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Mental Health and Psychiatric Disorders

Schizophrenia and Psychotic Disorders Practice Questions

20 free Schizophrenia and Psychotic Disorders practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.

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Question 1 of 20 Medium

According to the DSM‑5 criteria, for a diagnosis of Schizophrenia the person must have at least how many Criterion A symptoms and for what minimum duration?

  1. A One Criterion A symptom lasting at least one month in total
  2. B Two or more symptoms lasting at least one month (less if treated)
  3. C Three Criterion A symptoms lasting at least two weeks in total
  4. D One Criterion A symptom lasting at least six continuous months

Correct answer: Two or more symptoms lasting at least one month (less if treated)

The DSM-5 requires two or more of the defined symptoms (such as delusions, hallucinations, disorganized speech) for at least one month (or less if successfully treated) to diagnose schizophrenia.

Question 2 of 20 Easy

Which of the following is not one of the five domains of psychotic symptoms in the schizophrenia spectrum according to the DSM-5?

  1. A Brief Psychotic Disorder
  2. B Schizophrenia
  3. C Schizoaffective Disorder
  4. D Delusional Disorder

Correct answer: Brief Psychotic Disorder

Brief Psychotic Disorder involves full psychotic symptoms (delusions, hallucinations, disorganized speech) lasting at least one day but less than one month, with full return to prior functioning. Among the options, it is the only schizophrenia-spectrum disorder whose psychosis resolves in under six months; schizophrenia requires symptoms for at least six months.

Question 3 of 20 Medium

In the schizophrenia spectrum, which disorder is characterized by full psychotic symptoms lasting less than six months?

  1. A Brief Psychotic Disorder
  2. B Schizophrenia
  3. C Schizoaffective Disorder
  4. D Delusional Disorder

Correct answer: Brief Psychotic Disorder

Brief Psychotic Disorder involves psychotic symptoms (delusions, hallucinations) that last at least one day but less than one month, and can extend up to less than six months in some versions. (It falls under the schizophrenia spectrum category.)

Question 4 of 20 Easy

A client states “I hear voices commenting on my behaviour,” which of the following best describes this symptom?

  1. A A visual hallucination of seeing people or objects
  2. B An auditory hallucination of voices giving a running commentary
  3. C An obsessive, intrusive thought that recurs against the will
  4. D A depressive rumination on guilt and self-criticism

Correct answer: An auditory hallucination of voices giving a running commentary

Hearing voices commenting on one’s behaviour is an auditory hallucination often seen in schizophrenia and is one of the more distinctive Criterion A features.

Question 5 of 20 Medium

Which of the following correctly differentiates a delusion from a highly improbable belief?

  1. A A delusion is a false belief that is shared and accepted by the person's culture
  2. B A delusion is a fixed, false belief unchanged by logic or contradictory evidence
  3. C A delusion is a false belief that must always be accompanied by hearing voices
  4. D A delusion is a false belief that occurs only during episodes of mania

Correct answer: A delusion is a fixed, false belief unchanged by logic or contradictory evidence

Delusions are firmly held false beliefs that persist despite evidence to the contrary and are characteristic of psychotic disorders.

Question 6 of 20 Easy

Which symptom cluster in schizophrenia is represented by diminished emotional expression and avolition?

  1. A Positive symptoms
  2. B Negative symptoms
  3. C Cognitive symptoms
  4. D Mood symptoms

Correct answer: Negative symptoms

Negative symptoms involve reduction or loss of normal functions such as affective flattening, alogia (poverty of speech), and avolition (lack of motivation).

Question 7 of 20 Medium

A client exhibiting disorganized speech such as “word salad” is demonstrating which type of symptom?

  1. A A negative symptom such as flat affect or avolition
  2. B A mood symptom such as sadness or elation
  3. C Disorganized speech, a form of formal thought disorder
  4. D Catatonia, a disturbance of motor behavior

Correct answer: Disorganized speech, a form of formal thought disorder

Disorganized speech, such as incoherence or word salad, reflects a formal thought disorder typical of disorganized symptoms in schizophrenia.

Question 8 of 20 Easy

A diagnosis of schizoaffective disorder requires:

  1. A Psychotic symptoms occurring only during major mood episodes
  2. B Psychosis occurring apart from mood episodes, plus a lifetime major mood episode
  3. C Only depressive symptoms, with no psychotic features at any time
  4. D Psychotic symptoms that are directly induced by a substance or medication

Correct answer: Psychosis occurring apart from mood episodes, plus a lifetime major mood episode

Schizoaffective disorder is diagnosed when there are psychotic symptoms that occur outside of major mood episodes, and there has been a major mood episode (depressive or manic) in addition.

Question 9 of 20 Medium

Which of the following risk factors is most closely associated with schizophrenia?

  1. A Having one or more first-degree relatives with the disorder
  2. B Eating a diet that is consistently high in sugar and refined carbohydrates
  3. C Living at a high altitude with reduced atmospheric oxygen levels
  4. D Having chronic seasonal allergies to pollen and other allergens

Correct answer: Having one or more first-degree relatives with the disorder

A family history, especially first-degree relatives with schizophrenia, strongly increases risk; genetic factors are significant in its etiology.

Question 10 of 20 Medium

Catatonia may present with a variety of features. Which of the following would be consistent with catatonia?

  1. A Increased socialization
  2. B Waxy flexibility and mutism
  3. C Enhanced logical reasoning
  4. D Reduced appetite only

Correct answer: Waxy flexibility and mutism

Catatonia involves motor abnormalities such as waxy flexibility, stupor, mutism, and sometimes excessive movement, and can occur in schizophrenia spectrum disorders.

Question 11 of 20 Easy

In the context of group therapy for clients with psychotic disorders, which intervention is most appropriate initially?

  1. A Require detailed disclosure of hallucinations in the first session
  2. B Establish safety, trust, norms of confidentiality, and orientation to reality
  3. C Encourage avoidance of all experiences of hearing voices
  4. D Focus only on medication discussion and ignore group interaction

Correct answer: Establish safety, trust, norms of confidentiality, and orientation to reality

Establishing a safe and trusting environment with confidentiality and orientation is essential in group settings before deeper therapeutic work begins.

Question 12 of 20 Easy

Which of the following medications is considered a first-line treatment for schizophrenia spectrum disorders?

  1. A Selective serotonin reuptake inhibitor (SSRI)
  2. B Atypical antipsychotic medication
  3. C Benzodiazepine only
  4. D Mood stabilizer only

Correct answer: Atypical antipsychotic medication

Atypical antipsychotic medications (e.g., risperidone, olanzapine) are first-line treatments for schizophrenia spectrum disorders to manage positive and negative symptoms.

Question 13 of 20 Medium

When differentiating substance-induced psychotic disorder from primary psychotic disorder, which factor is most critical?

  1. A The specific type or content of the hallucinations experienced
  2. B The presence of a concomitant chronic medical illness in the client
  3. C Temporal link between substance use and psychosis onset, with resolution once the substance clears
  4. D The client's age at the time of first psychotic symptom onset

Correct answer: Temporal link between substance use and psychosis onset, with resolution once the substance clears

Substance-induced psychotic disorder requires that onset of psychotic symptoms follows substance use or withdrawal, and resolves once the substance is removed (while primary psychotic disorders persist).

Question 14 of 20 Medium

Which of the following describes the 'prodromal phase' of schizophrenia?

  1. A Acute, sudden onset of full-blown psychosis without warning signs
  2. B Subtle mood, cognitive, and behavioural changes with social withdrawal before the first psychotic episode
  3. C The recovery and reintegration phase after hospital discharge
  4. D Presence of only positive symptoms with no negative symptoms at all

Correct answer: Subtle mood, cognitive, and behavioural changes with social withdrawal before the first psychotic episode

The prodromal phase involves subtle symptoms like social withdrawal, mild cognitive changes and decreased functioning prior to first full psychotic episode.

Question 15 of 20 Medium

A client is experiencing flat affect, alogia, avolition, and social withdrawal for months. These symptoms imply:

  1. A Predominantly positive symptom profile
  2. B Predominantly negative symptom profile
  3. C A mood disorder only
  4. D A personality disorder exclusively

Correct answer: Predominantly negative symptom profile

Flat affect, poverty of speech (alogia), lack of motivation (avolition) and social withdrawal are negative symptoms characteristic of schizophrenia spectrum disorders.

Question 16 of 20 Medium

While facilitating a group for clients with schizophrenia spectrum disorders, a nurse notices one member becoming suspicious of other members. The best group-management response is:

  1. A Confront the client harshly about the suspicion in front of the whole group
  2. B Gently redirect the discussion, validate feelings, reinforce reality, and offer follow-up
  3. C Allow the suspicion to escalate unchecked while the group continues talking
  4. D Remove the client from the room immediately without any explanation given

Correct answer: Gently redirect the discussion, validate feelings, reinforce reality, and offer follow-up

The correct approach in group mental-health care is to validate the client’s feelings, re-orient to reality gently, redirect to safe discussion, and provide individual follow-up rather than confrontation or abrupt removal.

Question 17 of 20 Medium

Which of the following best characterizes delusional disorder?

  1. A Prominent persistent hallucinations occurring without any fixed delusional belief
  2. B One or more non-bizarre delusions for at least a month, without marked functional impairment
  3. C Psychosis accompanied by full-duration major mood episodes throughout the illness
  4. D Catatonic features only, occurring in the complete absence of any delusions

Correct answer: One or more non-bizarre delusions for at least a month, without marked functional impairment

Delusional disorder involves non-bizarre delusions (plausible but false) for at least one month, without marked overall impairment or prominent hallucinations beyond delusion theme.

Question 18 of 20 Medium

In schizophrenia spectrum disorders, which cognitive domain is especially affected and contributes significantly to functional impairment?

  1. A Language development only
  2. B Information processing, attention, working memory
  3. C Heart rate regulation
  4. D Color perception

Correct answer: Information processing, attention, working memory

Cognitive deficits such as impaired attention, working memory, and processing speed are common and worsen functional outcomes in schizophrenia.

Question 19 of 20 Medium

A client presents with psychotic symptoms lasting eight days which began after a major stressor. The symptoms then resolved fully. The most appropriate diagnosis is:

  1. A Schizophrenia
  2. B Brief Psychotic Disorder
  3. C Schizoaffective Disorder
  4. D Delusional Disorder

Correct answer: Brief Psychotic Disorder

Psychotic symptoms lasting less than one month (but more than one day) and resolving fit Brief Psychotic Disorder criteria under schizophrenia spectrum disorders.

Question 20 of 20 Easy

Which of the following is a valid nursing priority when caring for a client with a psychotic disorder?

  1. A Encourage the client to act on hallucinations to explore them
  2. B Assess for command hallucinations and risk of self-harm or harm to others
  3. C Ignore delusional beliefs as they will resolve automatically
  4. D Focus only on medication and ignore psychosocial interventions

Correct answer: Assess for command hallucinations and risk of self-harm or harm to others

Assessing for command hallucinations and violence risk is a nursing priority because psychotic symptoms can directly lead to self-harm or harm to others; comprehensive care includes psychosocial as well as pharmacologic interventions.

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