RN Nursing · Psychotic Disorders — Schizophrenia · Practice question
A nurse is caring for a client who has schizophrenia. Which of the following findings indicates that the client is in the prodromal phase?
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Withdrawn behavior
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Incoherent speech
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Severe delusions
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Frequent hallucinations
Answer & explanation
Correct: Withdrawn behavior
The prodromal phase of schizophrenia occurs before the first full psychotic episode and is characterized by subtle, nonspecific changes in behavior and functioning. Withdrawn behavior, social isolation, declining school or work performance, odd thinking, and mild perceptual disturbances are hallmarks of this early phase. The individual has not yet developed the florid positive symptoms that define active schizophrenia. Incoherent speech, severe delusions, and frequent hallucinations are all positive symptoms associated with the active or acute phase of schizophrenia, not the prodromal phase. During the prodromal period, these psychotic symptoms are either absent or present only in very attenuated forms. Nurses must recognize prodromal signs because early intervention during this phase is associated with better long-term outcomes. Withdrawn behavior is the best indicator here because social withdrawal is one of the most consistently documented early warning signs before a psychotic break occurs. Students often confuse the prodromal phase with either the residual phase (which follows an acute episode) or the active phase. The key distinction is timing and severity: prodromal symptoms are mild and precede the first full psychotic episode, making withdrawn behavior the only option that fits this description.
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