NUR 256 MENTAL HEALTH – EXAM 4
100+ QUESTIONS & ANSWERS
WITH RATIONALES
Schizophrenia & Psychotic Disorders (Questions 1–20)
1. A client with paranoid schizophrenia tells the nurse, “The FBI is
watching me through the TV.” Which response is therapeutic?
A) “That’s not true. No one is watching you.”
B) “Why do you think the FBI is watching you?”
C) “I don’t see anyone, but I understand you feel scared.”
D) “Let’s turn off the TV so they can’t see you.”
Answer: C
Rationale: Acknowledging the client’s feelings without validating the
delusion is therapeutic. Option A challenges the delusion directly.
Option B asks “why,” which may increase paranoia. Option D reinforces
the delusion.
2. A client with schizophrenia has alogia, anhedonia, and flat affect.
These are classified as:
A) Positive symptoms
B) Negative symptoms
,C) Cognitive symptoms
D) Affective symptoms
Answer: B
Rationale: Negative symptoms include diminished emotional
expression (flat affect), avolition, alogia (poverty of speech), and
anhedonia (inability to feel pleasure).
3. Which antipsychotic medication is most likely to cause
agranulocytosis?
A) Haloperidol
B) Risperidone
C) Clozapine
D) Olanzapine
Answer: C
Rationale: Clozapine is effective for treatment-resistant
schizophrenia but requires regular WBC monitoring due to risk of
agranulocytosis.
4. A client on haloperidol exhibits rigid muscles, fever, and autonomic
instability. The nurse suspects:
A) Tardive dyskinesia
B) Neuroleptic malignant syndrome (NMS)
C) Acute dystonia
D) Akathisia
Answer: B
Rationale: NMS presents with rigidity, hyperthermia, autonomic
instability, and elevated creatine kinase. Tardive dyskinesia involves
,involuntary movements. Acute dystonia is muscle spasms. Akathisia is
restlessness.
5. A client states, “The moon is made of green cheese, and I’m the
cheese king.” This is an example of:
A) Neologism
B) Loose associations
C) Word salad
D) Clang association
Answer: C
Rationale: Word salad is a mixture of real and made-up words with
no logical connection. Neologism is creating new words. Loose
associations shift between topics. Clang association uses rhyming.
6. First-line treatment for acute aggression in schizophrenia is:
A) Sertraline
B) Lorazepam IM
C) Lithium
D) Carbamazepine
Answer: B
Rationale: IM benzodiazepines (lorazepam) or antipsychotics
(haloperidol) are used for acute agitation. SSRIs are for depression.
7. A client reports hearing a voice telling them to “jump.” This is a:
A) Illusion
B) Command hallucination
C) Delusion of control
D) Depersonalization
, Answer: B
Rationale: Command hallucinations are auditory hallucinations
instructing the person to act, often dangerously.
8. Which symptom is most characteristic of schizoaffective disorder?
A) Hallucinations without mood symptoms
B) Major mood episode + psychotic symptoms for at least 2 weeks
without mood symptoms
C) Only negative symptoms
D) Disorganized speech without delusions
Answer: B
Rationale: Schizoaffective disorder requires a period of psychotic
symptoms alone, plus a major mood episode (mania or depression) for
most of the illness.
9. The nurse observes a client standing motionless in a weird posture
for 30 minutes. This is:
A) Waxy flexibility
B) Catatonic stupor
C) Echopraxia
D) Negativism
Answer: A
Rationale: Waxy flexibility is maintaining positions imposed by
others. Catatonic stupor is lack of movement/response.
10. A client on risperidone develops galactorrhea. The likely cause is:
A) Serotonin syndrome
B) Hyperprolactinemia
100+ QUESTIONS & ANSWERS
WITH RATIONALES
Schizophrenia & Psychotic Disorders (Questions 1–20)
1. A client with paranoid schizophrenia tells the nurse, “The FBI is
watching me through the TV.” Which response is therapeutic?
A) “That’s not true. No one is watching you.”
B) “Why do you think the FBI is watching you?”
C) “I don’t see anyone, but I understand you feel scared.”
D) “Let’s turn off the TV so they can’t see you.”
Answer: C
Rationale: Acknowledging the client’s feelings without validating the
delusion is therapeutic. Option A challenges the delusion directly.
Option B asks “why,” which may increase paranoia. Option D reinforces
the delusion.
2. A client with schizophrenia has alogia, anhedonia, and flat affect.
These are classified as:
A) Positive symptoms
B) Negative symptoms
,C) Cognitive symptoms
D) Affective symptoms
Answer: B
Rationale: Negative symptoms include diminished emotional
expression (flat affect), avolition, alogia (poverty of speech), and
anhedonia (inability to feel pleasure).
3. Which antipsychotic medication is most likely to cause
agranulocytosis?
A) Haloperidol
B) Risperidone
C) Clozapine
D) Olanzapine
Answer: C
Rationale: Clozapine is effective for treatment-resistant
schizophrenia but requires regular WBC monitoring due to risk of
agranulocytosis.
4. A client on haloperidol exhibits rigid muscles, fever, and autonomic
instability. The nurse suspects:
A) Tardive dyskinesia
B) Neuroleptic malignant syndrome (NMS)
C) Acute dystonia
D) Akathisia
Answer: B
Rationale: NMS presents with rigidity, hyperthermia, autonomic
instability, and elevated creatine kinase. Tardive dyskinesia involves
,involuntary movements. Acute dystonia is muscle spasms. Akathisia is
restlessness.
5. A client states, “The moon is made of green cheese, and I’m the
cheese king.” This is an example of:
A) Neologism
B) Loose associations
C) Word salad
D) Clang association
Answer: C
Rationale: Word salad is a mixture of real and made-up words with
no logical connection. Neologism is creating new words. Loose
associations shift between topics. Clang association uses rhyming.
6. First-line treatment for acute aggression in schizophrenia is:
A) Sertraline
B) Lorazepam IM
C) Lithium
D) Carbamazepine
Answer: B
Rationale: IM benzodiazepines (lorazepam) or antipsychotics
(haloperidol) are used for acute agitation. SSRIs are for depression.
7. A client reports hearing a voice telling them to “jump.” This is a:
A) Illusion
B) Command hallucination
C) Delusion of control
D) Depersonalization
, Answer: B
Rationale: Command hallucinations are auditory hallucinations
instructing the person to act, often dangerously.
8. Which symptom is most characteristic of schizoaffective disorder?
A) Hallucinations without mood symptoms
B) Major mood episode + psychotic symptoms for at least 2 weeks
without mood symptoms
C) Only negative symptoms
D) Disorganized speech without delusions
Answer: B
Rationale: Schizoaffective disorder requires a period of psychotic
symptoms alone, plus a major mood episode (mania or depression) for
most of the illness.
9. The nurse observes a client standing motionless in a weird posture
for 30 minutes. This is:
A) Waxy flexibility
B) Catatonic stupor
C) Echopraxia
D) Negativism
Answer: A
Rationale: Waxy flexibility is maintaining positions imposed by
others. Catatonic stupor is lack of movement/response.
10. A client on risperidone develops galactorrhea. The likely cause is:
A) Serotonin syndrome
B) Hyperprolactinemia
