Question 1

A patient who has just been started on Haldol 5 mg po bid is complaining of a sudden painful stiff neck and jaw muscles. This is most likely&#10;A) Akinesia&#10;B) Akathisia&#10;C) Dystonia&#10;D) Somatization

Accepted Answer

The sudden onset of painful stiff neck and jaw muscles is a classic presentation of acute dystonia, which is a serious side effect of neuroleptic medications such as Haldol. Akinesia refers to the loss of voluntary movement, akathisia refers to restlessness and motor agitation, and somatization refers to the manifestation of psychological distress as physical symptoms.

Question 2

Brain imaging techniques have revealed which one of the following anatomic changes in some people with schizophrenia?&#10;A) Increased blood flow in the prefrontal area&#10;B) Increased ventricular size&#10;C) Increased brain activity in the frontal area&#10;D) Enlargement of the thalamus

Accepted Answer

Increased ventricular size has been repeatedly observed in brain imaging studies of people with schizophrenia, indicating a loss of brain tissue in certain areas. This is thought to be associated with the cognitive and functional impairments often seen in the disorder. The other options listed are not consistently associated with schizophrenia in brain imaging studies.

Question 3

When used for treatment of a patient with schizophrenia, typical antipsychotics could be expected to be most effective for which of the following symptoms?&#10;A) Social isolation&#10;B) Ineffective individual coping&#10;C) Hallucinations&#10;D) Lack of ability to make decisions

Accepted Answer

Typical antipsychotics are most effective in reducing positive symptoms of schizophrenia, including hallucinations. They have limited effectiveness on negative symptoms such as social isolation and lack of ability to make decisions. Ineffective individual coping may require a combination of therapy and medication.

Question 4

A patient states that she hears voices telling her that she should kill herself. The psychiatric advanced practice nurse states that the patient is&#10;A) Experiencing delusions&#10;B) Experiencing hallucinations&#10;C) Experiencing an aura&#10;D) Experiencing a dissociative state

Accepted Answer

Hearing voices that are not present is a symptom of hallucinations. The content of the voices, in this case telling the patient to harm herself, is consistent with auditory hallucinations in the context of a potential psychotic disorder.

Question 5

Men with schizophrenia have&#10;A) An older age of onset&#10;B) Fewer negative symptoms&#10;C) A more favorable premorbid history&#10;D) A less favorable course

Accepted Answer

Men with schizophrenia have a less favorable course, which means that they may experience more severe symptoms, more frequent relapses, and a poorer response to treatment. This may be due in part to the fact that men tend to have an earlier age of onset of the illness and are more likely to have negative symptoms like apathy, social withdrawal, and poverty of speech. Additionally, men with schizophrenia may be more likely to abuse drugs, which can worsen their symptoms and complicate their treatment.

Question 6

A patient who is being evaluated in the emergency room says that she is a mother deity, the earth mother god who is all-powerful. The psychiatric advanced practice nurse states that the patient is&#10;A) Experiencing a delusion&#10;B) Experiencing a hallucination&#10;C) Experiencing impaired impulse control&#10;D) Experiencing an acute stress reaction

Accepted Answer

The patient's belief that she is a mother deity is a false fixed belief that is not based in reality, which is characteristic of a delusion. A hallucination would involve sensory perceptions that are not based in reality, impaired impulse control is unrelated to the patient's reported symptoms, and an acute stress reaction typically involves physical and emotional symptoms such as increased heart rate or difficulty sleeping, rather than delusions or hallucinations.

Question 7

Which of the following features is associated with positive outcome among patients with schizophrenia?&#10;A) Younger age of onset&#10;B) Male gender&#10;C) Living in an industrialized country&#10;D) Having positive symptoms

Accepted Answer

Positive symptoms of schizophrenia, such as hallucinations and delusions, are often more responsive to treatment than negative symptoms (e.g., lack of emotion, social withdrawal), which can lead to a more positive outcome for patients.

Question 8

An atypical antipsychotic would be expected to work better than a typical antipsychotic for which of the following symptoms?&#10;A) Hallucinations&#10;B) Delusions&#10;C) Paranoia&#10;D) Cognitive dysfunction

Accepted Answer

Atypical antipsychotics are known to have a better effect on cognitive dysfunction, as they target both positive and negative symptoms of schizophrenia, while typical antipsychotics only target positive symptoms such as hallucinations and delusions. Therefore, the correct answer is D as it is related to negative symptoms such as cognitive impairment.

Question 9

Abnormalities of motor function characterized by a marked lack of motion or remaining in one posture are most characteristic of which subtype of schizophrenia?&#10;A) Paranoid&#10;B) Catatonic&#10;C) Disorganized&#10;D) Undifferentiated

Accepted Answer

Catatonic subtype of schizophrenia is characterized by abnormal motor function such as immobility, extreme negativism, posturing, and/or unresponsiveness.

Question 10

It has been suggested that reduced volume of the temporal lobe is related to&#10;A) Persistence of negative symptoms&#10;B) Severity of auditory hallucinations&#10;C) Deficits in working memory&#10;D) Impairment of motor coordination

Accepted Answer

Reduced volume of the temporal lobe has been associated with the severity of auditory hallucinations, as this region is involved in processing auditory information.

Deck 15: Schizophrenia and Schizoaffective Disorder