Psychiatric Nursing Chapter 15: Schizophrenia Spectrum and Other
Psychotic Disorders Exam Questions and Answers 100% Pass
1. A paranoid client presents with bizarre behaviors, neologisms, and thought
insertion. Which nursing action should be prioritized to maintain this client's safety?
1. Assess for medication nonadherance.
2. Note escalating behaviors and intervene immediately.
3. Interpret attempts at communication.
4. Assess triggers for bizarre, inappropriate behaviors. - CORRECT ANSWERS
ANS: 2
Rationale: The nurse should note escalating behaviors and intervene immediately,
to maintain this client's safety. Early intervention may prevent an aggressive
response and keep the client and others safe.
2. A client diagnosed with schizoaffective disorder is admitted for social skills
training. Which information should be included in the nurse's teaching?
1. The side effects of medications
2. Deep breathing techniques to decrease stress
3. How to make eye contact when communicating
4. How to be a leader - CORRECT ANSWERS ANS: 3
Rationale: The nurse should plan to teach the client how to make eye contact when
communicating. Social skills, such as making eye contact, can assist clients to
communicate needs and to establish relationships.
3. A 16-year-old client diagnosed with schizophrenia spectrum disorder experiences
command hallucinations to harm others. The client's parents ask a nurse, "Where do
the voices come from?" Which is the appropriate nursing response?
1. "Your child has a chemical imbalance of the brain, which leads to altered
perceptions."
2. "Your child's hallucinations are caused by medication interactions."
3. "Your child has too little serotonin in the brain, causing delusions and
hallucinations."
4. "Your child's abnormal hormonal changes have precipitated auditory
hallucinations." - CORRECT ANSWERS ANS: 1
Rationale: The nurse should explain that a chemical imbalance of the brain leads to
altered perceptions. Hallucinations, or false sensory perceptions, may occur in all
five senses. The client hearing voices is experiencing an auditory hallucination.
, Psychiatric Nursing Chapter 15: Schizophrenia Spectrum and Other
Psychotic Disorders Exam Questions and Answers 100% Pass
4. Parents ask a nurse how they should reply when their child, diagnosed with
schizophrenia spectrum disorder, tells them that voices command him to harm
others. Which is the appropriate nursing response?
1. "Tell him to stop discussing the voices."
2. "Ignore what he is saying, while attempting to discover the underlying cause."
3. "Focus on the feelings generated by the hallucinations and present reality."
4. "Present objective evidence that the voices are not real." - CORRECT ANSWERS
ANS: 3
Rationale: The most appropriate response by the nurse is to instruct the parents to
focus on the feelings generated by the hallucinations and present reality. The
parents should accept that their child is experiencing the hallucination but should
not reinforce this unreal sensory perception.
5. A nurse is assessing a client diagnosed with schizophrenia spectrum disorder. The
nurse asks the client, "Do you receive special messages from certain sources, such
as the television or radio?" The nurse is assessing which potential symptom of this
disorder?
1. Thought insertion
2. Paranoid delusions
3. Magical thinking
4. Delusions of reference - CORRECT ANSWERS ANS: 4
Rationale: The nurse is assessing for the potential symptom of delusions of
reference. A client that believes he or she receives messages through the radio is
experiencing delusions of reference. These delusions involve the client interpreting
events within the environment as being directed toward him- or herself.
6. A client diagnosed with schizophrenia spectrum disorder states, "Can't you hear
him? It's the devil. He's telling me I'm going to hell." Which is the most appropriate
nursing response?
1. "Did you take your medicine this morning?"
2. "You are not going to hell. You are a good person."
3. "The voices must sound scary, but the devil is not talking to you. This is part of
your illness."
4. "The devil only talks to people who are receptive to his influence." - CORRECT
ANSWERS ANS: 3
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