SCHIZOPHRENIA DISORDERS NCLEX
EXAM QUESTIONS WITH CORRECT
ANSWERS
A teenaged client is being discharged from the psychiatric unit with a prescription for
risperidone. The nurse providing medication teaching to the client's mother should
provide which response when asked about the risk her son faces for extrapyramidal
side effects (EPSs)?
A. All antipsychotic medications have an equal chance of producing EPSs.
B. Newer antipsychotic medications have a higher risk for EPSs.
C. Risperidone is a newer antipsychotic medication and has a lower risk of EPSs
than older antipsychotics.
D. Advise the mother to ask the provider to change the medication to clozapine
instead of risperidone. - ANSWER-C
Risperidone is a newer, atypical antipsychotic. All newer antipsychotic medications
have a lower incidence of EPSs than older, traditional antipsychotics. The other
responses are untrue. There is no reason to advise a medication change at this time.
The nurse is planning long-term goals for a 17-year-old male client recently
diagnosed with schizophrenia. Which statement should serve as the basis for the
goal-setting process?
A. If treated quickly following diagnosis, schizophrenia can be cured.
B. Schizophrenia can be managed by receiving treatment only at the time of acute
exacerbations.
C. Patients with schizophrenia often do not fully respond to treatment and have
residual symptoms and varying degrees of disability.
D. If patients with schizophrenia stay on their drug regimen, they usually lead fully
productive lives with no further symptoms. - ANSWER-C
Unfortunately, in most cases, schizophrenia does not respond fully to available
treatments; it leaves residual symptoms and causes varying degrees of dysfunction
or disability. The other options are all untrue of schizophrenia.
A patient has had difficulty keeping a job because of arguing with co-workers and
accusing them of conspiracy. Today this patient shouts, "They're all plotting to
destroy me. Isn't that true?" Select the nurse's most therapeutic response.
a. "Everyone here is trying to help you. No one wants to harm you."
b. "Feeling that people want to destroy you must be very frightening."
c. "That is not true. People here are trying to help you if you will let them."
d. "Staff members are health care professionals who are qualified to help you." -
ANSWER-ANS: B
Resist focusing on content; instead, focus on the feelings the patient is expressing.
This strategy prevents arguing about the reality of delusional beliefs. Such
arguments increase patient anxiety and the tenacity with which the patient holds to
the delusion. The other options focus on content and provide opportunity for
argument.
,A newly admitted patient diagnosed with schizophrenia is hypervigilant and
constantly scans the environment. The patient states, "I saw two doctors talking in
the hall. They were
plotting to kill me." The nurse may correctly assess this behavior as
a. echolalia.
b. an idea of reference.
c. a delusion of infidelity.
d. an auditory hallucination. - ANSWER-ANS: B
Ideas of reference are misinterpretations of the verbalizations or actions of others
that give special personal meanings to these behaviors; for example, when seeing
two people talking, the individual assumes they are talking about him or her. The
other terms do not correspond with the scenario.
A patient diagnosed with schizophrenia says, "My co-workers are out to get me. I
also saw two doctors plotting to kill me. How does this patient perceive the
environment?
a. Disorganized
b. Dangerous
c. Supportive
d. Bizarre - ANSWER-ANS: B
The patient sees the world as hostile and dangerous. This assessment is important
because
the nurse can be more effective by using empathy to respond to the patient. Data are
not
present to support any of the other options
The purpose of the Abnormal Involuntary Movement Scale (AIMS) assessment on a
persistently mentally ill client who has been diagnosed with schizophrenia is early
detection of
A. acute dystonia
B. tardive dyskinesia
C. cholestatic jaundice
D. pseudoparkinsonism - ANSWER-B
An AIMS assessment should be performed periodically on clients who are being
treated with antipsychotic medication known to cause tardive dyskinesia. This tool is
not used to assess or monitor any of the other options.
Nico, a 22-year-old patient, is diagnosed with schizophrenia. Which of the following
symptoms would alert a provider to a possible diagnosis of schizophrenia in a 22-
year-old male client?
A. Excessive sleeping with disturbing dreams
B. Hearing voices telling him to hurt his roommate
C. Withdrawal from college because of failing grades
D. Chaotic and dysfunctional relationships with his family and peers - ANSWER-B
People diagnosed with schizophrenia all have at least one psychotic symptom such
as hallucinations, delusional thinking, or disorganized speech. The other options do
not describe schizophrenia but could be caused by a number of problems.
, A client diagnosed with schizophrenia states to the nurse, "My, oh my. My mother is
brother. Anytime now it can happen to my mother." Your best response would be:
A. "You are having problems with your speech. You need to try harder to be clear."
B. "You are confused. I will take you to your room to rest a while."
C. "I will get you a prn medication for agitation."
D. "I'm sorry, I didn't understand that. Do you want to talk more about your mother as
we did yesterday?" - ANSWER-D
The guidelines that are useful in communicating with a patient with disorganized or
bizarre speech are to place the difficulty in understanding on yourself, not the
patient, and look for themes that may be helpful in interpreting what the patient
wants to say. Telling the patient he needs to try harder to be clearer is unrealistic
since the patient would be unable do this. The other options are not useful in
communicating with this patient and attempting to find common themes.
Tara and Aaron are twins who are both diagnosed with schizophrenia. Aaron was
diagnosed at 23 years old and Tara at 31 years old. Based on your knowledge of
early and late onset of schizophrenia, which of the following is true?
A. Tara and Aaron have the same expectation of a poor long-term prognosis.
B. Tara will experience more positive signs of schizophrenia such as hallucinations.
C. Aaron will be more likely to hold a job and live a productive life.
D. Tara has a better chance for positive outcomes because of later onset. -
ANSWER-D
Female patients diagnosed with schizophrenia between the ages of 25 and 35 years
have better outcomes than do their male counterparts diagnosed earlier. These two
patients do not have the same expectation of a poor prognosis. There is no evidence
suggesting that Tara will have more positive signs of schizophrenia. It is actually
more unlikely that Aaron will be able to live a productive life because of his earlier
onset, which has a poorer prognosis.
When a patient diagnosed with schizophrenia was discharged 6 months ago,
haloperidol was prescribed. The patient now says, "I stopped taking those pills. They
made me feel like a
robot." What are common side effects the nurse should validate with the patient?
a. Sedation and muscle stiffness
b. Sweating, nausea, and diarrhea
c. Mild fever, sore throat, and skin rash
d. Headache, watery eyes, and runny nose - ANSWER-ANS: A
Typical antipsychotic drugs often produce sedation and extrapyramidal side effects
such as
stiffness and gait disturbance, effects the patient might describe as making him or
her feel like a "robot." The side effects mentioned in the other options are usually not
associated with typical antipsychotic therapy or would not have the effect described
by the patient.
Which hallucination necessitates the nurse to implement safety measures? The
patient says,
a. "I hear angels playing harps."
b. "The voices say everyone is trying to kill me."
c. "My dead father tells me I am a good person."
d. "The voices talk only at night when I'm trying to sleep." - ANSWER-ANS: B
EXAM QUESTIONS WITH CORRECT
ANSWERS
A teenaged client is being discharged from the psychiatric unit with a prescription for
risperidone. The nurse providing medication teaching to the client's mother should
provide which response when asked about the risk her son faces for extrapyramidal
side effects (EPSs)?
A. All antipsychotic medications have an equal chance of producing EPSs.
B. Newer antipsychotic medications have a higher risk for EPSs.
C. Risperidone is a newer antipsychotic medication and has a lower risk of EPSs
than older antipsychotics.
D. Advise the mother to ask the provider to change the medication to clozapine
instead of risperidone. - ANSWER-C
Risperidone is a newer, atypical antipsychotic. All newer antipsychotic medications
have a lower incidence of EPSs than older, traditional antipsychotics. The other
responses are untrue. There is no reason to advise a medication change at this time.
The nurse is planning long-term goals for a 17-year-old male client recently
diagnosed with schizophrenia. Which statement should serve as the basis for the
goal-setting process?
A. If treated quickly following diagnosis, schizophrenia can be cured.
B. Schizophrenia can be managed by receiving treatment only at the time of acute
exacerbations.
C. Patients with schizophrenia often do not fully respond to treatment and have
residual symptoms and varying degrees of disability.
D. If patients with schizophrenia stay on their drug regimen, they usually lead fully
productive lives with no further symptoms. - ANSWER-C
Unfortunately, in most cases, schizophrenia does not respond fully to available
treatments; it leaves residual symptoms and causes varying degrees of dysfunction
or disability. The other options are all untrue of schizophrenia.
A patient has had difficulty keeping a job because of arguing with co-workers and
accusing them of conspiracy. Today this patient shouts, "They're all plotting to
destroy me. Isn't that true?" Select the nurse's most therapeutic response.
a. "Everyone here is trying to help you. No one wants to harm you."
b. "Feeling that people want to destroy you must be very frightening."
c. "That is not true. People here are trying to help you if you will let them."
d. "Staff members are health care professionals who are qualified to help you." -
ANSWER-ANS: B
Resist focusing on content; instead, focus on the feelings the patient is expressing.
This strategy prevents arguing about the reality of delusional beliefs. Such
arguments increase patient anxiety and the tenacity with which the patient holds to
the delusion. The other options focus on content and provide opportunity for
argument.
,A newly admitted patient diagnosed with schizophrenia is hypervigilant and
constantly scans the environment. The patient states, "I saw two doctors talking in
the hall. They were
plotting to kill me." The nurse may correctly assess this behavior as
a. echolalia.
b. an idea of reference.
c. a delusion of infidelity.
d. an auditory hallucination. - ANSWER-ANS: B
Ideas of reference are misinterpretations of the verbalizations or actions of others
that give special personal meanings to these behaviors; for example, when seeing
two people talking, the individual assumes they are talking about him or her. The
other terms do not correspond with the scenario.
A patient diagnosed with schizophrenia says, "My co-workers are out to get me. I
also saw two doctors plotting to kill me. How does this patient perceive the
environment?
a. Disorganized
b. Dangerous
c. Supportive
d. Bizarre - ANSWER-ANS: B
The patient sees the world as hostile and dangerous. This assessment is important
because
the nurse can be more effective by using empathy to respond to the patient. Data are
not
present to support any of the other options
The purpose of the Abnormal Involuntary Movement Scale (AIMS) assessment on a
persistently mentally ill client who has been diagnosed with schizophrenia is early
detection of
A. acute dystonia
B. tardive dyskinesia
C. cholestatic jaundice
D. pseudoparkinsonism - ANSWER-B
An AIMS assessment should be performed periodically on clients who are being
treated with antipsychotic medication known to cause tardive dyskinesia. This tool is
not used to assess or monitor any of the other options.
Nico, a 22-year-old patient, is diagnosed with schizophrenia. Which of the following
symptoms would alert a provider to a possible diagnosis of schizophrenia in a 22-
year-old male client?
A. Excessive sleeping with disturbing dreams
B. Hearing voices telling him to hurt his roommate
C. Withdrawal from college because of failing grades
D. Chaotic and dysfunctional relationships with his family and peers - ANSWER-B
People diagnosed with schizophrenia all have at least one psychotic symptom such
as hallucinations, delusional thinking, or disorganized speech. The other options do
not describe schizophrenia but could be caused by a number of problems.
, A client diagnosed with schizophrenia states to the nurse, "My, oh my. My mother is
brother. Anytime now it can happen to my mother." Your best response would be:
A. "You are having problems with your speech. You need to try harder to be clear."
B. "You are confused. I will take you to your room to rest a while."
C. "I will get you a prn medication for agitation."
D. "I'm sorry, I didn't understand that. Do you want to talk more about your mother as
we did yesterday?" - ANSWER-D
The guidelines that are useful in communicating with a patient with disorganized or
bizarre speech are to place the difficulty in understanding on yourself, not the
patient, and look for themes that may be helpful in interpreting what the patient
wants to say. Telling the patient he needs to try harder to be clearer is unrealistic
since the patient would be unable do this. The other options are not useful in
communicating with this patient and attempting to find common themes.
Tara and Aaron are twins who are both diagnosed with schizophrenia. Aaron was
diagnosed at 23 years old and Tara at 31 years old. Based on your knowledge of
early and late onset of schizophrenia, which of the following is true?
A. Tara and Aaron have the same expectation of a poor long-term prognosis.
B. Tara will experience more positive signs of schizophrenia such as hallucinations.
C. Aaron will be more likely to hold a job and live a productive life.
D. Tara has a better chance for positive outcomes because of later onset. -
ANSWER-D
Female patients diagnosed with schizophrenia between the ages of 25 and 35 years
have better outcomes than do their male counterparts diagnosed earlier. These two
patients do not have the same expectation of a poor prognosis. There is no evidence
suggesting that Tara will have more positive signs of schizophrenia. It is actually
more unlikely that Aaron will be able to live a productive life because of his earlier
onset, which has a poorer prognosis.
When a patient diagnosed with schizophrenia was discharged 6 months ago,
haloperidol was prescribed. The patient now says, "I stopped taking those pills. They
made me feel like a
robot." What are common side effects the nurse should validate with the patient?
a. Sedation and muscle stiffness
b. Sweating, nausea, and diarrhea
c. Mild fever, sore throat, and skin rash
d. Headache, watery eyes, and runny nose - ANSWER-ANS: A
Typical antipsychotic drugs often produce sedation and extrapyramidal side effects
such as
stiffness and gait disturbance, effects the patient might describe as making him or
her feel like a "robot." The side effects mentioned in the other options are usually not
associated with typical antipsychotic therapy or would not have the effect described
by the patient.
Which hallucination necessitates the nurse to implement safety measures? The
patient says,
a. "I hear angels playing harps."
b. "The voices say everyone is trying to kill me."
c. "My dead father tells me I am a good person."
d. "The voices talk only at night when I'm trying to sleep." - ANSWER-ANS: B
