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41 Cards in this Set

  • Front
  • Back

Phase I of Schizophrenia

Premorbid phase

Social maladjustment

Antagonistic thoughts and behavior

Shy and withdrawn

Poor peer relationships

Doing poorly in school

Antisocial behavior

Phase II of Schizophrenia

Prodromal phase

Lasts from a few weeks to a few years

Deterioration in role functioning and social withdrawal

Substantial functional impairment

Sleep disturbance, anxiety, irritability

Depressed mood, poor concentration, fatigue

Perceptual abnormalities, ideas of reference, and suspiciousness herald onset of psychosis

Phase III of Schizophrenia


In the active phase of the disorder, psychotic symptoms are prominent



Impairment in work, social relations, and


Phase IV of Schizophrenia

Residual phase

Symptoms similar to those of the prodromal phase

Flat affect and impairment in role functioning are prominent

Delusional Disorder

Characterized by the presence of delusions that have been experienced by the individual for at least 1 month

Types: Grandiose, Jealous, persecutory, somatic

Brief Psychotic disorder

Sudden onset of psychotic symptoms that may or may not be preceded by a severe psychosocial stressor

lasts less than one month

Substance induced psychotic disorder

The prominent hallucinations and delusions associated with this disorder are found to be directly attributable to substance intoxication or withdrawal or after exposure to a medication or toxin

The catatonic features specifier

Catatonic features may be associated with other psychotic disorders

Stupor and muscle rigidity or excessive, purposeless motor activity

Waxy flexibility, negativism, echolalia, echopraxia

Schizophreniform Disorder

Same symptoms as schizophrenia

duration at least 1 month > 6 months

Schizoaffective Disorder

Schizophrenic symptoms plus mania or depression

1. A client is admitted with a diagnosis of brief psychotic disorder, with catatonic features. Which symptoms are associated with the catatonic specifier?

a) Strong ego boundaries and abstract thinking

b) Ataxia and akinesia

c) Stupor, muscle rigidity, and negativism

d) Substance abuse and cachexia

Correct answer: C

Symptoms associated with the catatonic specifier include stupor and muscle rigidity or excessive, purposeless motor activity. Waxy flexibility, negativism, echolalia, and echopraxia are also common behaviors.


False personal beliefs


Excessive demonstration of obsession with religious ideas and behavior


Extreme suspiciousness of others

Magical Thinking

Ideas that one's thoughts or behaviors have control over specific situations

Associative looseness (loose association)

Shift in ideas from one unrelated topic to another


Made-up words that have meaning only to the person who invents them

Concrete thinking

Literal interpretations of the environment

Clang Associations

Choice of words is governed by sound (often rhyming)

Word Salad

Group of words put together randomly


Delay in reaching the point of communication due to unnecessary and tedious details


Inability to get to the point of communication due to introduction of many new topics


Inability or refusal to speak


persistent repetition of the same word or idea in response to different questions

2. The client hears the word “match.” The client replies, “A match. I like matches. They are the light of the world. God will light the world. Let your light so shine.” Which communication pattern does the nurse identify?

a) Word salad

b) Clang association

c) Loose association

d) Ideas of reference

Correct answer: C

Loose association is characterized by communication in which ideas shift from one unrelated topic to another. The situation in the question represents this communication pattern.


False sensory perceptions not associated with real external stimuli







Misperceptions of real external stimuli


Repeating words that are heard


Repeating movements that are observed

Identification and imitation

Taking on the form of behavior one observes in another


Feelings of unreality

Negative Symptoms

Loss of normal function


The feeling state or emotional tone

Inappropriate affect: emotions are incongruent with the circumstances

Bland: weak emotional tone

Flat: appears to be void of emotional tone

Apathy: disinterest in the environment


Impaired ability to initiate goal-directed activity

Emotional ambivalence

Deterioration in appearance

Impaired interpersonal functioning

Impaired social interaction

clinging and intruding on the personal space of others

exhibiting behaviors that are not culturally and socially acceptable

Social isolation

Focus inward and exclusion of external environment

Psychomotor behavior

Anergia: deficiency of energy

Waxy flexibility

Posturing: voluntary assumption of inappropriate or bizarre postures

Pacing and rocking

Associated features

Anhedonia: inability to experience pleasure

Regression: retreat to an earlier level of development

4. To deal with a client's hallucinations therapeutically, which nursing intervention should be implemented?

a) Reinforce the perceptual distortions until the client develops new defenses

b) Provide an unstructured environment

c) Avoid making connections between anxiety-producing situations and hallucinations

d) Distract the client's attention

Correct answer: D

The nurse should first empathize with the client by focusing on feelings generated by the hallucination, present objective reality, and then distract or redirect the client to reality-based activities.

5. A client, diagnosed with paranoid schizophrenia, states, “My roommate is plotting to have others kill me.” Which is the appropriate nursing response?

a) “I find that hard to believe.”

b) “What would make you think such a thing?”

c) “I know your roommate. He would do no such thing.”

d) “I can see why you feel that way.”

Correct answer: A

This client is experiencing a persecutory delusion. This nursing response is an example of “voicing doubt,” which expresses uncertainty as to the reality of the client’s perceptions. This is an appropriate therapeutic communication technique in dealing with clients who are experiencing delusional thinking.

Typical Antipsychotics


Greater EPS SE: tardive dyskanisia, dystonia, ataksia, parkinsonism

EPS reversal: Cogentin and benadryl

Atypical Antipsychotics



Treats positive and negative symptoms of Schizophrenia

6. A client who has been taking chlorpromazine (Thorazine) for several months presents in the ED with extrapyramidal symptoms (EPS) of restlessness, drooling, and tremors. What medication will the nurse expect the physician to order?

a) Paroxetine (Paxil)

b) Carbamazepine (Tegretol)

c) Benztropine (Cogentin)

d) Lorazepam (Ativan)

Correct answer: C

Benztropine is an anticholinergic medication that blocks cholinergic activity in the central nervous system, which is responsible for EPS. Anticholinergics are the drugs of choice to treat extrapyramidal symptoms associated with antipsychotic medications.