Question

the nurse is reviewing the chart of a psychotic patient admitted to the mental health unit. the patient is a 20-year-old male with a suspected diagnosis of schizophrenia. the nurse knows that which part of the patients history support the diagnosis of schizophrenia?

the patient has recently been smoking synthetic marijuana and drinking alcohol.
the patient has been able to function at school and work up until the past week.
the patient has been having hallucinations, delusions, and avolition for the past month.
the patient has been depressed, anxious, and suicidal for several weeks before being admitted.

Explanation:

Analyze diagnostic criteria for schizophrenia

According to DSM-5 diagnostic criteria, a diagnosis of schizophrenia requires the presence of at least two active-phase symptoms (such as delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms like avolition) for a significant portion of time during a 1-month period.

Evaluate the clinical options

• Option 1 describes substance use, which must be ruled out as the primary cause of psychosis rather than supporting a primary schizophrenia diagnosis.
• Option 2 describes a very brief duration of dysfunction (one week), which does not meet the chronic duration requirements.
• Option 3 directly identifies core positive symptoms (hallucinations, delusions) and a negative symptom (avolition) persisting for the required active-phase duration of one month.
• Option 4 describes mood and anxiety symptoms, which are indicative of depressive or anxiety disorders rather than the primary diagnostic criteria for schizophrenia.

Answer:

• (A) The patient has recently been smoking synthetic marijuana and drinking alcohol.
• (B) The patient has been able to function at school and work up until the past week.
• (C) The patient has been having hallucinations, delusions, and avolition for the past month. (Correct answer)
• (D) The patient has been depressed, anxious, and suicidal for several weeks before being admitted.