Focused Exam Schizophrenia 2026/2027 –
Completed Shadow Health Transcript with
Verified Answers – Eric Ford – Psychiatric
Assessment Simulation and Exam
Preparation Material
Course
Shadow Health
1. During a focused psychiatric assessment, which question best assesses auditory
hallucinations?
A. “Do you ever feel unusually energetic?”
B. “Do you hear voices or sounds that other people do not hear?”
C. “Have you recently lost interest in activities?”
D. “Do you have difficulty remembering appointments?”
Answer: B
Rationale: Auditory hallucinations involve perceiving sounds or voices without an external
stimulus. Direct, nonjudgmental questioning is appropriate.
,2. A patient reports that two voices are discussing his behavior. This finding is most
consistent with:
A. Illusion
B. Delusion
C. Auditory hallucination
D. Depersonalization
Answer: C
Rationale: Hearing voices in the absence of an external auditory stimulus is an auditory
hallucination.
3. Which statement best assesses persecutory delusions?
A. “Do you believe someone is trying to harm or monitor you?”
B. “Have you been sleeping well?”
C. “Do you feel sad most days?”
D. “Have you noticed changes in your appetite?”
Answer: A
Rationale: Persecutory delusions involve a fixed false belief that others intend to harm, follow,
spy on, or otherwise target the person.
4. A patient says, “The television news anchor is sending secret messages specifically to
me.” This is most consistent with:
A. Delusion of reference
B. Somatic delusion
,C. Grandiose delusion
D. Obsession
Answer: A
Rationale: A delusion of reference occurs when neutral events or communications are
incorrectly interpreted as having a special personal meaning.
5. Which finding represents a negative symptom of schizophrenia?
A. Hallucination
B. Delusion
C. Avolition
D. Disorganized speech
Answer: C
Rationale: Negative symptoms include reduced motivation, diminished emotional expression,
social withdrawal, and reduced speech or pleasure. Avolition refers to reduced motivation.
6. Which assessment finding is most concerning for immediate safety?
A. Social withdrawal
B. Flat affect
C. Command hallucinations instructing the patient to kill himself
D. Reduced spontaneous speech
Answer: C
Rationale: Command hallucinations involving suicide or violence require immediate safety
assessment and intervention.
, 7. When assessing suicidal ideation in a patient with schizophrenia, the nurse should:
A. Avoid asking directly about suicide
B. Ask directly about suicidal thoughts, intent, plan, and access to means
C. Wait until the patient mentions suicide
D. Assume hallucinations are harmless
Answer: B
Rationale: Direct assessment is clinically appropriate. The nurse should determine ideation,
intent, plan, means, and protective factors.
8. Which response is most therapeutic when a patient says, “The voices are telling me that
you are dangerous”?
A. “The voices are real, and you should listen to them.”
B. “That is impossible. You are imagining everything.”
C. “I understand that you are hearing voices. I do not hear them, but I can see that they are
frightening to you.”
D. “Ignore them and stop talking about them.”
Answer: C
Rationale: The response acknowledges the patient's experience without validating the
hallucination as objectively real.
9. Which question best evaluates thought content?
A. “Can you tell me what has been on your mind lately?”
B. “What did you eat this morning?”
Completed Shadow Health Transcript with
Verified Answers – Eric Ford – Psychiatric
Assessment Simulation and Exam
Preparation Material
Course
Shadow Health
1. During a focused psychiatric assessment, which question best assesses auditory
hallucinations?
A. “Do you ever feel unusually energetic?”
B. “Do you hear voices or sounds that other people do not hear?”
C. “Have you recently lost interest in activities?”
D. “Do you have difficulty remembering appointments?”
Answer: B
Rationale: Auditory hallucinations involve perceiving sounds or voices without an external
stimulus. Direct, nonjudgmental questioning is appropriate.
,2. A patient reports that two voices are discussing his behavior. This finding is most
consistent with:
A. Illusion
B. Delusion
C. Auditory hallucination
D. Depersonalization
Answer: C
Rationale: Hearing voices in the absence of an external auditory stimulus is an auditory
hallucination.
3. Which statement best assesses persecutory delusions?
A. “Do you believe someone is trying to harm or monitor you?”
B. “Have you been sleeping well?”
C. “Do you feel sad most days?”
D. “Have you noticed changes in your appetite?”
Answer: A
Rationale: Persecutory delusions involve a fixed false belief that others intend to harm, follow,
spy on, or otherwise target the person.
4. A patient says, “The television news anchor is sending secret messages specifically to
me.” This is most consistent with:
A. Delusion of reference
B. Somatic delusion
,C. Grandiose delusion
D. Obsession
Answer: A
Rationale: A delusion of reference occurs when neutral events or communications are
incorrectly interpreted as having a special personal meaning.
5. Which finding represents a negative symptom of schizophrenia?
A. Hallucination
B. Delusion
C. Avolition
D. Disorganized speech
Answer: C
Rationale: Negative symptoms include reduced motivation, diminished emotional expression,
social withdrawal, and reduced speech or pleasure. Avolition refers to reduced motivation.
6. Which assessment finding is most concerning for immediate safety?
A. Social withdrawal
B. Flat affect
C. Command hallucinations instructing the patient to kill himself
D. Reduced spontaneous speech
Answer: C
Rationale: Command hallucinations involving suicide or violence require immediate safety
assessment and intervention.
, 7. When assessing suicidal ideation in a patient with schizophrenia, the nurse should:
A. Avoid asking directly about suicide
B. Ask directly about suicidal thoughts, intent, plan, and access to means
C. Wait until the patient mentions suicide
D. Assume hallucinations are harmless
Answer: B
Rationale: Direct assessment is clinically appropriate. The nurse should determine ideation,
intent, plan, means, and protective factors.
8. Which response is most therapeutic when a patient says, “The voices are telling me that
you are dangerous”?
A. “The voices are real, and you should listen to them.”
B. “That is impossible. You are imagining everything.”
C. “I understand that you are hearing voices. I do not hear them, but I can see that they are
frightening to you.”
D. “Ignore them and stop talking about them.”
Answer: C
Rationale: The response acknowledges the patient's experience without validating the
hallucination as objectively real.
9. Which question best evaluates thought content?
A. “Can you tell me what has been on your mind lately?”
B. “What did you eat this morning?”
