A nurse is working with a client who is diagnosed with schizophrenia. During the admission assessment, the client says, “I’m just here to do undercover work. I’m the head of the FBI, I’ve worked closely with every president since Reagan.” This statement is an example of what symptom of schizophrenia?

Circumstantiality

Echolalia

Grandiose Delusions

Depersonalization

Magical Thinking

Answer and Explanation

The Correct Answer is C

A: Circumstantiality involves excessive and unnecessary detail in conversation, eventually reaching the point. It is not related to the content of the client’s statement, which is more about delusional thinking.

B: Echolalia is the repetition of another person’s spoken words. It does not apply to the client’s statement, which is an original delusional claim.

C: Grandiose delusions are false beliefs of exceptional abilities, wealth, or fame. The client’s claim of being the head of the FBI and working with presidents is a clear example of a grandiose delusion, reflecting an inflated sense of self-importance and unrealistic achievements.

D: Depersonalization involves feelings of detachment from oneself, as if observing oneself from outside the body. This symptom does not fit the client’s statement, which is more about delusional beliefs.

E: Magical thinking involves believing that one’s thoughts or actions can influence events in a way that defies the laws of cause and effect. The client’s statement does not reflect magical thinking but rather grandiose delusions.

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Correct Answer is B

Explanation

A: Impulsivity refers to acting on urges without considering consequences, which is a feature of borderline personality disorder but not the best description of the scenario.
B: Emotional lability, or rapid and intense mood swings, accurately describes the client’s behavior in the scenario.
C: Reaction formation involves behaving in a way that is opposite to one’s true feelings, which is not depicted in the scenario.
D: Splitting involves viewing people or situations as all good or all bad, which can be a feature of borderline personality disorder but is not the primary feature shown in the scenario.

A. “I’m thirsty, give me a drink of water.” B. “I punched him because he’s rude to us.” C. “I’m going to report you because this is an illegal use of restraints.” D. “If I say I’m sorry, would you let me out of here?”

Correct Answer is A

Explanation

A: This statement requires immediate attention because it indicates a basic need that must be addressed to ensure the patient’s well-being while in restraints.

B: This statement reflects the patient’s justification for their behavior but does not require immediate attention.

C: This statement indicates the patient’s intention to report the use of restraints but does not require immediate attention.

D: This statement reflects the patient’s attempt to negotiate release from restraints but does not indicate an immediate need.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A patient was placed in restraints after punching a staff member. Which statement by the patient requires the nurse’s immediate attention?

Correct Answer is A

Explanation

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