Week 4 Midterm Exam: NR547 / NR-547 (Latest 2026/2027)
Differential Diagnosis in Psychiatric-Mental Health across the
Lifespan Practicum/ EXAM LATEST VERSION 2025 QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A
symptoms began a few days ago. If symptoms resolve within one month, this
is an appropriate diagnosis. If not, an alternate diagnosis should be
considered. Delusional Disorder - ANSWER//involves a person having
prominent delusions without hallucinations -tend to have false beliefs that
involve real-life situations • ex: belief that they are being followed or that
others are plotting against them -often retain their personalities and are more
functional socially Geoff is two days post-op from knee surgery. He has been
awake, alert, oriented, and pleasant over the last few days and has shown no
signs of mental distress. The surgical team asked for a psychiatric consult
after Geoff became increasingly angry, argumentative, and agitated with
nursing staff when he was offered a flu shot. Geoff states that he was given a
flu shot against his will at work several years ago, and since then the
government has been tracking him and listening in on private conversations.
He states that taking another shot will "triple the power" of the surveillance.
Upon follow-up, Geoff's wife confirms that he has held this belief for many
years. He believes the same is true for other vaccines, but he does not hold
other delusions. He has maintained employment, relationships, and social
interactions. Based on the DSM-5-TR, does Geoff meet diagnostic criteria for
delusional disorder? yes no unable to - ANSWER//Yes Rationale: Geoff has
one belief that is irrational and fixed and has held the delusion for several
years. His functioning is not impaired. He meets diagnostic criteria for
delusional disorder Catatonia - ANSWER//psychomotor syndrome that
presents as a decreased reactivity to one's environment -typically occurs in
tandem with other medical or psychiatric disorders • most often associated
with schizophrenia, affective disorders, autism, and infectious disease -
Clinical signs: • immobility, mutism, withdrawal, refusing to eat, staring,
negativism, posturing, and rigidity. -failure to recognize and treat can lead to
increased mortality Helmut is a 58-year-old who has a history of alcoholism
and liver failure. He presents to the emergency department with his wife, who
is concerned about recent changes in his behavior, including a decrease in
mobility and verbal response. He will not follow instructions during the
examination. Facial grimacing is noted. His physical exam is positive for
ascites and asterixis. A CT scan shows no acute concerns. His blood
ammonia level is elevated. Based on DSM-5-TR criteria, what is the most
appropriate diagnosis for Helmut at this time? - ANSWER//hepatic
encephalopathy (572.2) and catatonic disorder due to hepatic encephalopathy
(293.89). rationale: Helmut is experiencing signs and symptoms consistent
with hepatic encephalopathy, including a negative CT scan, ascites, asterixis,
and elevated blood ammonia level. He meets diagnostic criteria for catatonia
as he has four symptoms: stupor, mutism, negativism, and grimacing. Medical
Diagnoses that Mimic Psychotic Disorders - ANSWER//Alzheimer's disease
Huntington disease brain tumors Creutzfeldt-Jakob disease adrenal disorders
Rationale: Medical conditions that commonly present with psychotic
symptoms include Alzheimer's disease, Huntington disease, multiple sclerosis,
,brain tumors, head trauma, Creutzfeldt-Jakob disease, syphilis, viral
encephalitis, hepatic encephalopathy, adrenal disorders, and vitamin B12
deficiency. medications or substances commonly cause symptoms that mimic
psychosis - ANSWER//cephalosporins steroids amphetamines alcohol
marijuana Rationale: Medications with side effects mimicking psychosis
include cephalosporins, penicillin, anticholinergics, steroids, amphetamines,
cocaine, alcohol, marijuana, and hallucinogens. treatment of psychotic
disorders - ANSWER//complex -Decision-making about medications is
influenced by treatment response and side effects, as well as the phase of
illness (acute vs. stable) -antipsychotics as well as other medications,
psychotherapy, and close collaboration between providers and the client's
support system -Treatment goal setting should be client-driven, though some
clients may be too ill or agitated to participate in the process -care should
include the client's wishes, safety is of paramount importance • Providers may
need to initiate treatment and/or hospitalization against a client's will treatment
of psychotic disorders: Pharmacologic - ANSWER//Antipsychotic medications
-management of psychosis • Second-generation or atypical antipsychotics
(SGA) are effective for the tx of both (+) & (-) symptoms, first-line treatment for
psychotic disorders • First-generation antipsychotics or typical antipsychotics,
effective for (+) symptoms but have a higher incidence of unwanted side
effects Antipsychotics: Potency low to high - ANSWER//Chlorpromazine - Low
Mesoridazine - Low Thioridazine - Low Thiothixene - Medium Fluphenazine -
Medium Haloperidol - High Second Generation Antipsychotics (SGA) -
ANSWER//Pines -olanzapine (Zyprexa) -quetiapine (Seroquel) -asenapine
(Saphris) -clozapine (Clozaril) Many Dones and a Rone -risperidone
(Risperidol) -paliperidone (Invega) -ziprasidone (Geodon) -iloperidone (Fanapt)
-lurasidone (Latuda) 2 Pips and a Rip -aripiprazole (Abilify) -brexpiprazole
(Rexulti) -cariprazine (Vraylar) Erica is a 24-year-old with a newly diagnosed
schizophreniform disorder. She is a current smoker. She does not use alcohol
or other drugs. She has no medical history. Which of the following would be
the least appropriate initial medication for Erica? aripiprazole lurasidone
olanzapine quetiapine - ANSWER//olanzapine Rationale: Olanzapine requires
up to 30% increased dosage for clients who smoke concurrently. Initiating a
medication that does not interact with smoking is preferable. Tony is a 56-
year-old who has recently been diagnosed with schizophrenia. He takes
amiodarone for a history of cardiac dysrhythmias. He does not use alcohol or
other drugs. He is a nonsmoker. Which of the following is the most
appropriate medication for Tony? aripiprazole lurasidone quetiapine
risperidone - ANSWER//risperidone Rationale: Amiodarone is a moderate
CYP3A4 inhibitor. Risperidone does not interact with CYP3A4 inhibitors or
inducers. Jenny is a 22-year-old who has been prescribed aripiprazole 15
milligrams(mg)/day for the past 8 months. She has gained approximately 30
pounds (lbs.) during treatment. Jenny's psychiatric symptoms have been
managed well on aripiprazole and she has no other adverse effects. What is
the most appropriate initial intervention for Jenny? switch to a different
antipsychotic medication prescribe metformin refer to a bariatric specialist -
ANSWER//prescribe metformin Rationale: Prescribing metformin as an
adjunct treatment to assist with weight loss associated with antipsychotics is
appropriate. Jenny is well-managed on the current dose of aripiprazole;
switching to a different medication is not indicated at this time. Referral to a
,bariatric specialist may be indicated if the client continues to gain weight but is
not indicated as the most appropriate initial intervention. Scott is a 33-year-old
who is currently without housing. He has been unable to adhere to his
prescribed oral medication regimen. The psychiatric mental health nurse
practitioner (PMHNP) recommends a long-acting intramuscular form of
medication. Scott is willing to try but would like to receive the medication at
the community clinic near the shelter where he is staying. Which medication
option is the least appropriate for Scott at this time? aripiprazole monohydrate
olanzapine paliperidone palmitate risperidone - ANSWER//olanzapine
Rationale: Olanzapine must be given in a registered health care facility with
available emergency medical services. The client receiving olanzapine must
be monitored for 3 hours post-injection. Changing from one antipsychotic
medication to another: - ANSWER//-req specific dosage adjustments. -
Guidelines include: • DAYS 1 - 7, Approx. 25% of target dose • DAYS 8 - 21,
Approx. 50% of target dose • DAYS 22 - 35, Approx. 75% of target dose •
DAY 36, Target dose Example: RX: aripiprazole 5 mg Dispense: #64 Sig:
Take ½ tablet once a day for 7 days; then, take 1 tablet once a day for 14
days; then, take 1 ½ tablets once a day for 14 days; then, take 2 tablets once
a day. Refills: 0 Which of the following laboratory tests are indicated for a
client who is taking olanzapine? Select all that apply. BMI CBC HbA1C Lipid
panel Kidney function tests - ANSWER//BMI HbA1C Lipid panel Rationale:
Monitoring should include fasting glucose or hemoglobin A1C, lipid profile,
weight, and BMI at regular intervals during the first year of antipsychotic
therapy and then annually. Which of the following tests are indicated for a
client who is taking ziprasidone? Select all that apply. CT scan ECG vital
signs EEG - ANSWER//ECG vital signs Rationale: Ziprasidone may cause
prolonged QT interval; clients who are prescribed this medication should have
an ECG before taking the medication, at three months, and annually
thereafter. The provider should also monitor pulse and blood pressure at each
visit. Ziprasidone may cause orthostatic hypotension and subsequent
tachycardia. A client has been on clozapine for 9 months. Absolute neutrophil
counts (ANC) have consistently been less than 1500/microliter? At what
frequency should a CBC be drawn? daily weekly every 2 weeks monthly -
ANSWER//every 2 weeks Rationale: With a normal baseline ANC, the CBC
should be monitored weekly for 6 months; every 2 weeks for months 6-12;
and monthly thereafter treatment of psychotic disorders: Nonpharmacologic -
ANSWER//Psychosocial Therapy -provides the opportunity to build a
therapeutic alliance, provide education, and instill hope -CBT, improve
cognitive distortions and help provide insight into their illness -Social skills
training and group therapy -Family-oriented therapies -Case management -
vocational therapy and supported employment Lifestyle -Adequate sleep -
stress management -healthy diet -regular exercise -avoid substances •
alcohol, drugs, and nicotine RAISE - ANSWER//(Recovery After an Initial
Schizophrenia Episode) provides specific schizophrenia-related resources for
newly diagnosed clients. follow-up monitoring for clients diagnosed with a
psychotic disorder - ANSWER//-symptom assessment and review of
medications and side effects -Periodic laboratory testing -Weekly follow-up is
recommended for most clients for the first three months then once to twice per
month thereafter depending on clinical progress Marijuana may remain
detectable in urine for ________ days after use - ANSWER//3-30 days The
, PMHNP continues with the psychiatric interview. Angelo denies feelings of
hopelessness or depression within the past two weeks. He also denies
feelings of elevated mood, grandiosity, or reckless behaviors. He states that
he earned a 4.0-grade point average his freshman year. He is currently
carrying a D average in his classes, as he has been skipping classes to stay
in his dorm room to ensure his roommates cannot touch his food. He has
shouted at his roommates on several occasions, and they have reported his
behavior to the resident advisor. He states he has a hard time making and
keeping friends, but that his lack of social interactions does not bother him. He
denies feeling anxious or worried. schizoaffective disorder schizophrenia
schizophreniform disorder - ANSWER//schizoaffective disorder -Angelo
denies symptoms of mania and depression. Schizoaffective disorder includes
symptoms that meet the criteria for a major depressive or manic episode in
addition to criteria for schizophrenia or schizophreniform disorder. Therefore,
schizoaffective disorder is a less likely diagnosis. schizophreniform disorder -
Angelo endorses a significant decline in his level of academic functioning over
the past several months as a direct consequence of his delusions. This
decrease in the level of functioning makes schizophreniform disorder a less
likely diagnosis. Mental status exam findings that support a diagnosis of
schizophrenia? - ANSWER//Appearance -poor grooming and stained apparel
Speech and behavior -random laughter -long pauses before answering a
question -lack of eye contact -heightened emotional tone -pressured speech
Motor -fidgeting, picking at fingernails during interview Thought process -
occasional perseverations -thought blocking Thought content -persecutory
delusions of being poisoned -verbalized anger towards roommates Perception
-admits to auditory hallucinations daily within the past week Psychosis and
____________ are strongly associated - ANSWER//suicide -leading cause of
premature death among individuals with schizophrenia Psychosis: Factors
strongly correlated with suicide risk - ANSWER//-young age -male gender -
high level of education other factors: -history of prior suicide attempts -
comorbid substance use -presence of depressive symptoms -active
hallucinations -delusions only _____________ is approved by the Food and
Drug Administration (FDA) for preventing suicide in clients with schizophrenia
- ANSWER//clozapine Psychosis Safety and Lifespan Considerations:
Pediatric - ANSWER//Schizophrenia rare cases, onset may occur during
childhood -Pediatric schizophrenia 0.5 per 1,000 -Symptoms: • delays in
language & other development • behaviors such as rocking, posturing, or
flapping before the onset of psychotic symptoms • usually appear at age
seven or later Psychosis Safety and Lifespan Considerations: Adolescence -
ANSWER//-onset in adolescence is often insidious -Initial signs: • withdrawal
from friends or interests • changes in personal hygiene • decreased school
performance -tx with antipsychotic meds, weight gain may be problematic for:
• self esteem and body image • chronic health conditions (diabetes, HTN,
heart disease) • provide nutritional education • may need metformin • boys
more vulnerable to dystonic reactions than adults, prophylactic use of
antiparkinsonian meds may be appropriate. Psychosis Safety and Lifespan
Considerations: Older Adults - ANSWER//-Late-onset schizophrenia is rare •
more common in women, can occur after age 45 • presentation more often
paranoid type -Delusional disorder can also develop in older adulthood, often
paranoid-persecutory type -Older adults with schizophrenia • higher incidence
Differential Diagnosis in Psychiatric-Mental Health across the
Lifespan Practicum/ EXAM LATEST VERSION 2025 QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A
symptoms began a few days ago. If symptoms resolve within one month, this
is an appropriate diagnosis. If not, an alternate diagnosis should be
considered. Delusional Disorder - ANSWER//involves a person having
prominent delusions without hallucinations -tend to have false beliefs that
involve real-life situations • ex: belief that they are being followed or that
others are plotting against them -often retain their personalities and are more
functional socially Geoff is two days post-op from knee surgery. He has been
awake, alert, oriented, and pleasant over the last few days and has shown no
signs of mental distress. The surgical team asked for a psychiatric consult
after Geoff became increasingly angry, argumentative, and agitated with
nursing staff when he was offered a flu shot. Geoff states that he was given a
flu shot against his will at work several years ago, and since then the
government has been tracking him and listening in on private conversations.
He states that taking another shot will "triple the power" of the surveillance.
Upon follow-up, Geoff's wife confirms that he has held this belief for many
years. He believes the same is true for other vaccines, but he does not hold
other delusions. He has maintained employment, relationships, and social
interactions. Based on the DSM-5-TR, does Geoff meet diagnostic criteria for
delusional disorder? yes no unable to - ANSWER//Yes Rationale: Geoff has
one belief that is irrational and fixed and has held the delusion for several
years. His functioning is not impaired. He meets diagnostic criteria for
delusional disorder Catatonia - ANSWER//psychomotor syndrome that
presents as a decreased reactivity to one's environment -typically occurs in
tandem with other medical or psychiatric disorders • most often associated
with schizophrenia, affective disorders, autism, and infectious disease -
Clinical signs: • immobility, mutism, withdrawal, refusing to eat, staring,
negativism, posturing, and rigidity. -failure to recognize and treat can lead to
increased mortality Helmut is a 58-year-old who has a history of alcoholism
and liver failure. He presents to the emergency department with his wife, who
is concerned about recent changes in his behavior, including a decrease in
mobility and verbal response. He will not follow instructions during the
examination. Facial grimacing is noted. His physical exam is positive for
ascites and asterixis. A CT scan shows no acute concerns. His blood
ammonia level is elevated. Based on DSM-5-TR criteria, what is the most
appropriate diagnosis for Helmut at this time? - ANSWER//hepatic
encephalopathy (572.2) and catatonic disorder due to hepatic encephalopathy
(293.89). rationale: Helmut is experiencing signs and symptoms consistent
with hepatic encephalopathy, including a negative CT scan, ascites, asterixis,
and elevated blood ammonia level. He meets diagnostic criteria for catatonia
as he has four symptoms: stupor, mutism, negativism, and grimacing. Medical
Diagnoses that Mimic Psychotic Disorders - ANSWER//Alzheimer's disease
Huntington disease brain tumors Creutzfeldt-Jakob disease adrenal disorders
Rationale: Medical conditions that commonly present with psychotic
symptoms include Alzheimer's disease, Huntington disease, multiple sclerosis,
,brain tumors, head trauma, Creutzfeldt-Jakob disease, syphilis, viral
encephalitis, hepatic encephalopathy, adrenal disorders, and vitamin B12
deficiency. medications or substances commonly cause symptoms that mimic
psychosis - ANSWER//cephalosporins steroids amphetamines alcohol
marijuana Rationale: Medications with side effects mimicking psychosis
include cephalosporins, penicillin, anticholinergics, steroids, amphetamines,
cocaine, alcohol, marijuana, and hallucinogens. treatment of psychotic
disorders - ANSWER//complex -Decision-making about medications is
influenced by treatment response and side effects, as well as the phase of
illness (acute vs. stable) -antipsychotics as well as other medications,
psychotherapy, and close collaboration between providers and the client's
support system -Treatment goal setting should be client-driven, though some
clients may be too ill or agitated to participate in the process -care should
include the client's wishes, safety is of paramount importance • Providers may
need to initiate treatment and/or hospitalization against a client's will treatment
of psychotic disorders: Pharmacologic - ANSWER//Antipsychotic medications
-management of psychosis • Second-generation or atypical antipsychotics
(SGA) are effective for the tx of both (+) & (-) symptoms, first-line treatment for
psychotic disorders • First-generation antipsychotics or typical antipsychotics,
effective for (+) symptoms but have a higher incidence of unwanted side
effects Antipsychotics: Potency low to high - ANSWER//Chlorpromazine - Low
Mesoridazine - Low Thioridazine - Low Thiothixene - Medium Fluphenazine -
Medium Haloperidol - High Second Generation Antipsychotics (SGA) -
ANSWER//Pines -olanzapine (Zyprexa) -quetiapine (Seroquel) -asenapine
(Saphris) -clozapine (Clozaril) Many Dones and a Rone -risperidone
(Risperidol) -paliperidone (Invega) -ziprasidone (Geodon) -iloperidone (Fanapt)
-lurasidone (Latuda) 2 Pips and a Rip -aripiprazole (Abilify) -brexpiprazole
(Rexulti) -cariprazine (Vraylar) Erica is a 24-year-old with a newly diagnosed
schizophreniform disorder. She is a current smoker. She does not use alcohol
or other drugs. She has no medical history. Which of the following would be
the least appropriate initial medication for Erica? aripiprazole lurasidone
olanzapine quetiapine - ANSWER//olanzapine Rationale: Olanzapine requires
up to 30% increased dosage for clients who smoke concurrently. Initiating a
medication that does not interact with smoking is preferable. Tony is a 56-
year-old who has recently been diagnosed with schizophrenia. He takes
amiodarone for a history of cardiac dysrhythmias. He does not use alcohol or
other drugs. He is a nonsmoker. Which of the following is the most
appropriate medication for Tony? aripiprazole lurasidone quetiapine
risperidone - ANSWER//risperidone Rationale: Amiodarone is a moderate
CYP3A4 inhibitor. Risperidone does not interact with CYP3A4 inhibitors or
inducers. Jenny is a 22-year-old who has been prescribed aripiprazole 15
milligrams(mg)/day for the past 8 months. She has gained approximately 30
pounds (lbs.) during treatment. Jenny's psychiatric symptoms have been
managed well on aripiprazole and she has no other adverse effects. What is
the most appropriate initial intervention for Jenny? switch to a different
antipsychotic medication prescribe metformin refer to a bariatric specialist -
ANSWER//prescribe metformin Rationale: Prescribing metformin as an
adjunct treatment to assist with weight loss associated with antipsychotics is
appropriate. Jenny is well-managed on the current dose of aripiprazole;
switching to a different medication is not indicated at this time. Referral to a
,bariatric specialist may be indicated if the client continues to gain weight but is
not indicated as the most appropriate initial intervention. Scott is a 33-year-old
who is currently without housing. He has been unable to adhere to his
prescribed oral medication regimen. The psychiatric mental health nurse
practitioner (PMHNP) recommends a long-acting intramuscular form of
medication. Scott is willing to try but would like to receive the medication at
the community clinic near the shelter where he is staying. Which medication
option is the least appropriate for Scott at this time? aripiprazole monohydrate
olanzapine paliperidone palmitate risperidone - ANSWER//olanzapine
Rationale: Olanzapine must be given in a registered health care facility with
available emergency medical services. The client receiving olanzapine must
be monitored for 3 hours post-injection. Changing from one antipsychotic
medication to another: - ANSWER//-req specific dosage adjustments. -
Guidelines include: • DAYS 1 - 7, Approx. 25% of target dose • DAYS 8 - 21,
Approx. 50% of target dose • DAYS 22 - 35, Approx. 75% of target dose •
DAY 36, Target dose Example: RX: aripiprazole 5 mg Dispense: #64 Sig:
Take ½ tablet once a day for 7 days; then, take 1 tablet once a day for 14
days; then, take 1 ½ tablets once a day for 14 days; then, take 2 tablets once
a day. Refills: 0 Which of the following laboratory tests are indicated for a
client who is taking olanzapine? Select all that apply. BMI CBC HbA1C Lipid
panel Kidney function tests - ANSWER//BMI HbA1C Lipid panel Rationale:
Monitoring should include fasting glucose or hemoglobin A1C, lipid profile,
weight, and BMI at regular intervals during the first year of antipsychotic
therapy and then annually. Which of the following tests are indicated for a
client who is taking ziprasidone? Select all that apply. CT scan ECG vital
signs EEG - ANSWER//ECG vital signs Rationale: Ziprasidone may cause
prolonged QT interval; clients who are prescribed this medication should have
an ECG before taking the medication, at three months, and annually
thereafter. The provider should also monitor pulse and blood pressure at each
visit. Ziprasidone may cause orthostatic hypotension and subsequent
tachycardia. A client has been on clozapine for 9 months. Absolute neutrophil
counts (ANC) have consistently been less than 1500/microliter? At what
frequency should a CBC be drawn? daily weekly every 2 weeks monthly -
ANSWER//every 2 weeks Rationale: With a normal baseline ANC, the CBC
should be monitored weekly for 6 months; every 2 weeks for months 6-12;
and monthly thereafter treatment of psychotic disorders: Nonpharmacologic -
ANSWER//Psychosocial Therapy -provides the opportunity to build a
therapeutic alliance, provide education, and instill hope -CBT, improve
cognitive distortions and help provide insight into their illness -Social skills
training and group therapy -Family-oriented therapies -Case management -
vocational therapy and supported employment Lifestyle -Adequate sleep -
stress management -healthy diet -regular exercise -avoid substances •
alcohol, drugs, and nicotine RAISE - ANSWER//(Recovery After an Initial
Schizophrenia Episode) provides specific schizophrenia-related resources for
newly diagnosed clients. follow-up monitoring for clients diagnosed with a
psychotic disorder - ANSWER//-symptom assessment and review of
medications and side effects -Periodic laboratory testing -Weekly follow-up is
recommended for most clients for the first three months then once to twice per
month thereafter depending on clinical progress Marijuana may remain
detectable in urine for ________ days after use - ANSWER//3-30 days The
, PMHNP continues with the psychiatric interview. Angelo denies feelings of
hopelessness or depression within the past two weeks. He also denies
feelings of elevated mood, grandiosity, or reckless behaviors. He states that
he earned a 4.0-grade point average his freshman year. He is currently
carrying a D average in his classes, as he has been skipping classes to stay
in his dorm room to ensure his roommates cannot touch his food. He has
shouted at his roommates on several occasions, and they have reported his
behavior to the resident advisor. He states he has a hard time making and
keeping friends, but that his lack of social interactions does not bother him. He
denies feeling anxious or worried. schizoaffective disorder schizophrenia
schizophreniform disorder - ANSWER//schizoaffective disorder -Angelo
denies symptoms of mania and depression. Schizoaffective disorder includes
symptoms that meet the criteria for a major depressive or manic episode in
addition to criteria for schizophrenia or schizophreniform disorder. Therefore,
schizoaffective disorder is a less likely diagnosis. schizophreniform disorder -
Angelo endorses a significant decline in his level of academic functioning over
the past several months as a direct consequence of his delusions. This
decrease in the level of functioning makes schizophreniform disorder a less
likely diagnosis. Mental status exam findings that support a diagnosis of
schizophrenia? - ANSWER//Appearance -poor grooming and stained apparel
Speech and behavior -random laughter -long pauses before answering a
question -lack of eye contact -heightened emotional tone -pressured speech
Motor -fidgeting, picking at fingernails during interview Thought process -
occasional perseverations -thought blocking Thought content -persecutory
delusions of being poisoned -verbalized anger towards roommates Perception
-admits to auditory hallucinations daily within the past week Psychosis and
____________ are strongly associated - ANSWER//suicide -leading cause of
premature death among individuals with schizophrenia Psychosis: Factors
strongly correlated with suicide risk - ANSWER//-young age -male gender -
high level of education other factors: -history of prior suicide attempts -
comorbid substance use -presence of depressive symptoms -active
hallucinations -delusions only _____________ is approved by the Food and
Drug Administration (FDA) for preventing suicide in clients with schizophrenia
- ANSWER//clozapine Psychosis Safety and Lifespan Considerations:
Pediatric - ANSWER//Schizophrenia rare cases, onset may occur during
childhood -Pediatric schizophrenia 0.5 per 1,000 -Symptoms: • delays in
language & other development • behaviors such as rocking, posturing, or
flapping before the onset of psychotic symptoms • usually appear at age
seven or later Psychosis Safety and Lifespan Considerations: Adolescence -
ANSWER//-onset in adolescence is often insidious -Initial signs: • withdrawal
from friends or interests • changes in personal hygiene • decreased school
performance -tx with antipsychotic meds, weight gain may be problematic for:
• self esteem and body image • chronic health conditions (diabetes, HTN,
heart disease) • provide nutritional education • may need metformin • boys
more vulnerable to dystonic reactions than adults, prophylactic use of
antiparkinsonian meds may be appropriate. Psychosis Safety and Lifespan
Considerations: Older Adults - ANSWER//-Late-onset schizophrenia is rare •
more common in women, can occur after age 45 • presentation more often
paranoid type -Delusional disorder can also develop in older adulthood, often
paranoid-persecutory type -Older adults with schizophrenia • higher incidence
