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 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, or 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 is an exclusion criterion if symptoms are solely due to physiological effects of a substance.
• Option 2 describes a very short duration of dysfunction (one week), which does not meet the required timeline.
• 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 symptoms (depression, anxiety, suicidality) rather than the primary psychotic symptoms characteristic of schizophrenia.

Answer:

• 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. (Correct answer)
• The patient has been depressed, anxious, and suicidal for several weeks before being admitted.