NR 326 Mental Health Nursing: Schizophrenia and Psychotic Disorders
Practice Pack 2026 |Chamberlain College
1. A patient with schizophrenia states, ‘The government is using the television
to send me secret messages.’ What type of delusion is the patient experiencing?
A. Grandiose delusion
B. Somatic delusion
C. Delusion of reference
D. Erotomanic delusion
Answer: C
Rationale: A delusion of reference involves the belief that neutral events or objects in the
environment have a special personal meaning for the individual.
2. Which of the following is considered a ‘negative’ symptom of schizophrenia?
A. Auditory hallucinations
B. Anhedonia
C. Disorganized speech
D. Delusions of persecution
Answer: B
Rationale: Negative symptoms represent a loss of normal function, such as anhedonia
(inability to feel pleasure), alogia, and flat affect. Hallucinations and delusions are positive
symptoms.
,3. A patient taking Clozapine must have which lab value monitored weekly for
the first six months?
A. Serum potassium
B. Blood urea nitrogen (BUN)
C. Liver function tests (LFTs)
D. White blood cell (WBC) count
Answer: D
Rationale: Clozapine carries a risk for agranulocytosis; therefore, regular monitoring of
the absolute neutrophil count (ANC) and WBC count is mandatory.
4. The nurse observes a patient with schizophrenia standing in the same
position for hours, resembling a statue. This is known as:
A. Akathisia
B. Waxy flexibility
C. Echopraxia
D. Dystonia
Answer: B
Rationale: Waxy flexibility is a form of catatonia where the patient maintains a posture for
long periods even if it is uncomfortable.
5. Which medication is most likely to be prescribed to treat Extrapyramidal
Symptoms (EPS) caused by antipsychotics?
A. Lorazepam
B. Fluoxetine
C. Benztropine
D. Lithium
Answer: C
Rationale: Benztropine is an anticholinergic medication used to treat extrapyramidal
symptoms such as tremors and muscle rigidity.
, 6. A patient is experiencing Neuroleptic Malignant Syndrome (NMS). Which
symptom would the nurse expect to find?
A. Hypothermia and hypotension
B. Severe muscle rigidity and hyperpyrexia
C. Diarrhea and pupillary dilation
D. Respiratory alkalosis and bradycardia
Answer: B
Rationale: NMS is a medical emergency characterized by high fever (hyperpyrexia),
muscle ‘lead-pipe’ rigidity, and autonomic instability.
7. When a patient hears voices telling them to ‘hurt others,’ what is the priority
nursing intervention?
A. Ask the patient to describe the voices in detail
B. Provide a quiet environment for the patient
C. Initiate safety precautions to protect the patient and others
D. Administer an antidepressant
Answer: C
Rationale: Command hallucinations require immediate safety assessment and precautions
because the patient may act on the commands to harm themselves or others.
8. The nurse asks a patient, ‘How are you?’ and the patient responds, ‘How are
you? How are you? How are you?’ This is an example of:
A. Neologism
B. Word salad
C. Echolalia
D. Clang association
Answer: C
Rationale: Echolalia is the pathological repeating of words or phrases spoken by another
person.
Practice Pack 2026 |Chamberlain College
1. A patient with schizophrenia states, ‘The government is using the television
to send me secret messages.’ What type of delusion is the patient experiencing?
A. Grandiose delusion
B. Somatic delusion
C. Delusion of reference
D. Erotomanic delusion
Answer: C
Rationale: A delusion of reference involves the belief that neutral events or objects in the
environment have a special personal meaning for the individual.
2. Which of the following is considered a ‘negative’ symptom of schizophrenia?
A. Auditory hallucinations
B. Anhedonia
C. Disorganized speech
D. Delusions of persecution
Answer: B
Rationale: Negative symptoms represent a loss of normal function, such as anhedonia
(inability to feel pleasure), alogia, and flat affect. Hallucinations and delusions are positive
symptoms.
,3. A patient taking Clozapine must have which lab value monitored weekly for
the first six months?
A. Serum potassium
B. Blood urea nitrogen (BUN)
C. Liver function tests (LFTs)
D. White blood cell (WBC) count
Answer: D
Rationale: Clozapine carries a risk for agranulocytosis; therefore, regular monitoring of
the absolute neutrophil count (ANC) and WBC count is mandatory.
4. The nurse observes a patient with schizophrenia standing in the same
position for hours, resembling a statue. This is known as:
A. Akathisia
B. Waxy flexibility
C. Echopraxia
D. Dystonia
Answer: B
Rationale: Waxy flexibility is a form of catatonia where the patient maintains a posture for
long periods even if it is uncomfortable.
5. Which medication is most likely to be prescribed to treat Extrapyramidal
Symptoms (EPS) caused by antipsychotics?
A. Lorazepam
B. Fluoxetine
C. Benztropine
D. Lithium
Answer: C
Rationale: Benztropine is an anticholinergic medication used to treat extrapyramidal
symptoms such as tremors and muscle rigidity.
, 6. A patient is experiencing Neuroleptic Malignant Syndrome (NMS). Which
symptom would the nurse expect to find?
A. Hypothermia and hypotension
B. Severe muscle rigidity and hyperpyrexia
C. Diarrhea and pupillary dilation
D. Respiratory alkalosis and bradycardia
Answer: B
Rationale: NMS is a medical emergency characterized by high fever (hyperpyrexia),
muscle ‘lead-pipe’ rigidity, and autonomic instability.
7. When a patient hears voices telling them to ‘hurt others,’ what is the priority
nursing intervention?
A. Ask the patient to describe the voices in detail
B. Provide a quiet environment for the patient
C. Initiate safety precautions to protect the patient and others
D. Administer an antidepressant
Answer: C
Rationale: Command hallucinations require immediate safety assessment and precautions
because the patient may act on the commands to harm themselves or others.
8. The nurse asks a patient, ‘How are you?’ and the patient responds, ‘How are
you? How are you? How are you?’ This is an example of:
A. Neologism
B. Word salad
C. Echolalia
D. Clang association
Answer: C
Rationale: Echolalia is the pathological repeating of words or phrases spoken by another
person.
