Psychosis Exam Questions

A patient experiences delusional thinking for over a month, but their self and interpersonal functioning remain intact. Which psychotic disorder is most likely present? A) Brief Psychotic Disorder B) Schizophreniform Disorder C) Delusional Disorder D) Substance-Induced Psychotic Disorder - ANS-- C) Delusional Disorder Rationale: Delusional Disorder is characterized by delusional thinking lasting at least 1 month, with no marked impairment in self or interpersonal functioning. A patient exhibits psychotic manifestations that have lasted for 5 months, but social and occupational dysfunction is not apparent. Which psychotic disorder is consistent with these symptoms? A) Brief Psychotic Disorder B) Schizophreniform Disorder C) Schizoaffective Disorder D) Substance-Induced Psychotic Disorder - ANS-- B) Schizophreniform Disorder Rationale: Schizophreniform Disorder is characterized by manifestations similar to schizophrenia, but with a duration of 1 to 6 months, and social or occupational dysfunction may not be apparent. A patient's psychotic disorder meets the criteria for both schizophrenia and depressive disorder. Which psychotic disorder is most likely present? A) Delusional Disorder B) Schizoaffective Disorder C) Brief Psychotic Disorder D) Substance-Induced Psychotic Disorder - ANS-- B) Schizoaffective Disorder Rationale: Schizoaffective Disorder is characterized by symptoms meeting criteria for both schizophrenia and depressive or bipolar disorder. A patient exhibits hallucinations, delusions, and disorganized behavior. Which category of symptoms are these manifestations classified as in schizophrenia? A) Positive symptoms B) Negative symptoms C) Cognitive symptoms D) Affective symptoms - ANS-- A) Positive symptoms Rationale: Hallucinations, delusions, and disorganized behavior are considered positive symptoms of schizophrenia, as they are excess or abnormal behaviors not normally present in individuals. A patient with schizophrenia exhibits blunt affect, poverty of thought or speech, and lack of motivation. Which category of symptoms are these manifestations classified as? A) Positive symptoms B) Negative symptoms C) Cognitive symptoms D) Affective symptoms - ANS-- B) Negative symptoms Rationale: Blunt affect, poverty of thought or speech, lack of motivation, lack of energy, and inability to experience pleasure are considered negative symptoms of schizophrenia. They represent deficits or decreases in normal functions. A patient experiences psychotic manifestations that last for only 3 weeks, but they exhibit marked social and occupational dysfunction. Which psychotic disorder is consistent with these symptoms? A) Schizophreniform DisorderB) Brief Psychotic DisorderC) Delusional DisorderD) Schizoaffective Disorder - ANS-- A) Schizophreniform Disorder Rationale: Schizophreniform Disorder is characterized by psychotic manifestations similar to schizophrenia lasting between 1 to 6 months, with marked social or occupational dysfunction. A patient exhibits psychosis due to substance intoxication. Which type of psychotic disorder does this presentation align with? A) Delusional Disorder B) Schizoaffective Disorder C) Substance-Induced Psychotic Disorder D) Brief Psychotic Disorder - ANS-- C) Substance-Induced Psychotic Disorder Rationale: Substance-Induced Psychotic Disorder occurs when psychosis is induced by substance intoxication or withdrawal. A patient with schizophrenia exhibits flat affect, poverty of thought, and lack of motivation. Which neurotransmitter imbalance is most likely contributing to these symptoms? A) Decreased dopamine in the mesolimbic pathway B) Increased dopamine in the mesocortical pathway C) Excess glutamate D) Decreased serotonin - ANS-- B) Increased dopamine in the mesocortical pathway Rationale: Negative symptoms of schizophrenia, such as flat affect, poverty of thought, and lack of motivation, are associated with decreased dopamine in the mesocortical pathway. A patient experiences recurrent delusions for over 6 months, but their daily functioning remains intact. Which psychotic disorder is consistent with these symptoms? A) Brief Psychotic Disorder B) Schizophreniform Disorder C) Delusional Disorder D) Schizoaffective Disorder - ANS-- C) Delusional Disorder Rationale: Delusional Disorder is characterized by delusions lasting for at least 1 month, with no marked impairment in daily functioning. A patient with schizophrenia exhibits hallucinations, delusions, and disorganized behavior. Which neurotransmitter imbalance is most likely contributing to these positive symptoms? A) Decreased dopamine in the mesolimbic pathway B) Increased dopamine in the mesocortical pathway C) Excess glutamate D) Decreased GABA - ANS-- A) Increased dopamine in the mesolimbic pathway Rationale: Positive symptoms of schizophrenia, such as hallucinations, delusions, and disorganized behavior, are associated with increased dopamine in the mesolimbic pathway. A nurse is assessing a patient who is experiencing false fixed beliefs that cannot be corrected by reasoning. The patient believes they have special powers and are invincible. Which alteration in thought process is the patient exhibiting? A) Loose associations B) Neologisms C) Delusion of grandeur D) Word salad - ANS-- C) Delusion of grandeur Rationale: Delusion of grandeur is a false belief that one possesses superior qualities, power, or abilities. The patient believes they are all-powerful and important. A patient experiences sensory perceptions such as hearing voices or sounds that are not actually present. Which alteration in perception is the patient experiencing? A) Neologisms B) Echolalia C) Hallucinations D) Clang association - ANS-- C) Hallucinations Rationale: Hallucinations are sensory perceptions that do not have any apparent external stimulus. Auditory hallucinations involve hearing voices or sounds when there is no external source. A nurse observes a patient exhibiting rapid and erratic movements with no clear purpose or meaning. The patient's speech is also jumbled and lacks coherence. Which alteration in behavior and speech is the patient displaying? A) Stereotyped behaviors and word salad B) Automatic obedience and echolalia C) Catatonia and clang association D) Agitation and loose associations - ANS-- A) Stereotyped behaviors and word salad Rationale: Stereotyped behaviors are repetitive motor patterns that lack purpose, while word salad is speech characterized by jumbled words with little meaning or coherence. A patient responds to questions with opposite or contrary actions or statements. For example, when asked to sit down, the patient stands up. Which alteration in behavior is the patient demonstrating? A) Negativism B) Automatic obedience C) Waxy flexibility D) Impaired impulse control - ANS-- A) Negativism Rationale: Negativism is the opposite of what is requested or expected. The patient demonstrates resistance or opposition to instructions or suggestions. A patient exhibits muscular rigidity and maintains a specific position for an extended period of time. Which alteration in behavior is the patient displaying? A) Stereotyped behaviors B) Automatic obedience C) Waxy flexibility D) Stupor - ANS-- C) Waxy flexibility Rationale: Waxy flexibility is a psychomotor symptom characterized by maintaining a specific position for an extended period of time, even when it is uncomfortable or impractical. A nurse is assessing a patient who exhibits rapid and unpredictable movements with no clear purpose or meaning. The patient's speech is also characterized by meaningless rhyming of words. Which alterations in behavior and speech are the patient displaying? A) Stereotyped behaviors and echolalia B) Catatonia and waxy flexibility C) Agitation and clang association D) Motor retardation and neologisms - ANS-- C) Agitation and clang association Rationale: Agitation refers to excessive motor activity that is not goal-directed, while clang association is speech characterized by meaningless rhyming of words. A patient expresses the belief that their thoughts are being controlled by an external force, and they feel powerless to stop it. Which alteration in thought process is the patient exhibiting? A) Thought broadcasting B) Thought insertion C) Thought withdrawal D) Religiosity - ANS-- B) Thought insertion Rationale: Thought insertion is a delusional belief that one's thoughts are being implanted or controlled by an external force. A patient exhibits repetitive and purposeless motor patterns, such as rocking back and forth or tapping their fingers repeatedly. Which alteration in behavior is the patient demonstrating? A) Automatic obedience B) Stereotyped behaviors C) Echopraxia D) Gesturing or posturing - ANS-- B) Stereotyped behaviors Rationale: Stereotyped behaviors are repetitive motor patterns that lack purpose or meaning. A nurse observes a patient maintaining a motionless posture for an extended period, appearing to be in a coma-like state. Which alteration in behavior is the patient displaying? A) Stupor B) Negativism C) Echopraxia D) Boundary impairment - ANS-- A) Stupor Rationale: Stupor is a psychomotor symptom characterized by a state of unresponsiveness and immobility. A patient expresses the belief that they are dead and no longer alive. Which type of delusion is the patient experiencing? A) Delusion of persecution B) Delusion of grandeur C) Nihilistic delusion D) Magical thinking - ANS-- C) Nihilistic delusion Rationale: Nihilistic delusion is a false belief that one is dead, nonexistent, or that the world has ceased to exist. A nurse is caring for a patient with schizophrenia who is experiencing auditory hallucinations instructing them to harm themselves. What is the priority nursing intervention? A) Encourage the patient to participate in therapeutic activities B) Establish a trusting relationship with the patient C) Assess for paranoid delusions or command hallucinations D) Teach the patient self-care activities - ANS-- C) Assess for paranoid delusions or command hallucinations Rationale: Assessing for paranoid delusions or command hallucinations is the priority to reduce the risk of self-harm or harm to others. A patient with schizophrenia is experiencing delusions of persecution. Which nursing intervention is most appropriate? A) Encourage the patient to engage in reality-based conversations B) Provide structured activities to decrease anxiety C) Use therapeutic communication to encourage participation D) Assess for risk of self-harm or harm to others - ANS-- D) Assess for risk of self-harm or harm to others Rationale: Delusions of persecution may increase the risk of harm to self or others. Assessing for this risk is crucial for ensuring patient safety. A nurse is teaching a patient about their antipsychotic medication. Which statement by the patient indicates a need for further teaching? A) "I should take my medication exactly as prescribed by my doctor" B) "It's important to report any side effects I experience while taking the medication" C) "I can stop taking my medication once I start feeling better" D) "I should avoid alcohol and recreational drugs while taking this medication" - ANS-- C) "I can stop taking my medication once I start feeling better" Rationale: It's important for the patient to understand that antipsychotic medication should not be stopped abruptly and should be taken as prescribed, even if they start feeling better. A patient with schizophrenia is experiencing severe anxiety due to auditory hallucinations. Which nursing intervention would be most appropriate? A) Administer a PRN antianxiety medication B) Encourage the patient to confront and challenge the hallucinations C) Provide a quiet and structured environment to decrease anxiety D) Engage the patient in group therapy sessions - ANS-- C) Provide a quiet and structured environment to decrease anxiety Rationale: Providing a quiet and structured environment can help decrease anxiety and provide a sense of safety for the patient experiencing hallucinations.