should monitor for which of the
following extrapyramidal symptoms (EPS) characterized by physical
restlessness?
A. Tardive dyskinesia
B. Akathisia
C. Pseudoparkinsonism
D. Acute dystonia
Answer: B
Rationale: Akathisia is an inner feeling of restlessness that causes the client to pace or be
unable to sit still.
