1
NCLEX PN Exam Bank Schizophrenia and
Delusional Disorder Care
Table of Contents
Subtopic 1: Foundations of Schizophrenia and Delusional Disorders (Overview, Etiology,
and Types) .................................................................................................................... 2
Subtopic 2: Pharmacologic Management of Schizophrenia and Delusional Disorders ...... 10
Subtopic 3: Therapeutic Communication and Client Interaction in Psychotic Disorders ... 18
Subtopic 4: Safety, Crisis Intervention, and Management of Aggression in Psychotic
Disorders ................................................................................................................... 26
Subtopic 5: Medication Management and Adherence in Schizophrenia and Delusional
Disorders ................................................................................................................... 34
Subtopic 6: Managing Comorbid Conditions and Medical-Surgical Issues in Patients with
Schizophrenia ............................................................................................................. 41
Subtopic 7: Nursing Considerations in Psychotropic Medication Management for
Schizophrenia and Delusional Disorders (Questions 121–140) ....................................... 50
Subtopic 8: Cultural Competence and Ethical Considerations in Psychotic Disorders ...... 58
Subtopic 9: Community-Based and Long-Term Support for Clients with Schizophrenia and
Delusional Disorders (Q161–Q180) .............................................................................. 67
Subtopic 10: Legal, Ethical, and Safety Issues in Schizophrenia and Delusional Disorders 75
, 2
Subtopic 1: Foundations of Schizophrenia and
Delusional Disorders (Overview, Etiology, and Types)
Questions 1–20
1. Which of the following is considered a hallmark positive symptom of schizophrenia?
A. Anhedonia
B. Affective flattening
C. Hallucinations
D. Social withdrawal
Correct Answer: C. Hallucinations
Rationale: Hallucinations, especially auditory, are classic positive symptoms of
schizophrenia. They involve perceiving something that isn’t there, differentiating them from
negative symptoms like anhedonia or social withdrawal.
2. A nurse is assessing a patient with schizophrenia who reports hearing voices telling them
to harm themselves. What is the priority nursing intervention?
A. Ask the patient to ignore the voices
B. Initiate safety protocols and notify the healthcare provider immediately
C. Reassure the patient that the voices are not real
D. Distract the patient with music or television
Correct Answer: B. Initiate safety protocols and notify the healthcare provider immediately
Rationale: Command hallucinations can pose a serious risk. Safety is the priority, and the
healthcare team must be notified.
3. What neurotransmitter is primarily associated with the development of schizophrenia?
, 3
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Correct Answer: B. Dopamine
Rationale: Schizophrenia is linked to increased dopamine activity in certain brain regions.
Dopamine antagonists help manage psychotic symptoms.
4. Which subtype of schizophrenia is characterized by prominent delusions or auditory
hallucinations with relatively preserved cognition and affect?
A. Paranoid schizophrenia
B. Disorganized schizophrenia
C. Catatonic schizophrenia
D. Undifferentiated schizophrenia
Correct Answer: A. Paranoid schizophrenia
Rationale: Paranoid schizophrenia involves well-formed delusions and auditory
hallucinations without significant disorganized behavior or affect.
5. A patient with delusional disorder believes their neighbor is secretly an FBI agent spying
on them. This belief has persisted for over a year without other symptoms. What type of
delusion is this?
A. Erotomanic
B. Persecutory
C. Grandiose
D. Somatic
, 4
Correct Answer: B. Persecutory
Rationale: Persecutory delusions involve beliefs that one is being conspired against or
harassed.
6. Which of the following best describes a negative symptom of schizophrenia?
A. Avolition
B. Hallucinations
C. Delusions
D. Agitation
Correct Answer: A. Avolition
Rationale: Avolition, or lack of motivation, is a negative symptom. Positive symptoms
include hallucinations and delusions.
7. Which of the following assessment findings would indicate disorganized schizophrenia?
A. A fixed, false belief
B. Incoherent speech and inappropriate affect
C. Catatonic posturing
D. Delusional jealousy
Correct Answer: B. Incoherent speech and inappropriate affect
Rationale: Disorganized schizophrenia presents with disorganized thoughts, speech, and
behaviors, along with inappropriate emotional responses.
8. What distinguishes delusional disorder from schizophrenia?
A. Presence of hallucinations
NCLEX PN Exam Bank Schizophrenia and
Delusional Disorder Care
Table of Contents
Subtopic 1: Foundations of Schizophrenia and Delusional Disorders (Overview, Etiology,
and Types) .................................................................................................................... 2
Subtopic 2: Pharmacologic Management of Schizophrenia and Delusional Disorders ...... 10
Subtopic 3: Therapeutic Communication and Client Interaction in Psychotic Disorders ... 18
Subtopic 4: Safety, Crisis Intervention, and Management of Aggression in Psychotic
Disorders ................................................................................................................... 26
Subtopic 5: Medication Management and Adherence in Schizophrenia and Delusional
Disorders ................................................................................................................... 34
Subtopic 6: Managing Comorbid Conditions and Medical-Surgical Issues in Patients with
Schizophrenia ............................................................................................................. 41
Subtopic 7: Nursing Considerations in Psychotropic Medication Management for
Schizophrenia and Delusional Disorders (Questions 121–140) ....................................... 50
Subtopic 8: Cultural Competence and Ethical Considerations in Psychotic Disorders ...... 58
Subtopic 9: Community-Based and Long-Term Support for Clients with Schizophrenia and
Delusional Disorders (Q161–Q180) .............................................................................. 67
Subtopic 10: Legal, Ethical, and Safety Issues in Schizophrenia and Delusional Disorders 75
, 2
Subtopic 1: Foundations of Schizophrenia and
Delusional Disorders (Overview, Etiology, and Types)
Questions 1–20
1. Which of the following is considered a hallmark positive symptom of schizophrenia?
A. Anhedonia
B. Affective flattening
C. Hallucinations
D. Social withdrawal
Correct Answer: C. Hallucinations
Rationale: Hallucinations, especially auditory, are classic positive symptoms of
schizophrenia. They involve perceiving something that isn’t there, differentiating them from
negative symptoms like anhedonia or social withdrawal.
2. A nurse is assessing a patient with schizophrenia who reports hearing voices telling them
to harm themselves. What is the priority nursing intervention?
A. Ask the patient to ignore the voices
B. Initiate safety protocols and notify the healthcare provider immediately
C. Reassure the patient that the voices are not real
D. Distract the patient with music or television
Correct Answer: B. Initiate safety protocols and notify the healthcare provider immediately
Rationale: Command hallucinations can pose a serious risk. Safety is the priority, and the
healthcare team must be notified.
3. What neurotransmitter is primarily associated with the development of schizophrenia?
, 3
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Correct Answer: B. Dopamine
Rationale: Schizophrenia is linked to increased dopamine activity in certain brain regions.
Dopamine antagonists help manage psychotic symptoms.
4. Which subtype of schizophrenia is characterized by prominent delusions or auditory
hallucinations with relatively preserved cognition and affect?
A. Paranoid schizophrenia
B. Disorganized schizophrenia
C. Catatonic schizophrenia
D. Undifferentiated schizophrenia
Correct Answer: A. Paranoid schizophrenia
Rationale: Paranoid schizophrenia involves well-formed delusions and auditory
hallucinations without significant disorganized behavior or affect.
5. A patient with delusional disorder believes their neighbor is secretly an FBI agent spying
on them. This belief has persisted for over a year without other symptoms. What type of
delusion is this?
A. Erotomanic
B. Persecutory
C. Grandiose
D. Somatic
, 4
Correct Answer: B. Persecutory
Rationale: Persecutory delusions involve beliefs that one is being conspired against or
harassed.
6. Which of the following best describes a negative symptom of schizophrenia?
A. Avolition
B. Hallucinations
C. Delusions
D. Agitation
Correct Answer: A. Avolition
Rationale: Avolition, or lack of motivation, is a negative symptom. Positive symptoms
include hallucinations and delusions.
7. Which of the following assessment findings would indicate disorganized schizophrenia?
A. A fixed, false belief
B. Incoherent speech and inappropriate affect
C. Catatonic posturing
D. Delusional jealousy
Correct Answer: B. Incoherent speech and inappropriate affect
Rationale: Disorganized schizophrenia presents with disorganized thoughts, speech, and
behaviors, along with inappropriate emotional responses.
8. What distinguishes delusional disorder from schizophrenia?
A. Presence of hallucinations
