W4 Psychosis & Psychotic Disorders Flashcards
1
Q
What is psychosis?
A
An experience where a person has problems interpreting the world around them, possibly seeing or hearing things that others cannot or having unusual ideas or beliefs.
Definition provided by headspace, 2025
2
Q
What are the key features of psychotic disorders?
A
- Delusions
- Hallucinations
- Disorganized Thinking (Formal Thought Disorder)
- Grossly Disorganized or Abnormal Motor Behaviour
- Negative Symptoms
3
Q
What is a Brief Psychotic Disorder?
A
Sudden onset of psychotic symptoms lasting less than one month, with complete recovery common. Occurs in three forms: with obvious stressor, without stressor, postpartum onset.
4
Q
What characterizes Substance-Induced Psychosis?
A
Delusions and/or hallucinations due to substance use or withdrawal, with symptoms typically resolving after the substance leaves the body.
5
Q
At what age is schizophrenia typically diagnosed?
A
Between ages 16–30 following a first episode of psychosis.
6
Q
What are delusions?
A
Fixed, false beliefs not aligned with reality, with themes that may include persecutory, grandiose, somatic, religious, and referential.
7
Q
What are hallucinations?
A
Perceptual experiences with no external stimulus, which can be visual, auditory, tactile, gustatory, or olfactory.
8
Q
What is disorganized thinking?
A
Characterized by abrupt topic shifts (derailment) and irrelevant responses (tangentiality).
9
Q
What are negative symptoms in psychotic disorders?
A
Symptoms common in schizophrenia, including diminished emotional expression and avolition, in contrast to positive symptoms like delusions and hallucinations.
10
Q
What are the key assessment domains for psychotic disorders?
A
- History
- Mental State Exam
- Biological
- Cognitive
- Screening for Comorbidity
- Risk Assessment
11
Q
What role do Mental Health Nurses (MHNs) play in the treatment of psychotic disorders?
A
They play a key role in care coordination.
12
Q
What are some key components of treatment for psychotic disorders?
A
- Case management
- Psychological therapy
- Medication
- Family/group therapy programs
- Vocational/educational support services
13
Q
True or False: Early detection of psychotic disorders improves functional outcomes and long-term recovery.
A
True
14
Q
What should nurses do when communicating with a person experiencing delusions?
A
Do not argue with delusions; validate the person’s experience while gently offering reality.
15
Q
What are some nursing interventions for psychosis?
A
- Establish trust and rapport
- Monitor symptoms and response to treatment
- Educate the person and family
- Encourage medication adherence
- Promote recovery-oriented care
16
Q
Fill in the blank: The first psychotic episodes often occur in the late teens to _______.
A
mid-20s
17
Q
What is the common misunderstanding regarding schizophrenia?
A
It is often the most misunderstood mental illness.
18
Q
What are the screening tools for assessing psychotic disorders?
A
Use available tools and guidelines, with specific examples outlined in clinical practice resources.
19
Q
What are the main characteristics of psychosis and schizophrenia?
A
Symptoms causing disconnection or misinterpretation of reality, including hallucinations, delusions, disorganized thinking and speech, and poor insight.
20
Q
Can psychosis occur without a diagnosis of schizophrenia?
A
Yes, it can occur in individuals with other mental health conditions or experiences of distress.
21
Q
What are some mental health conditions that may include psychotic symptoms?
A
- Bipolar disorder
- Depression
- Borderline personality disorder
22
Q
What medical conditions can present with psychosis?
A
- Delirium
- Substance use
- Extreme stress
- Trauma
23
Q
According to the DSM 5, what is a criterion for diagnosing schizophrenia?
A
Presence of psychotic symptoms for most days within a one month period.
24
Q
What are the learning objectives for the schizophrenia lecture?
A
- Describe features of schizophrenia
- Identify main signs and symptoms
- Distinguish between positive and negative symptoms
- Apply nursing considerations and interventions
25
What is known about the exact cause of schizophrenia?
The exact cause is unknown; it involves complex changes in brain function.
26
What is the prevalence of schizophrenia in Australia?
1 in 500 Australians; higher with family history.
27
What role do genetics play in schizophrenia?
No single gene is responsible; multiple genes increase risk.
28
What are common triggers for schizophrenia?
* Stress
* Hallucinogenic drug use
* Perinatal and childhood trauma
29
What are the key features of schizophrenia?
* Delusions
* Hallucinations
* Disorganized thinking (speech)
* Grossly disorganized or abnormal motor behavior
* Negative symptoms
30
What are positive symptoms of schizophrenia?
* Delusions
* Hallucinations
* Disorganized speech/behavior
31
What are negative symptoms of schizophrenia?
* Diminished emotional expression
* Avolition (lack of motivation)
32
What must be present for a schizophrenia diagnosis?
Symptoms must be present for more than 6 months.
33
What occurs during the prodromal phase of schizophrenia?
* Early signs in adolescence
* Social withdrawal
* Low-grade psychosis
* Decline in schooling/work/relationships
34
What characterizes the acute phase of schizophrenia?
Positive symptoms like hallucinations, delusions, and thought disorder.
35
What is the focus of treatment during the acute phase of schizophrenia?
Managing positive symptoms with antipsychotics.
36
What is the recovery phase of schizophrenia as per DSM-5-TR?
Terms like continuous, partial, or full remission are used (not 'chronic').
37
What percentage of individuals with schizophrenia make a full recovery?
Approximately 20%.
38
What are common comorbidities associated with schizophrenia?
* Substance use (tobacco, alcohol, cannabis)
* Mental health (anxiety, depression)
* Physical health (metabolic disorders, type 2 diabetes, cardiovascular disease)
39
What are first-line medications for schizophrenia?
Atypical antipsychotics.
40
What are the roles of mental health nurses (MHN) in managing schizophrenia?
* Administer medication
* Educate on effects/side effects
* Monitor response
* Collaborate in regular reviews
* Develop relapse prevention plans
41
What is an important aspect of nursing management for individuals with schizophrenia?
Building a Therapeutic Relationship (TR).
42
What should nurses do when dealing with a patient experiencing delusions?
Do not argue; validate the person's experience while gently offering reality.
43
What are some nursing interventions for schizophrenia?
* Symptom monitoring
* Medication education and support
* Encourage social engagement
* Support ADLs and routine
44
What is the summary of key points regarding schizophrenia?
* Complex mental illness with unknown exact causes
* Symptoms categorized into positive and negative
* Progresses through prodromal, acute, and recovery phases
* Treatment includes medication, rehabilitation, and nursing support
45
What is the purpose of a Mental State Exam (MSE)?
To assess the mental state of a person, especially those with schizophrenia or experiencing psychosis.
## Footnote
The MSE evaluates various aspects of mental health to provide a comprehensive picture of the individual's condition.
46
What should risk assessment differentiate between?
Long-term and acute risks.
## Footnote
This differentiation is crucial in understanding the immediate and future needs of the person being assessed.
47
What are command hallucinations?
Auditory hallucinations that instruct a person to perform specific actions.
## Footnote
These can pose significant risks to both the individual and others.
48
What risk is associated with substance use in psychosis?
Some people's psychosis may be linked to substance use, which can exacerbate symptoms and affect judgment.
## Footnote
It's essential to assess the impact of substances on the individual's mental health.
49
Why might individuals experiencing paranoia not adhere to medication?
They may believe the medication is harmful or poison.
## Footnote
Understanding the reasons for non-adherence is vital for effective treatment.
50
What is a common challenge in the experience of psychosis?
Everyone's experience of psychosis and schizophrenia is different.
## Footnote
This highlights the need for individualized assessment and treatment plans.
51
What general approaches should be taken when communicating with someone experiencing psychosis?
Acknowledge and validate the person's experience, explore what they are experiencing, avoid arguing, and be aware of non-verbal communication.
## Footnote
Effective communication can facilitate trust and support.
52
What is the importance of establishing therapeutic rapport?
It enhances the therapeutic relationship and supports the person's immediate needs.
## Footnote
Active listening and providing reassurance are key components.
53
What nursing consideration involves using targeted sensory input?
Sensory modulation.
## Footnote
This approach can help calm individuals experiencing psychosis or mental distress.
54
What role does education play in supporting families of individuals with psychosis?
It helps families understand symptoms, treatments, and strategies to support the individual.
## Footnote
Family involvement in care can enhance recovery outcomes.
55
What therapeutic approach uses music for interaction and expression?
Music therapy.
## Footnote
It has been found useful in reducing symptoms and improving quality of life in individuals with psychosis.
56
What are mixed effects observed with the use of CBT in schizophrenia?
CBT can decrease psychotic and affective symptoms but requires multiple sessions with a trained therapist.
## Footnote
The long-term nature of CBT makes it a significant commitment for patients.
57
Fill in the blank: Risk assessment should form part of the full assessment of a person's _______.
[need].
## Footnote
This comprehensive approach ensures that all aspects of an individual's health are considered.
58
True or False: Communication with a person experiencing psychosis should involve arguing about their experiences.
False.
## Footnote
Arguing can increase distress and hinder communication.
59
What are antipsychotic medications used to treat?
Psychotic disorders by acting on brain neurotransmitters
60
Do antipsychotic medications cure psychotic conditions?
No, they reduce symptoms but do not cure the condition
61
What are the two types of antipsychotics?
Typical antipsychotics and atypical antipsychotics
62
Which type of antipsychotics is rarely used in Australia today?
Typical antipsychotics
63
List three characteristics of atypical antipsychotics.
* Broader action
* Better side-effect profile
* Available in various forms (tablets, wafers, liquids, depot injections)
64
Why are antipsychotic medications important?
They are often the primary treatment for psychotic disorders like schizophrenia
65
What role do nurses play in the administration of antipsychotics?
Education, trust-building, and adherence support
66
What are the three main reasons for discontinuation of antipsychotic medication?
* Disagreement with diagnosis
* Lack of belief in medication efficacy
* Unpleasant or intolerable side effects
67
What is the role of the Mental Health Nurse (MHN) in medication management?
* Administer medication
* Monitor treatment effects and side effects
* Provide psychoeducation
* Collaborate in treatment reviews
68
List some common side effects of atypical antipsychotics.
* Weight gain
* Dry mouth
* Headache
* Constipation
* Urinary hesitancy
* Photophobia, sunburn
69
What are some central nervous system effects of atypical antipsychotics?
* Sedation
* Parkinsonian effects
* Akathisia
* Lowered seizure threshold
70
What are severe adverse reactions associated with atypical antipsychotics?
* Neuroleptic Malignant Syndrome (NMS)
* Tardive dyskinesia (TD)
* Dystonia
* Agranulocytosis
71
Name a common atypical antipsychotic and its brand name.
Olanzapine - Zyprexa
72
What is required for the use of Clozapine?
Regular blood monitoring
73
What is shared decision making (SDM) in the context of antipsychotic treatment?
Involves person, carers, and clinicians in treatment discussions to promote informed choice
74
True or False: Shared decision making includes the option not to proceed with treatment.
True
75
What do decision aids help explain in shared decision making?
* Benefits and risks
* Duration of treatment
* Person's values and preferences
76
What is a common concern regarding non-adherence to antipsychotics?
It is the primary cause of relapse into psychosis
77
Fill in the blank: Clozapine is more effective for treatment-resistant _______.
schizophrenia
78
What is the preferred therapy approach for antipsychotic treatment?
Monotherapy
79
What should Mental Health Nurses address to improve adherence?
* Side effects
* Education
* Premature cessation
* Insight into illness
80
List three common atypical antipsychotic medications.
* Olanzapine
* Risperidone
* Aripiprazole
81
Q1: What is psychosis primarily characterised by?
A. Difficulty sleeping
B. Problems interpreting reality
C. Memory loss
D. Hyperactivity
Q1: What is psychosis primarily characterised by?
A. Difficulty sleeping
B. Problems interpreting reality ✅
C. Memory loss
D. Hyperactivity
82
Q2: Which of the following is a key feature of schizophrenia?
A. High energy levels
B. Fixed, false beliefs (delusions)
C. Increased appetite
D. Mood swings only
Q2: Which of the following is a key feature of schizophrenia?
A. High energy levels
B. Fixed, false beliefs (delusions) ✅
C. Increased appetite
D. Mood swings only
83
Q3: Which term describes false sensory perceptions without external stimuli?
A. Obsessions
B. Hallucinations
C. Flashbacks
D. Illusions
Q3: Which term describes false sensory perceptions without external stimuli?
A. Obsessions
B. Hallucinations ✅
C. Flashbacks
D. Illusions
84
Q4: What is a common negative symptom of schizophrenia?
A. Hallucinations
B. Delusions
C. Avolition
D. Thought broadcasting
Q4: What is a common negative symptom of schizophrenia?
A. Hallucinations
B. Delusions
C. Avolition ✅
D. Thought broadcasting
85
Q5: What are delusions?
A. Vivid dreams
B. Fixed, false beliefs not aligned with reality
C. Thoughts that disappear
D. Misheard words
Q5: What are delusions?
A. Vivid dreams
B. Fixed, false beliefs not aligned with reality ✅
C. Thoughts that disappear
D. Misheard words
86
Q6: Disorganised speech may include:
A. Constant repetition
B. Tangentiality
C. Shouting
D. Muteness
Q6: Disorganised speech may include:
A. Constant repetition
B. Tangentiality ✅
C. Shouting
D. Muteness
87
Q7: Schizophrenia is typically diagnosed between what ages?
A. 10–15
B. 16–30
C. 40–60
D. After 65
Q7: Schizophrenia is typically diagnosed between what ages?
A. 10–15
B. 16–30 ✅
C. 40–60
D. After 65
88
Q8: What is the minimum symptom duration for schizophrenia diagnosis?
A. 1 week
B. 1 month
C. 3 months
D. 6 months
Q8: What is the minimum symptom duration for schizophrenia diagnosis?
A. 1 week
B. 1 month
C. 3 months
D. 6 months ✅
89
Q9: Which of the following is NOT a positive symptom?
A. Hallucinations
B. Disorganised speech
C. Avolition
D. Delusions
Q9: Which of the following is NOT a positive symptom?
A. Hallucinations
B. Disorganised speech
C. Avolition ✅
D. Delusions
90
Q10: What is the focus of nursing care during the acute phase of schizophrenia?
A. Building rapport
B. Treating positive symptoms
C. Developing independence
D. Career counselling
Q10: What is the focus of nursing care during the acute phase of schizophrenia?
A. Building rapport
B. Treating positive symptoms ✅
C. Developing independence
D. Career counselling
91
Q11: Which of the following is a prodromal symptom of schizophrenia?
A. Grandiosity
B. Severe hallucinations
C. Social withdrawal
D. Complete recovery
Q11: Which of the following is a prodromal symptom of schizophrenia?
A. Grandiosity
B. Severe hallucinations
C. Social withdrawal ✅
D. Complete recovery
92
Q12: What is the term for limited emotional expression in schizophrenia?
A. Elation
B. Avolition
C. Blunted affect
D. Paranoia
Q12: What is the term for limited emotional expression in schizophrenia?
A. Elation
B. Avolition
C. Blunted affect ✅
D. Paranoia
93
Q13: What is the role of the nurse when someone is experiencing a delusion?
A. Agree with the delusion
B. Challenge the belief
C. Validate the experience, offer reality
D. Avoid the person
Q13: What is the role of the nurse when someone is experiencing a delusion?
A. Agree with the delusion
B. Challenge the belief
C. Validate the experience, offer reality ✅
D. Avoid the person
94
Q14: What is the most common cause of psychotic relapse?
A. Medication side effects
B. Therapy
C. Medication non-adherence
D. Hospitalisation
Q14: What is the most common cause of psychotic relapse?
A. Medication side effects
B. Therapy
C. Medication non-adherence ✅
D. Hospitalisation
95
Q15: Atypical antipsychotics are preferred because they:
A. Are cheaper
B. Only treat positive symptoms
C. Are rarely used
D. Treat both positive and negative symptoms
Q15: Atypical antipsychotics are preferred because they:
A. Are cheaper
B. Only treat positive symptoms
C. Are rarely used
D. Treat both positive and negative symptoms ✅
96
Q16: What is a side effect of atypical antipsychotics?
A. Weight loss
B. Hair growth
C. Weight gain
D. Dry eyes
Q16: What is a side effect of atypical antipsychotics?
A. Weight loss
B. Hair growth
C. Weight gain ✅
D. Dry eyes
97
Q17: Which antipsychotic requires regular blood monitoring?
A. Olanzapine
B. Risperidone
C. Clozapine
D. Aripiprazole
Q17: Which antipsychotic requires regular blood monitoring?
A. Olanzapine
B. Risperidone
C. Clozapine ✅
D. Aripiprazole
98
Q18: What is Neuroleptic Malignant Syndrome?
A. Mild rash
B. Fatal side effect of antipsychotics
C. Eye twitch
D. Panic attack
Q18: What is Neuroleptic Malignant Syndrome?
A. Mild rash
B. Fatal side effect of antipsychotics ✅
C. Eye twitch
D. Panic attack
99
Q19: What is the best environment for someone with psychosis?
A. Bright and noisy
B. Stimulating and active
C. Quiet and low-stimulus
D. Isolated and dark
Q19: What is the best environment for someone with psychosis?
A. Bright and noisy
B. Stimulating and active
C. Quiet and low-stimulus ✅
D. Isolated and dark
100
Q20: What is shared decision making?
A. Doctor decides treatment
B. Family chooses care
C. Involves person, carers, and clinicians
D. Automatic medication orders
Q20: What is shared decision making?
A. Doctor decides treatment
B. Family chooses care
C. Involves person, carers, and clinicians ✅
D. Automatic medication orders
101
Q21: Which of the following is a form of psychosocial treatment?
A. Sedation
B. Surgery
C. Music therapy
D. Brain scan
Q21: Which of the following is a form of psychosocial treatment?
A. Sedation
B. Surgery
C. Music therapy ✅
D. Brain scan
102
Q22: What nursing action supports someone experiencing hallucinations?
A. Ignore them
B. Validate and provide distraction
C. Agree with hallucinations
D. Leave them alone
Q22: What nursing action supports someone experiencing hallucinations?
A. Ignore them
B. Validate and provide distraction ✅
C. Agree with hallucinations
D. Leave them alone
103
Q23: Substance use can cause which type of psychosis?
A. Organic
B. Brief
C. Schizophreniform
D. Substance-induced
Q23: Substance use can cause which type of psychosis?
A. Organic
B. Brief
C. Schizophreniform
D. Substance-induced ✅
104
Q24: How should nurses speak with someone experiencing psychosis?
A. Fast and loud
B. Short, simple, and slow
C. Complex and detailed
D. Emotionless and flat
Q24: How should nurses speak with someone experiencing psychosis?
A. Fast and loud
B. Short, simple, and slow ✅
C. Complex and detailed
D. Emotionless and flat
105
Q25: What is the prevalence of schizophrenia in Australia?
A. 1 in 1,000
B. 1 in 500
C. 1 in 50
D. 1 in 5
Q25: What is the prevalence of schizophrenia in Australia?
A. 1 in 1,000
B. 1 in 500 ✅
C. 1 in 50
D. 1 in 5
106
Q26: What are "command hallucinations"?
A. Visual hallucinations
B. Hallucinations that tell a person to act
C. Daydreams
D. Musical hallucinations
Q26: What are "command hallucinations"?
A. Visual hallucinations
B. Hallucinations that tell a person to act ✅
C. Daydreams
D. Musical hallucinations
107
Q27: Which symptom is more disabling long-term?
A. Positive
B. Negative
C. Acute
D. Delusional
Q27: Which symptom is more disabling long-term?
A. Positive
B. Negative ✅
C. Acute
D. Delusional
108
Q28: What type of thinking may involve derailment?
A. Logical
B. Disorganised
C. Focused
D. Depressed
Q28: What type of thinking may involve derailment?
A. Logical
B. Disorganised ✅
C. Focused
D. Depressed
109
Q29: CBT for schizophrenia is:
A. A cure
B. Ineffective
C. Always first-line
D. A long-term supportive therapy
Q29: CBT for schizophrenia is:
A. A cure
B. Ineffective
C. Always first-line
D. A long-term supportive therapy ✅
110
Q30: Which nursing strategy helps build a therapeutic relationship?
A. Avoiding eye contact
B. Touch without warning
C. Spending quiet time, even if unresponsive
D. Talking constantly
Q30: Which nursing strategy helps build a therapeutic relationship?
A. Avoiding eye contact
B. Touch without warning
C. Spending quiet time, even if unresponsive ✅
D. Talking constantly
111
Q31: When assessing risk, what should nurses consider?
A. Physical strength
B. Employment history
C. Acute and long-term risks
D. Family income
Q31: When assessing risk, what should nurses consider?
A. Physical strength
B. Employment history
C. Acute and long-term risks ✅
D. Family income
112
Q32: What is the nurse’s role in medication education?
A. Persuade at all costs
B. Avoid discussing side effects
C. Provide evidence-based information
D. Let the doctor explain everything
Q32: What is the nurse’s role in medication education?
A. Persuade at all costs
B. Avoid discussing side effects
C. Provide evidence-based information ✅
D. Let the doctor explain everything
113
Q33: In schizophrenia, disorganised behaviour may include:
A. Sleeping too much
B. Goal-directed exercise
C. Psychomotor agitation
D. Repetitive tics
Q33: In schizophrenia, disorganised behaviour may include:
A. Sleeping too much
B. Goal-directed exercise
C. Psychomotor agitation ✅
D. Repetitive tics
114
Q34: Who benefits from carer support staff?
A. Only nurses
B. Family and carers
C. Pharmacists
D. People with mild anxiety only
Q34: Who benefits from carer support staff?
A. Only nurses
B. Family and carers ✅
C. Pharmacists
D. People with mild anxiety only
115
Q35: What phase includes vague symptoms in adolescence?
A. Acute
B. Recovery
C. Prodromal
D. Chronic
Q35: What phase includes vague symptoms in adolescence?
A. Acute
B. Recovery
C. Prodromal ✅
D. Chronic
116
Q36: What is the purpose of sensory modulation?
A. Increase stimulation
B. Diagnose psychosis
C. Calm and reduce distress
D. Control the person
Q36: What is the purpose of sensory modulation?
A. Increase stimulation
B. Diagnose psychosis
C. Calm and reduce distress ✅
D. Control the person
117
Q37: Why is clozapine not commonly first-line?
A. Ineffective
B. Poor coverage
C. Requires blood monitoring
D. No available supply
Q37: Why is clozapine not commonly first-line?
A. Ineffective
B. Poor coverage
C. Requires blood monitoring ✅
D. No available supply
118
Q38: What is “word salad”?
A. Jumbled, incoherent speech
B. A healthy meal
C. A writing disorder
D. A memory lapse
Q38: What is “word salad”?
A. Jumbled, incoherent speech ✅
B. A healthy meal
C. A writing disorder
D. A memory lapse
119
Q39: How can music therapy help in schizophrenia?
A. Cure symptoms
B. Replace medication
C. Support symptom reduction and improve functioning
D. Cause hallucinations
Q39: How can music therapy help in schizophrenia?
A. Cure symptoms
B. Replace medication
C. Support symptom reduction and improve functioning ✅
D. Cause hallucinations
120
Q40: Nurses should support ADLs for people with schizophrenia because:
A. It’s part of hospital policy
B. They often need assistance
C. It keeps them busy
D. It prevents delusions
Q40: Nurses should support ADLs for people with schizophrenia because:
A. It’s part of hospital policy
B. They often need assistance ✅
C. It keeps them busy
D. It prevents delusions
