,South College NSG 2510 Exam 3 | Mental Health
Nursing (2026) Q&A
1. A client with schizophrenia has been stable on risperidone for several months but now
presents with involuntary tongue movements and lip smacking. Which term best describes
this finding?
A) Acute dystonia
B) Tardive dyskinesia
C) Pseudoparkinsonism
D) Akathisia
Correct Answer: Tardive dyskinesia
Rationale: Tardive dyskinesia is a late-onset extrapyramidal syndrome characterized by
involuntary movements of the tongue, lips, face, and extremities, often occurring after
months or years of antipsychotic treatment. Acute dystonia involves sudden muscle
spasms, pseudoparkinsonism mimics Parkinson disease with tremor and rigidity, and
akathisia is an intense sense of restlessness.
2. Which neurotransmitter system is most directly implicated in the positive symptoms of
schizophrenia?
A) Serotonergic system
B) Dopaminergic system
C) GABAergic system
D) Cholinergic system
Correct Answer: Dopaminergic system
,Rationale: Positive symptoms of schizophrenia, such as hallucinations and delusions, are
linked to hyperdopaminergic activity in the mesolimbic pathway. Serotonergic, GABAergic,
and cholinergic systems are involved in other aspects of schizophrenia but are not the
primary explanation for positive symptoms.
3. A client with schizophrenia tells the nurse, "The television is sending me special
messages." Which symptom is the client experiencing?
A) Auditory hallucination
B) Delusion of reference
C) Thought broadcasting
D) Nihilistic delusion
Correct Answer: Delusion of reference
Rationale: A delusion of reference is the belief that external events, objects, or people
have special personal significance, such as the television sending messages. An auditory
hallucination is a sensory perception without stimulus, thought broadcasting is the belief
that one's thoughts are accessible to others, and a nihilistic delusion involves beliefs of
nonexistence or catastrophe.
4. Which medication is associated with the highest risk of agranulocytosis among the
antipsychotics?
A) Risperidone
B) Olanzapine
C) Clozapine
D) Quetiapine
Correct Answer: Clozapine
, Rationale: Clozapine carries a significant risk of agranulocytosis, requiring regular
absolute neutrophil count monitoring. Risperidone, olanzapine, and quetiapine do not
carry the same mandatory monitoring requirement for agranulocytosis.
5. A client with schizophrenia is experiencing a sudden episode of muscle rigidity, fever, and
altered mental status after starting haloperidol. Which condition should the nurse suspect?
A) Serotonin syndrome
B) Neuroleptic malignant syndrome
C) Acute dystonia
D) Tardive dyskinesia
Correct Answer: Neuroleptic malignant syndrome
Rationale: Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotics characterized by muscle rigidity, fever, autonomic instability, and altered
mental status. Serotonin syndrome presents with hyperreflexia and clonus, acute dystonia
involves muscle spasms, and tardive dyskinesia involves involuntary movements.
6. Which communication approach is most appropriate when a client with schizophrenia
describes a delusion?
A) Arguing with the client about the false belief
B) Acknowledging the client's feelings without reinforcing the delusion
C) Agreeing with the delusion to build trust
D) Ignoring the client when they discuss the delusion
Correct Answer: Acknowledging the client's feelings without reinforcing the delusion
Nursing (2026) Q&A
1. A client with schizophrenia has been stable on risperidone for several months but now
presents with involuntary tongue movements and lip smacking. Which term best describes
this finding?
A) Acute dystonia
B) Tardive dyskinesia
C) Pseudoparkinsonism
D) Akathisia
Correct Answer: Tardive dyskinesia
Rationale: Tardive dyskinesia is a late-onset extrapyramidal syndrome characterized by
involuntary movements of the tongue, lips, face, and extremities, often occurring after
months or years of antipsychotic treatment. Acute dystonia involves sudden muscle
spasms, pseudoparkinsonism mimics Parkinson disease with tremor and rigidity, and
akathisia is an intense sense of restlessness.
2. Which neurotransmitter system is most directly implicated in the positive symptoms of
schizophrenia?
A) Serotonergic system
B) Dopaminergic system
C) GABAergic system
D) Cholinergic system
Correct Answer: Dopaminergic system
,Rationale: Positive symptoms of schizophrenia, such as hallucinations and delusions, are
linked to hyperdopaminergic activity in the mesolimbic pathway. Serotonergic, GABAergic,
and cholinergic systems are involved in other aspects of schizophrenia but are not the
primary explanation for positive symptoms.
3. A client with schizophrenia tells the nurse, "The television is sending me special
messages." Which symptom is the client experiencing?
A) Auditory hallucination
B) Delusion of reference
C) Thought broadcasting
D) Nihilistic delusion
Correct Answer: Delusion of reference
Rationale: A delusion of reference is the belief that external events, objects, or people
have special personal significance, such as the television sending messages. An auditory
hallucination is a sensory perception without stimulus, thought broadcasting is the belief
that one's thoughts are accessible to others, and a nihilistic delusion involves beliefs of
nonexistence or catastrophe.
4. Which medication is associated with the highest risk of agranulocytosis among the
antipsychotics?
A) Risperidone
B) Olanzapine
C) Clozapine
D) Quetiapine
Correct Answer: Clozapine
, Rationale: Clozapine carries a significant risk of agranulocytosis, requiring regular
absolute neutrophil count monitoring. Risperidone, olanzapine, and quetiapine do not
carry the same mandatory monitoring requirement for agranulocytosis.
5. A client with schizophrenia is experiencing a sudden episode of muscle rigidity, fever, and
altered mental status after starting haloperidol. Which condition should the nurse suspect?
A) Serotonin syndrome
B) Neuroleptic malignant syndrome
C) Acute dystonia
D) Tardive dyskinesia
Correct Answer: Neuroleptic malignant syndrome
Rationale: Neuroleptic malignant syndrome is a life-threatening reaction to
antipsychotics characterized by muscle rigidity, fever, autonomic instability, and altered
mental status. Serotonin syndrome presents with hyperreflexia and clonus, acute dystonia
involves muscle spasms, and tardive dyskinesia involves involuntary movements.
6. Which communication approach is most appropriate when a client with schizophrenia
describes a delusion?
A) Arguing with the client about the false belief
B) Acknowledging the client's feelings without reinforcing the delusion
C) Agreeing with the delusion to build trust
D) Ignoring the client when they discuss the delusion
Correct Answer: Acknowledging the client's feelings without reinforcing the delusion
