A patient diagnosed with schizophrenia has auditory hallucinations, delusions of grandeur, poor personal hygiene, and threatening behavior. Which assessment finding would the nurse regard as a negative symptom of schizophrenia?

Auditory hallucinations.

Threatening behavior.

Delusions of grandeur.

Poor personal hygiene.

Answer and Explanation

The Correct Answer is D

Choice A reason: Auditory hallucinations are positive symptoms of schizophrenia, driven by mesolimbic dopamine excess, causing sensory perceptions without stimuli. They reflect hyperactive neural signaling, not the diminished motivation or functioning characteristic of negative symptoms, making this incorrect.

Choice B reason: Threatening behavior is a positive symptom, reflecting dopamine-driven impulsivity and agitation in schizophrenia’s mesolimbic pathway. Negative symptoms involve deficits like apathy, not active behaviors, making this choice unrelated to negative symptom criteria.

Choice C reason: Delusions of grandeur are positive symptoms, stemming from excessive dopamine in the mesolimbic system, causing exaggerated beliefs. Negative symptoms involve reduced emotional or behavioral expression, not active psychotic beliefs, making this choice incorrect.

Choice D reason: Poor personal hygiene is a negative symptom of schizophrenia, reflecting reduced motivation and self-care due to prefrontal cortex dopamine hypofunction. This deficit in volition and functioning aligns with negative symptoms, distinguishing it from positive symptoms like hallucinations.

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Correct Answer is B

Explanation

Choice A reason: Asking why may escalate agitation, as anger involves amygdala-driven norepinephrine surges. In a crowded area, this risks further overstimulation, not addressing the immediate need to reduce environmental triggers and stabilize neural hyperactivity for safety.

Choice B reason: Escorting to a quiet area reduces sensory input, calming amygdala-driven anger and norepinephrine release. This de-escalates the situation, engaging prefrontal cortex regulation to prevent further aggression, prioritizing safety in a crowded, stimulating environment.

Choice C reason: Discussing feelings is therapeutic but not the priority in a crowded area. Anger’s amygdala hyperactivity requires immediate de-escalation to reduce norepinephrine-driven impulsivity, making a quiet environment the first step before verbal processing.

Choice D reason: Demanding the patient pick up the table is confrontational, risking escalation of amygdala-driven aggression and norepinephrine surges. It does not address immediate safety or de-escalation needs, making it inappropriate in a volatile, crowded situation.

A. Cerebral atrophy of brain tissue. B. Organic functional changes in the brain. C. An inadequate amount of dopamine. D. Increased amount of dopamine.

Correct Answer is D

Explanation

Choice A reason: Cerebral atrophy is associated with neurodegenerative diseases, not schizophrenia’s positive symptoms. Hallucinations and delusions stem from dopamine hyperactivity in the mesolimbic pathway, not structural brain loss, making atrophy irrelevant to the acute psychotic symptoms described.

Choice B reason: Organic functional changes are vague and not specific to schizophrenia’s positive symptoms. Dopamine excess in the mesolimbic pathway drives hallucinations and delusions, not unspecified functional changes, making this choice too broad and inaccurate for the mechanism.

Choice C reason: Inadequate dopamine is linked to negative symptoms like apathy, due to prefrontal cortex hypofunction. Positive symptoms like hallucinations result from excessive dopamine in the mesolimbic pathway, making low dopamine an incorrect mechanism for these symptoms.

Choice D reason: Positive symptoms like hallucinations and delusions in schizophrenia result from increased dopamine in the mesolimbic pathway, causing hyperactive neural signaling. This dopamine excess overstimulates D2 receptors, leading to psychotic perceptions and beliefs, accurately explaining the neurological dysfunction.

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A patient diagnosed with schizophrenia has auditory hallucinations, delusions of grandeur, poor personal hygiene, and threatening behavior. Which assessment finding would the nurse regard as a negative symptom of schizophrenia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After being told that his family will not be attending visitation, a 70-year-old patient turns over a table in a crowded common area. Which action takes priority?

Correct Answer is B

Explanation

Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?

Correct Answer is D

Explanation

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