32- Schizophrenia: Disorders - Psychiatric Mental Health Nursing (Level Up RN‬)

Source: https://www.youtube.com/watch?v=UyY3VVumHvM&list=PLj9YgcGzjQqxb8eR0DCKHFWt3MEHSz2GY&index=32

Correct Answer: B. Thought, behavior, and perception

Explanation:
Schizophrenia is a psychotic disorder characterized by disturbances in thought, behavior, and perception, as stated in the video.

Schizophrenia is best described as a disorder that primarily affects which of the following?

A. Mood, impulse control, and memory
B. Thought, behavior, and perception
C. Intelligence and learning ability
D. Consciousness and attention

Correct Answer: C. Hallucinations

Explanation:
Positive symptoms are added experiences that should not be present. Hallucinations are false sensory perceptions and are a classic positive symptom.

Positive Symptoms of Schizophrenia:

• Delusions ✔

• Hallucinations (auditory, command) ✔

• Disorganized speech ✔

• Disorganized or Catatonic behavior ✔

Which of the following is considered a positive symptom of schizophrenia?

A. Avolition
B. Flat affect
C. Hallucinations
D. Alogia

Correct Answer: B. Delusion

Explanation:
A delusion is a fixed, false belief that is not based in reality, even when evidence contradicts it.

Positive Symptoms of Schizophrenia:

• Delusions ✔

• Hallucinations (auditory, command) ✔

• Disorganized speech ✔

• Disorganized or Catatonic behavior ✔

A patient states, “I am the president of the United States.” This statement is an example of:

A. Hallucination
B. Delusion
C. Illusion
D. Echolalia

Correct Answer: C. Anhedonia

Explanation:
Negative symptoms involve a loss of normal function. Anhedonia refers to a lack of pleasure.

Negative Symptoms of Schizophrenia (Five A’s)

• Alogia (Poverty of Speech) ✔

• Avolition (Lack of Motivation) ✔

• Anhedonia (Inability to Experience Pleasure) ✔

• Affective Flattening / Flat affect (Diminished Emotional Expression ✔

• Asociality (Social Withdrawal and Lack of Interest in Social Interaction) ✔

Which symptom represents a negative symptom of schizophrenia?

A. Delusions
B. Word salad
C. Anhedonia
D. Auditory hallucinations

Correct Answer: D. Lack of speech

Explanation:
Alogia means poverty of speech, which is one of the five “A’s” used to remember negative symptoms.

Which of the following best describes alogia?

A. Lack of motivation
B. Lack of energy
C. Lack of emotional expression
D. Lack of speech

Correct Answer: C. Flight of ideas

Explanation:
Flight of ideas involves rapid movement from one idea or topic to another that may be unrelated.

A patient rapidly shifts from one unrelated topic to another during conversation. This speech pattern is known as:

A. Pressured speech
B. Echolalia
C. Flight of ideas
D. Clang association

Correct Answer: B. Neologisms

Explanation:
Neologisms are invented words that have meaning only to the patient.

Which speech alteration is characterized by made-up, unrecognizable words?

A. Word salad
B. Neologisms
C. Echolalia
D. Clang association

Correct Answer: A. Echolalia

Explanation:
Echolalia is the repetition or echoing of words spoken by another person.

A patient repeats the nurse’s words by saying, “Medications, medications, medications.” This is an example of:

A. Echolalia
B. Word salad
C. Pressured speech
D. Clang association

Correct Answer: C. Word salad

Explanation:
Word salad consists of real words that are strung together randomly, resulting in incoherent speech.

Which speech pattern involves combining real words in an incoherent, meaningless way?

A. Neologisms
B. Clang association
C. Word salad
D. Flight of ideas

Correct Answer: B. Clang association

Explanation:
Clang association occurs when words are linked by sound (rhyming) rather than meaning.

A patient says, “Dan ran to get his can.” This is an example of:

A. Echolalia
B. Clang association
C. Word salad
D. Neologism

Correct Answer: C. Last at least six months and impair functioning

Explanation:
Diagnosis requires two or more symptoms for at least six months with significant impairment in work or social functioning.

Schizophrenia is diagnosed when symptoms:

A. Last at least one month
B. Include hallucinations only
C. Last at least six months and impair functioning
D. Are present only during stress

Correct Answer: C. Physiological or substance-related causes

Explanation:
Medical causes such as electrolyte imbalance, hypoglycemia, or substance use must be ruled out.

Before diagnosing schizophrenia, the nurse must ensure symptoms are not caused by:

A. Anxiety disorders
B. Personality disorders
C. Physiological or substance-related causes
D. Mood disorders

Correct Answer: C. Long-acting IM antipsychotics

Explanation:
Long-acting injectable (IM) antipsychotics are given every 2–4 weeks and are useful when adherence is an issue.

Which medication option may improve treatment compliance in patients with schizophrenia?

A. PRN oral antipsychotics
B. Daily benzodiazepines
C. Long-acting IM antipsychotics
D. Antidepressants

Correct Answer: C. Community-based care for severe and persistent schizophrenia

Explanation:
ACT is a multidisciplinary, community-based approach designed to reduce hospitalization and incarceration.

ACT (Assertive Community Treatment) is best described as:

A. Short-term inpatient therapy
B. A medication-only approach
C. Community-based care for severe and persistent schizophrenia
D. Emergency crisis intervention only

Correct Answer: C. Ask what the voices are saying

Explanation:
Command hallucinations can lead to harm. The nurse must assess the content of the hallucinations to ensure safety.

What is the priority nursing action for a patient experiencing command hallucinations?

A. Provide distraction
B. Reorient to reality
C. Ask what the voices are saying
D. Administer PRN medication

Correct Answer: C. “I do not hear voices, but I believe you are hearing them.”

Explanation:
The nurse should acknowledge the patient’s experience without reinforcing the hallucination.

Which nursing response correctly acknowledges but does not validate hallucinations?

A. “The voices are not real.”
B. “I hear the voices too.”
C. “I do not hear voices, but I believe you are hearing them.”
D. “Ignore the voices and they will go away.”

Correct Answer: C. Decrease environmental stimuli

Explanation:
Reducing environmental stimuli helps minimize sensory overload, which can worsen hallucinations.

Which nursing intervention is most appropriate to help reduce hallucinations in a patient with schizophrenia?

A. Encourage group interaction
B. Increase environmental stimulation
C. Decrease environmental stimuli
D. Provide frequent reality testing

Correct Answer: A. It may increase paranoia or misinterpretation

Explanation:
Whispering may be misinterpreted as secretive behavior and can increase paranoia or delusions.

Why should a nurse avoid whispering in the presence of a patient with schizophrenia?

A. It may increase paranoia or misinterpretation
B. It violates patient confidentiality
C. It interferes with therapeutic communication
D. It increases auditory hallucinations directly

Correct Answer: C. Warn the patient first

Explanation:
Sudden touch may be perceived as threatening, especially in patients with paranoia or hallucinations.

Before touching a patient with schizophrenia, the nurse should:

A. Obtain written consent
B. Ask family permission
C. Warn the patient first
D. Use restraints if needed

Correct Answer: C. Gently redirecting the patient to reality

Explanation:
Reality orientation involves gently reminding the patient of what is real without arguing or validating false beliefs.

Which nursing action best supports reality orientation in a patient with schizophrenia?

A. Agreeing with the patient’s beliefs
B. Ignoring hallucinations
C. Gently redirecting the patient to reality
D. Challenging delusions directly

Correct Answer: B. Offering music or structured activities

Explanation:
Distraction techniques such as music or activities can reduce the patient’s focus on hallucinations.

Providing distraction for hallucinations may include which intervention?

A. Encouraging the patient to focus on the voices
B. Offering music or structured activities
C. Asking detailed questions about hallucinations
D. Placing the patient in isolation

Correct Answer: C. Suicide ideation assessment

Explanation:
Patients with schizophrenia are at increased risk for suicide, making ongoing suicide assessment critical.

Which assessment is essential when caring for a patient with schizophrenia due to increased risk?

A. Fall risk assessment
B. Nutrition assessment
C. Suicide ideation assessment
D. Pain assessment

Correct Answer: B. Hallucinations and delusions can lead to harm

Explanation:
Hallucinations—especially command hallucinations—and delusions can place the patient and others at risk.

Which statement best explains why safety is the priority in nursing care of schizophrenia?

A. Patients may refuse medication
B. Hallucinations and delusions can lead to harm
C. Cognitive deficits impair learning
D. Social withdrawal is common

Correct Answer: B. Rapid speech with little or no pause

Explanation:
Pressured speech is rapid, continuous speech that allows little opportunity for interruption.

Which of the following best describes pressured speech?

A. Repetition of another person’s words
B. Rapid speech with little or no pause
C. Use of made-up words
D. Rhyming words without meaning

Speech Alterations

• Flight of ideas ✔

• Pressured speech ✔

• Neologisms ✔

• Echolalia ✔

• Word salad ✔

• Clang association ✔

Speech Alterations: