NR 326 Exam 3 – Mental Health and Illness 80
Multiple-Choice Questions with Rationales –
Chamberlain
SCHIZOPHRENIA SPECTRUM (~25 questions)
1. A patient with schizophrenia tells the nurse, "I have an appointment at the White
House today to advise the president." This is an example of which type of delusion?
A. Persecutory
B. Grandiose
C. Somatic
D. Erotomanic
Answer: B
Rationale: Grandiose delusions involve an exaggerated sense of importance, power, or
identity, such as believing one has a special relationship with a high-ranking official.
2. A patient states, "The FBI has been following me for weeks and has my apartment
bugged." This is an example of:
A. Grandiose delusion
B. Persecutory delusion
C. Jealous delusion
D. Somatic delusion
Answer: B
Rationale: Persecutory delusions involve the belief that one is being harassed,
threatened, or conspired against. This is the most common type of delusion in
schizophrenia.
3. A patient with schizophrenia repeatedly says the same word, "help," in response
to every question from the nurse. This is an example of:
A. Echolalia
B. Perseveration
C. Neologism
D. Clang association
Answer: B
,Rationale: Perseveration is the persistent repetition of the same word or phrase in
response to different stimuli or questions.
4. A patient with schizophrenia says, "I'm going to the store, I need to buy a door, the
floor is wet, forget the war." This speech pattern is best described as:
A. Circumstantiality
B. Tangentiality
C. Loose associations
D. Word salad
Answer: C
Rationale: Loose associations involve shifting from one unrelated idea to another,
making speech difficult to follow. Word salad is a random jumble of words without
logical connection.
5. A patient with schizophrenia tells the nurse, "I hear voices telling me that I am
worthless and should kill myself." The nurse's best initial response is:
A. "Those voices are not real. Ignore them."
B. "I do not hear any voices, but I know they seem real to you. You are safe here."
C. "Why do you think you hear those voices?"
D. "Let's talk about something else to distract you."
Answer: B
Rationale: The nurse should acknowledge the patient's experience without arguing,
present reality, and provide reassurance of safety. Asking "why" is non-therapeutic.
6. A patient with schizophrenia demonstrates waxy flexibility, remaining in a rigid
position for extended periods. This is a symptom of:
A. Catatonia
B. Akathisia
C. Dystonia
D. Tardive dyskinesia
Answer: A
Rationale: Waxy flexibility is a catatonic symptom where the patient maintains a
position after being moved into it, like a wax figure.
, 7. The nurse is caring for a patient experiencing auditory hallucinations. Which
milieu intervention is most appropriate?
A. Place the patient in a high-stimulation group activity
B. Encourage the patient to sit alone in their room
C. Engage the patient in a quiet, structured activity
D. Ignore the patient's reports of voices
Answer: C
Rationale: Structured, quiet activities can distract from hallucinations and reduce
anxiety. Isolation and high stimulation can worsen symptoms.
8. A patient with schizophrenia says, "The devil told me the world will end tonight."
Which nursing diagnosis has the highest priority?
A. Disturbed thought processes
B. Risk for self-directed or other-directed violence
C. Social isolation
D. Ineffective coping
Answer: B
Rationale: Command hallucinations (voices telling the patient to harm self or others)
require immediate safety assessment. The risk of violence is the priority.
9. Which phase of schizophrenia is characterized by social withdrawal, deteriorating
function, and depressive symptoms before the onset of psychosis?
A. Premorbid
B. Prodromal
C. Active psychotic
D. Residual
Answer: B
Rationale: The prodromal phase involves significant behavioral and cognitive changes,
including social withdrawal and depressive symptoms. Fifty percent of patients have
depressive symptoms in this phase.
10. A patient with schizophrenia has not bathed in a week, avoids eye contact, and
speaks only in short, monotone phrases. These symptoms are classified as:
A. Positive symptoms
B. Negative symptoms
C. Cognitive symptoms
D. Mood symptoms
Multiple-Choice Questions with Rationales –
Chamberlain
SCHIZOPHRENIA SPECTRUM (~25 questions)
1. A patient with schizophrenia tells the nurse, "I have an appointment at the White
House today to advise the president." This is an example of which type of delusion?
A. Persecutory
B. Grandiose
C. Somatic
D. Erotomanic
Answer: B
Rationale: Grandiose delusions involve an exaggerated sense of importance, power, or
identity, such as believing one has a special relationship with a high-ranking official.
2. A patient states, "The FBI has been following me for weeks and has my apartment
bugged." This is an example of:
A. Grandiose delusion
B. Persecutory delusion
C. Jealous delusion
D. Somatic delusion
Answer: B
Rationale: Persecutory delusions involve the belief that one is being harassed,
threatened, or conspired against. This is the most common type of delusion in
schizophrenia.
3. A patient with schizophrenia repeatedly says the same word, "help," in response
to every question from the nurse. This is an example of:
A. Echolalia
B. Perseveration
C. Neologism
D. Clang association
Answer: B
,Rationale: Perseveration is the persistent repetition of the same word or phrase in
response to different stimuli or questions.
4. A patient with schizophrenia says, "I'm going to the store, I need to buy a door, the
floor is wet, forget the war." This speech pattern is best described as:
A. Circumstantiality
B. Tangentiality
C. Loose associations
D. Word salad
Answer: C
Rationale: Loose associations involve shifting from one unrelated idea to another,
making speech difficult to follow. Word salad is a random jumble of words without
logical connection.
5. A patient with schizophrenia tells the nurse, "I hear voices telling me that I am
worthless and should kill myself." The nurse's best initial response is:
A. "Those voices are not real. Ignore them."
B. "I do not hear any voices, but I know they seem real to you. You are safe here."
C. "Why do you think you hear those voices?"
D. "Let's talk about something else to distract you."
Answer: B
Rationale: The nurse should acknowledge the patient's experience without arguing,
present reality, and provide reassurance of safety. Asking "why" is non-therapeutic.
6. A patient with schizophrenia demonstrates waxy flexibility, remaining in a rigid
position for extended periods. This is a symptom of:
A. Catatonia
B. Akathisia
C. Dystonia
D. Tardive dyskinesia
Answer: A
Rationale: Waxy flexibility is a catatonic symptom where the patient maintains a
position after being moved into it, like a wax figure.
, 7. The nurse is caring for a patient experiencing auditory hallucinations. Which
milieu intervention is most appropriate?
A. Place the patient in a high-stimulation group activity
B. Encourage the patient to sit alone in their room
C. Engage the patient in a quiet, structured activity
D. Ignore the patient's reports of voices
Answer: C
Rationale: Structured, quiet activities can distract from hallucinations and reduce
anxiety. Isolation and high stimulation can worsen symptoms.
8. A patient with schizophrenia says, "The devil told me the world will end tonight."
Which nursing diagnosis has the highest priority?
A. Disturbed thought processes
B. Risk for self-directed or other-directed violence
C. Social isolation
D. Ineffective coping
Answer: B
Rationale: Command hallucinations (voices telling the patient to harm self or others)
require immediate safety assessment. The risk of violence is the priority.
9. Which phase of schizophrenia is characterized by social withdrawal, deteriorating
function, and depressive symptoms before the onset of psychosis?
A. Premorbid
B. Prodromal
C. Active psychotic
D. Residual
Answer: B
Rationale: The prodromal phase involves significant behavioral and cognitive changes,
including social withdrawal and depressive symptoms. Fifty percent of patients have
depressive symptoms in this phase.
10. A patient with schizophrenia has not bathed in a week, avoids eye contact, and
speaks only in short, monotone phrases. These symptoms are classified as:
A. Positive symptoms
B. Negative symptoms
C. Cognitive symptoms
D. Mood symptoms
