IGNOU PB Bsc Entrance-2022
Mental Health Nursing
Easy
Mutism, negativism, waxy flexibility and bizarre posture are characteristics of:
Appeared in: IGNOU PB Bsc Entrance-2022
Explanation
- The symptoms listed—mutism, negativism, waxy flexibility, and bizarre posture—are hallmark psychomotor disturbances that define Catatonic Schizophrenia.
- Catatonia involves a marked decrease in reactivity to the environment, manifesting as either extreme motor inhibition (stupor) or excessive, purposeless motor activity (excitement).
- Waxy flexibility (cerea flexibilitas) is a specific form of catalepsy where the patient's limbs offer slight, even resistance to being moved and then hold the new position.
- Negativism is an active resistance to instructions, while mutism is the absence of speech, both indicating a profound withdrawal from the external world.
Why Other Options Were Wrong
- Option A: Paranoid Schizophrenia is primarily characterized by positive symptoms like delusions of persecution or grandeur and auditory hallucinations, not the profound motor disturbances seen in catatonia.
- Option B: Hebephrenic (or Disorganized) Schizophrenia is defined by disorganized speech, disorganized behavior, and flat or inappropriate affect. The symptoms are chaotic rather than the structured motor patterns of catatonia.
- Option D: Residual Schizophrenia is diagnosed when the prominent positive symptoms (delusions, hallucinations, disorganized behavior) have subsided, but persistent negative symptoms (like blunted affect or social withdrawal) remain.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical features of different types of schizophrenia as background academic context rather than a clinical decision trigger.
- The primary nursing goal for a patient with catatonia is ensuring physiological safety and stability. Due to immobility and refusal to eat or drink, these patients are at high risk for malnutrition, dehydration, pressure ulcers, and deep vein thrombosis (DVT).
- Nurses must be vigilant for the potential of a rapid shift from a stuporous, immobile state to one of catatonic excitement, which involves agitated, purposeless motor activity that can be dangerous to the patient and others.
- What if? If a patient with waxy flexibility has their arm placed in an elevated position by another person and it remains there, the nursing priority is to gently and safely reposition the limb to a neutral, comfortable position to prevent circulatory impairment and muscle strain.
How to Approach the Question
- First, identify the key terms in the question stem: 'mutism,' 'negativism,' 'waxy flexibility,' and 'bizarre posture.'
- Recognize that these are all related to motor function and behavior (psychomotor symptoms).
- Next, review the options provided, which are different subtypes of schizophrenia.
- Systematically recall the defining characteristics of each subtype.
- Paranoid type is associated with delusions/hallucinations.
- Hebephrenic (Disorganized) type is associated with disorganized speech and affect.
Concept Tested & Keywords
- Concept Tested: Clinical features of different types of schizophrenia.
- Stem keywords: Mutism, negativism, waxy flexibility, bizarre posture, schizophrenia
- Lead-in keywords: characteristics of
- Negative lead-in flag: false
Question ID
QB7ZtSpZKgr9fLkGbT48Xg
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1102-1104, 1104-1106
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4738-4740
Practise the full IGNOU PB Bsc Entrance-2022
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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