Schizophrenia & Psychotic Disorders
answers and rationales
1. A client with schizophrenia demonstrates disorganized speech,
frequent derailment, and incoherence. This is an example of:
a. Catatonia
b. Tangentiality
c. Thought disorder
d. Delusions
Rationale: Thought disorders are characterized by disorganized
thinking, which often manifests as incoherent or tangential speech.
2. A nurse observes a client pacing continuously, muttering to self,
and responding to internal stimuli. The nurse should prioritize:
a. Administering PRN antipsychotic
b. Ensuring client safety
c. Providing structured group therapy
d. Documenting behaviors
Rationale: Safety is the priority for clients responding to hallucinations
or displaying agitated behaviors to prevent harm.
3. Which of the following is a positive symptom of schizophrenia?
a. Flat affect
b. Hallucinations
c. Avolition
d. Social withdrawal
Rationale: Positive symptoms involve the presence of abnormal
behaviors, such as hallucinations, delusions, or thought disorders.
, 4. Negative symptoms in schizophrenia are characterized by:
a. Delusions and hallucinations
b. Loss of normal functions such as motivation and affect
c. Paranoia
d. Hyperactivity
Rationale: Negative symptoms represent deficits in normal emotional
and behavioral functioning.
5. Which neurotransmitter is most closely associated with the
pathophysiology of schizophrenia?
a. Serotonin
b. GABA
c. Dopamine
d. Acetylcholine
Rationale: Dopamine dysregulation, particularly hyperactivity in the
mesolimbic pathway, is strongly linked to schizophrenia.
6. A client reports hearing voices that command self-harm. The
nurse’s immediate intervention should be to:
a. Reassure the client and continue assessment
b. Implement suicide precautions
c. Encourage group discussion
d. Offer distraction techniques
Rationale: Command hallucinations can lead to dangerous behavior;
ensuring safety through suicide precautions is critical.
7. Which antipsychotic is classified as a first-generation (typical)
antipsychotic?
a. Clozapine
b. Risperidone
, c. Haloperidol
d. Olanzapine
Rationale: Haloperidol is a typical antipsychotic, primarily targeting
positive symptoms but with higher EPS risk.
8. Extrapyramidal symptoms (EPS) include all except:
a. Akathisia
b. Tardive dyskinesia
c. Hyperglycemia
d. Dystonia
Rationale: EPS are movement disorders caused by antipsychotics;
hyperglycemia is a metabolic side effect, not EPS.
9. A client taking clozapine develops a fever and sore throat. The
nurse should:
a. Increase the dose of clozapine
b. Hold the medication and notify the provider immediately
c. Encourage rest and fluids
d. Monitor vital signs only
Rationale: Fever and sore throat may indicate agranulocytosis, a life-
threatening side effect of clozapine.
10. A client with schizophrenia is withdrawn, shows minimal
speech, and demonstrates poor grooming. These are examples of:
a. Positive symptoms
b. Negative symptoms
c. Cognitive distortions
d. Mood disorder features
Rationale: Negative symptoms include social withdrawal, limited
speech (alogia), and poor self-care.
, 11. Cognitive symptoms in schizophrenia may include:
a. Hallucinations
b. Delusions
c. Impaired attention, memory, and executive function
d. Catatonia
Rationale: Cognitive deficits affect thinking processes, impacting daily
functioning and treatment adherence.
12. The nurse recognizes that a client repeatedly repeats
another person’s words (echolalia). This is an example of:
a. Catatonia
b. Disorganized behavior
c. Alogia
d. Neologism
Rationale: Echolalia is a type of disorganized speech and behavior
commonly seen in schizophrenia.
13. A client believes the government is monitoring thoughts
through television. This is an example of:
a. Hallucination
b. Delusion
c. Illusion
d. Paranoia
Rationale: Delusions are fixed, false beliefs not based in reality,
common in psychotic disorders.
14. Which is a priority nursing intervention for a client
experiencing auditory hallucinations?
a. Teach relaxation techniques
b. Provide psychoeducation
answers and rationales
1. A client with schizophrenia demonstrates disorganized speech,
frequent derailment, and incoherence. This is an example of:
a. Catatonia
b. Tangentiality
c. Thought disorder
d. Delusions
Rationale: Thought disorders are characterized by disorganized
thinking, which often manifests as incoherent or tangential speech.
2. A nurse observes a client pacing continuously, muttering to self,
and responding to internal stimuli. The nurse should prioritize:
a. Administering PRN antipsychotic
b. Ensuring client safety
c. Providing structured group therapy
d. Documenting behaviors
Rationale: Safety is the priority for clients responding to hallucinations
or displaying agitated behaviors to prevent harm.
3. Which of the following is a positive symptom of schizophrenia?
a. Flat affect
b. Hallucinations
c. Avolition
d. Social withdrawal
Rationale: Positive symptoms involve the presence of abnormal
behaviors, such as hallucinations, delusions, or thought disorders.
, 4. Negative symptoms in schizophrenia are characterized by:
a. Delusions and hallucinations
b. Loss of normal functions such as motivation and affect
c. Paranoia
d. Hyperactivity
Rationale: Negative symptoms represent deficits in normal emotional
and behavioral functioning.
5. Which neurotransmitter is most closely associated with the
pathophysiology of schizophrenia?
a. Serotonin
b. GABA
c. Dopamine
d. Acetylcholine
Rationale: Dopamine dysregulation, particularly hyperactivity in the
mesolimbic pathway, is strongly linked to schizophrenia.
6. A client reports hearing voices that command self-harm. The
nurse’s immediate intervention should be to:
a. Reassure the client and continue assessment
b. Implement suicide precautions
c. Encourage group discussion
d. Offer distraction techniques
Rationale: Command hallucinations can lead to dangerous behavior;
ensuring safety through suicide precautions is critical.
7. Which antipsychotic is classified as a first-generation (typical)
antipsychotic?
a. Clozapine
b. Risperidone
, c. Haloperidol
d. Olanzapine
Rationale: Haloperidol is a typical antipsychotic, primarily targeting
positive symptoms but with higher EPS risk.
8. Extrapyramidal symptoms (EPS) include all except:
a. Akathisia
b. Tardive dyskinesia
c. Hyperglycemia
d. Dystonia
Rationale: EPS are movement disorders caused by antipsychotics;
hyperglycemia is a metabolic side effect, not EPS.
9. A client taking clozapine develops a fever and sore throat. The
nurse should:
a. Increase the dose of clozapine
b. Hold the medication and notify the provider immediately
c. Encourage rest and fluids
d. Monitor vital signs only
Rationale: Fever and sore throat may indicate agranulocytosis, a life-
threatening side effect of clozapine.
10. A client with schizophrenia is withdrawn, shows minimal
speech, and demonstrates poor grooming. These are examples of:
a. Positive symptoms
b. Negative symptoms
c. Cognitive distortions
d. Mood disorder features
Rationale: Negative symptoms include social withdrawal, limited
speech (alogia), and poor self-care.
, 11. Cognitive symptoms in schizophrenia may include:
a. Hallucinations
b. Delusions
c. Impaired attention, memory, and executive function
d. Catatonia
Rationale: Cognitive deficits affect thinking processes, impacting daily
functioning and treatment adherence.
12. The nurse recognizes that a client repeatedly repeats
another person’s words (echolalia). This is an example of:
a. Catatonia
b. Disorganized behavior
c. Alogia
d. Neologism
Rationale: Echolalia is a type of disorganized speech and behavior
commonly seen in schizophrenia.
13. A client believes the government is monitoring thoughts
through television. This is an example of:
a. Hallucination
b. Delusion
c. Illusion
d. Paranoia
Rationale: Delusions are fixed, false beliefs not based in reality,
common in psychotic disorders.
14. Which is a priority nursing intervention for a client
experiencing auditory hallucinations?
a. Teach relaxation techniques
b. Provide psychoeducation
