During the assessment stage, a client with schizophrenia leaves his arm in the air after the nurse has taken his blood pressure. His action shows an evidence of:

Appeared in: OSSSC Nursing Officer-2021

Explanation

Waxy flexibility is a psychomotor symptom characterized by a slight, even resistance to the positioning of a limb by an examiner, after which the limb remains in the position it was placed.
This phenomenon is a form of catalepsy and is a classic sign of catatonia, a behavioral syndrome that can be associated with schizophrenia.
The client's action of keeping their arm elevated in the same position after the blood pressure measurement is a textbook demonstration of waxy flexibility.

Why Other Options Were Wrong

Option A: Somatic delusions are a disturbance of thought content, not motor behavior. It involves a false belief about one's body.
Option C: Neologisms are a disorder of speech and thought process where a person invents new words. The client's action is non-verbal.
Option D: Nihilistic delusions are a disturbance of thought content involving the belief that one does not exist or is dead. This does not match the motor symptom described.

Related Visual

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Psychomotor symptoms in schizophrenia in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Nurses must be able to recognize signs of catatonia, such as waxy flexibility, as it indicates a serious psychiatric state and places the patient at risk for physical complications like deep vein thrombosis, pressure ulcers, and malnutrition due to immobility.
Prompt identification and reporting of catatonic symptoms are crucial for initiating timely and appropriate treatment, which may include benzodiazepines or electroconvulsive therapy (ECT), leading to better patient outcomes.
What if? - If the client actively resisted the nurse's attempt to move their arm back down (a symptom called negativism), it would still be a sign of catatonia. The nurse's priority would remain the same: ensure safety, monitor for complications of immobility, and report the finding.

How to Approach the Question

First, identify the key behavior described in the clinical scenario: a client's arm remains in the air after being positioned for a BP check.
Next, characterize this behavior. It is a non-verbal, physical sign involving motor function and posture.
Evaluate the given options to see which term correctly defines this specific motor sign.
Somatic and nihilistic delusions are disorders of thought content (beliefs), and neologisms are a disorder of speech (words). These do not describe a physical action.
Waxy flexibility is the precise medical term for the passive holding of a posture imposed by another person, which perfectly matches the scenario.

Concept Tested & Keywords

Concept Tested: Psychomotor symptoms in schizophrenia
Stem keywords: schizophrenia, assessment stage, leaves his arm in the air, blood pressure
Lead-in keywords: shows an evidence of
Negative lead-in flag: false

Question ID

QJz7JmB7rCGf4b6IUtF5ai

Reference Book

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1091-1093, 1090-1092

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 3306-3308

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