RML MAINS 2025
Mental Health Nursing
Easy
Hallucinations and delusions are commonly seen in:
Appeared in: RML MAINS 2025
Explanation
- Hallucinations (false sensory perceptions) and delusions (fixed, false beliefs) are the hallmark positive symptoms of schizophrenia.
- According to diagnostic criteria, the presence of these symptoms is central to making a diagnosis of schizophrenia.
- Auditory hallucinations, such as hearing voices that are not there, are particularly characteristic of this disorder.
- Delusions in schizophrenia are often bizarre and can involve themes of persecution, grandiosity, or control (e.g., thought insertion or withdrawal).
Why Other Options Were Wrong
- Option A: Depression is primarily a mood disorder. While psychotic features can occur in severe cases (Major Depressive Disorder with Psychotic Features), they are not a common or defining characteristic of depression in general.
- Option C: Anxiety neurosis (an older term for anxiety disorders) is characterized by excessive fear, worry, and panic. Reality testing remains intact, and psychotic symptoms like hallucinations and delusions are not a feature of this condition.
- Option D: Dementia is a neurocognitive disorder defined by significant cognitive decline, especially memory loss. While delusions (often paranoid, like theft) and hallucinations (more commonly visual) can occur, they are typically seen in later stages and are secondary to the primary cognitive impairment.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The question tests the knowledge of the characteristic symptoms of major psychiatric disorders, specifically the prevalence of hallucinations and delusions as background academic context rather than a clinical decision trigger.
- Nurses must perform a thorough mental status examination to assess for the presence, type, and content of hallucinations and delusions.
- Patient safety is a top priority. Command hallucinations (voices telling the patient to harm themselves or others) or severe paranoid delusions require immediate risk assessment and safety interventions.
- Therapeutic communication is key. Nurses should acknowledge the patient's experience without arguing about or confirming the reality of the delusion or hallucination (e.g., "That must be very frightening," rather than "There's no one there.").
How to Approach the Question
- First, identify the keywords in the question stem: "Hallucinations" and "delusions."
- Recognize these as core psychotic symptoms, also known as 'positive symptoms'.
- Next, review the options provided, which are different psychiatric and neurocognitive disorders.
- Recall the primary features of each disorder. Schizophrenia is defined as a psychotic disorder. Depression is a mood disorder. Anxiety is characterized by fear/worry. Dementia is a cognitive disorder.
- Match the key symptoms (hallucinations and delusions) to the disorder where they are a primary, common, and defining feature.
- Conclude that schizophrenia is the best fit, as these symptoms are central to its diagnosis, unlike the other conditions where they are either absent, less common, or secondary features.
Concept Tested & Keywords
- Concept Tested: The question tests the knowledge of the characteristic symptoms of major psychiatric disorders, specifically the prevalence of hallucinations and delusions.
- Stem keywords: Hallucinations, delusions
- Lead-in keywords: commonly seen in
Question ID
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Reference Book
E6 Medicine Macleod Clinical Examination 15e p. 372-374
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 13421-13423, 13871-13873
Practise the full RML MAINS 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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