A patient reports that a television news anchor is secretly sending messages to me during a broadcast. This i… - NORCET 10 Prelims-2026

NORCET 10 Prelims-2026

Mental Health Nursing

Easy

Appeared in: NORCET 10 Prelims-2026

Explanation

A delusion of reference is characterized by the false belief that insignificant remarks, events, or objects in one's environment have personal meaning or significance.
The patient's belief that a television news anchor is sending them secret messages during a public broadcast perfectly fits this definition.
The key feature is the personalization of a neutral, public event, making it seem as if it is directed specifically at the individual.

Option B: A delusion of persecution involves the belief that one is being harmed, harassed, or conspired against. The patient in the scenario does not report feeling threatened or persecuted, only that they are receiving messages.
Option C: A delusion of grandeur is an exaggerated belief of one's own importance, power, or identity. Receiving a message does not inherently imply a sense of grandeur.
Option D: Thought broadcasting is the belief that one's own thoughts are being broadcasted out loud for others to hear. The scenario describes the patient receiving messages (an incoming process), not sending their own thoughts out (an outgoing process).

Visual 1: Flowchart: A flowchart illustrating the different categories of thought disorders, branching into delusions, and then further into specific types like reference, persecution, grandeur, etc., with brief definitions for each.

Clinical Relevance

Nursing practice connection: Use the key finding related to Identification of specific types of delusions in psychiatric nursing to guide bedside assessment, documentation, and the next nursing action.
Accurately identifying the type of delusion is a critical nursing skill for mental status assessment and helps in the diagnosis of conditions like schizophrenia, schizoaffective disorder, and delusional disorder.
Nursing interventions should focus on building trust and not directly challenging the delusion, which can increase agitation and paranoia. Instead, focus on the feelings associated with the belief (e.g., 'That must feel confusing').
What if? If the patient believed the news anchor was commanding them to harm themselves or others (a command hallucination, often linked with delusions), this would constitute a psychiatric emergency requiring immediate safety precautions and intervention to protect the patient and others.

How to Approach the Question

First, analyze the patient's statement to identify the core belief. The patient believes a public, neutral event (a news broadcast) has a secret, personal meaning for them.
Next, define each of the four options provided.
Delusion of reference: Believing neutral events have personal meaning.
Delusion of persecution: Believing one is being harmed or plotted against.
Delusion of grandeur: Believing one is exceptionally important or powerful.
Thought broadcasting: Believing one's own thoughts are being sent out to others.

Concept Tested & Keywords

Concept Tested: Identification of specific types of delusions in psychiatric nursing.
Stem keywords: patient reports, television news anchor, secretly sending messages, broadcast
Lead-in keywords: example of
Clinical cues: The patient's interpretation of a public broadcast as a personal, secret message is the key clinical cue pointing to a delusion of reference.

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