NCLEX RN Schizophrenia Practice Exam
100 Questions And Correct Answers
(Verified Answers) Plus Rationales
2026
1. A nurse is assessing a client experiencing schizophrenia. Which finding is
considered a positive symptom?
A. Flat affect
B. Avolition
C. Auditory hallucinations
D. Social withdrawal
Answer: Auditory hallucinations
Rationale: Positive symptoms are additions to normal behavior and include
hallucinations, delusions, disorganized speech, and disorganized behavior.
2. A client with schizophrenia says, “The television is sending me secret
messages.” Which type of delusion is this?
A. Grandiose
B. Persecutory
C. Referential
D. Somatic
Answer: Referential
Rationale: A delusion of reference occurs when a client incorrectly believes
that neutral events, such as television programs, contain special personal
messages.
3. A client reports hearing a voice saying, “You are worthless.” What is the
nurse’s priority response?
,A. “The voice is not real.”
B. “Why do you think you hear voices?”
C. “What is the voice telling you to do?”
D. “Try to ignore the voice.”
Answer: “What is the voice telling you to do?”
Rationale: The nurse must first determine whether the hallucination is
commanding and whether it presents a risk of harm to the client or others.
4. Which finding is classified as a negative symptom of schizophrenia?
A. Delusion
B. Hallucination
C. Avolition
D. Disorganized speech
Answer: Avolition
Rationale: Negative symptoms represent diminished or absent normal
functions and include avolition, anhedonia, alogia, and reduced emotional
expression.
5. A client with schizophrenia has severe disorganized behavior and is
unable to maintain personal hygiene. Which nursing intervention is most
appropriate?
A. Allow the client complete independence with hygiene.
B. Provide simple, step-by-step instructions.
C. Ask several questions simultaneously.
D. Encourage the client to make all decisions independently.
Answer: Provide simple, step-by-step instructions.
Rationale: Clients with severe disorganization often benefit from simple,
concrete directions and structured assistance with activities of daily living.
6. A client taking clozapine reports a sore throat and fever. Which action
should the nurse take?
A. Administer the medication as prescribed.
B. Encourage increased fluid intake.
,C. Notify the healthcare provider immediately.
D. Reassure the client that this is expected.
Answer: Notify the healthcare provider immediately.
Rationale: Clozapine can cause severe neutropenia/agranulocytosis. Fever
and sore throat may indicate infection associated with a dangerously low
white blood cell count.
7. Which laboratory value is especially important to monitor in a client
receiving clozapine?
A. Hemoglobin A1c only
B. Absolute neutrophil count
C. Serum calcium
D. Amylase
Answer: Absolute neutrophil count
Rationale: Clozapine can cause severe neutropenia, so ANC monitoring is
required during therapy.
8. A client taking haloperidol develops severe muscle rigidity, high fever,
confusion, and diaphoresis. Which condition should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Acute dystonia
D. Tardive dyskinesia
Answer: Neuroleptic malignant syndrome
Rationale: Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotic medications characterized by hyperthermia, severe rigidity,
altered mental status, and autonomic instability.
9. What is the priority nursing intervention for a client suspected of having
neuroleptic malignant syndrome?
A. Administer the next antipsychotic dose.
B. Encourage ambulation.
, C. Hold the antipsychotic medication and notify the provider.
D. Place the client in seclusion.
Answer: Hold the antipsychotic medication and notify the provider.
Rationale: Neuroleptic malignant syndrome is a medical emergency. The
offending antipsychotic should be stopped and urgent medical treatment
initiated.
10.A client receiving an antipsychotic medication develops painful neck
spasms and involuntary upward deviation of the eyes. Which adverse
effect is occurring?
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Pseudoparkinsonism
Answer: Acute dystonia
Rationale: Acute dystonia involves sudden, painful muscle contractions,
commonly affecting the neck, jaw, eyes, or tongue, and can occur early in
antipsychotic therapy.
11.Which medication is commonly used to treat acute dystonia caused by
an antipsychotic?
A. Benztropine
B. Lithium
C. Fluoxetine
D. Propranolol
Answer: Benztropine
Rationale: Anticholinergic medications such as benztropine can rapidly relieve
acute dystonic reactions.
12.A client taking an antipsychotic reports feeling extremely restless and
unable to sit still. Which adverse effect should the nurse suspect?
A. Akathisia
B. Agranulocytosis
100 Questions And Correct Answers
(Verified Answers) Plus Rationales
2026
1. A nurse is assessing a client experiencing schizophrenia. Which finding is
considered a positive symptom?
A. Flat affect
B. Avolition
C. Auditory hallucinations
D. Social withdrawal
Answer: Auditory hallucinations
Rationale: Positive symptoms are additions to normal behavior and include
hallucinations, delusions, disorganized speech, and disorganized behavior.
2. A client with schizophrenia says, “The television is sending me secret
messages.” Which type of delusion is this?
A. Grandiose
B. Persecutory
C. Referential
D. Somatic
Answer: Referential
Rationale: A delusion of reference occurs when a client incorrectly believes
that neutral events, such as television programs, contain special personal
messages.
3. A client reports hearing a voice saying, “You are worthless.” What is the
nurse’s priority response?
,A. “The voice is not real.”
B. “Why do you think you hear voices?”
C. “What is the voice telling you to do?”
D. “Try to ignore the voice.”
Answer: “What is the voice telling you to do?”
Rationale: The nurse must first determine whether the hallucination is
commanding and whether it presents a risk of harm to the client or others.
4. Which finding is classified as a negative symptom of schizophrenia?
A. Delusion
B. Hallucination
C. Avolition
D. Disorganized speech
Answer: Avolition
Rationale: Negative symptoms represent diminished or absent normal
functions and include avolition, anhedonia, alogia, and reduced emotional
expression.
5. A client with schizophrenia has severe disorganized behavior and is
unable to maintain personal hygiene. Which nursing intervention is most
appropriate?
A. Allow the client complete independence with hygiene.
B. Provide simple, step-by-step instructions.
C. Ask several questions simultaneously.
D. Encourage the client to make all decisions independently.
Answer: Provide simple, step-by-step instructions.
Rationale: Clients with severe disorganization often benefit from simple,
concrete directions and structured assistance with activities of daily living.
6. A client taking clozapine reports a sore throat and fever. Which action
should the nurse take?
A. Administer the medication as prescribed.
B. Encourage increased fluid intake.
,C. Notify the healthcare provider immediately.
D. Reassure the client that this is expected.
Answer: Notify the healthcare provider immediately.
Rationale: Clozapine can cause severe neutropenia/agranulocytosis. Fever
and sore throat may indicate infection associated with a dangerously low
white blood cell count.
7. Which laboratory value is especially important to monitor in a client
receiving clozapine?
A. Hemoglobin A1c only
B. Absolute neutrophil count
C. Serum calcium
D. Amylase
Answer: Absolute neutrophil count
Rationale: Clozapine can cause severe neutropenia, so ANC monitoring is
required during therapy.
8. A client taking haloperidol develops severe muscle rigidity, high fever,
confusion, and diaphoresis. Which condition should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Acute dystonia
D. Tardive dyskinesia
Answer: Neuroleptic malignant syndrome
Rationale: Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotic medications characterized by hyperthermia, severe rigidity,
altered mental status, and autonomic instability.
9. What is the priority nursing intervention for a client suspected of having
neuroleptic malignant syndrome?
A. Administer the next antipsychotic dose.
B. Encourage ambulation.
, C. Hold the antipsychotic medication and notify the provider.
D. Place the client in seclusion.
Answer: Hold the antipsychotic medication and notify the provider.
Rationale: Neuroleptic malignant syndrome is a medical emergency. The
offending antipsychotic should be stopped and urgent medical treatment
initiated.
10.A client receiving an antipsychotic medication develops painful neck
spasms and involuntary upward deviation of the eyes. Which adverse
effect is occurring?
A. Akathisia
B. Acute dystonia
C. Tardive dyskinesia
D. Pseudoparkinsonism
Answer: Acute dystonia
Rationale: Acute dystonia involves sudden, painful muscle contractions,
commonly affecting the neck, jaw, eyes, or tongue, and can occur early in
antipsychotic therapy.
11.Which medication is commonly used to treat acute dystonia caused by
an antipsychotic?
A. Benztropine
B. Lithium
C. Fluoxetine
D. Propranolol
Answer: Benztropine
Rationale: Anticholinergic medications such as benztropine can rapidly relieve
acute dystonic reactions.
12.A client taking an antipsychotic reports feeling extremely restless and
unable to sit still. Which adverse effect should the nurse suspect?
A. Akathisia
B. Agranulocytosis
