Schizophrenia: NCLEX Priorities
Positive vs negative symptoms, antipsychotics, EPS, NMS, therapeutic communication.
Schizophrenia is a thought disorder. NCLEX tests symptoms, meds, and communication.
Positive symptoms
Hallucinations, delusions, disorganized speech/behavior. Respond better to antipsychotics.
Negative symptoms
Flat affect, anhedonia, alogia, avolition. Harder to treat.
Meds
Atypicals first-line (lower EPS). Clozapine for treatment-resistant. Long-acting injectables for adherence.
Therapeutic communication
Don't argue with delusions/hallucinations. Don't reinforce them. Acknowledge feelings: 'The voices sound frightening.' Redirect to reality.
Frequently asked
Patient says 'I hear voices'?
Acknowledge. Ask if voices command harm. Reality test: 'I don't hear them, but I understand they're real to you.'
Anosognosia?
Lack of insight into illness. Common in schizophrenia. Affects adherence.
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