UP CHO - 2018
Mental Health Nursing (E5)
Easy
Mutism (speechlessness), negativism (negativism), waxy flexibility, bizarre posture and stupor are symptoms of.?
Appeared in: UP CHO - 2018
Explanation
- The symptoms listed in the question—mutism, negativism, waxy flexibility, bizarre posturing, and stupor—are hallmark diagnostic criteria for catatonia.
- Catatonic Schizophrenia is a subtype defined by extreme psychomotor disturbances.
- These symptoms specifically describe the state of catatonic stupor, where there is a marked decrease in reactivity and motor activity.
- Waxy flexibility, in particular, is a classic sign where the patient's limbs can be moved into a new position and will be held there for an extended time.
Why Other Options Were Wrong
- Option A: Hebephrenic (or Disorganized) Schizophrenia is primarily characterized by disorganized thought, speech, and behavior, along with flat or inappropriate emotions. It does not feature the profound motor disturbances like waxy flexibility or stupor.
- Option B: Paranoid Schizophrenia is defined by the presence of prominent delusions (often of persecution or grandeur) and auditory hallucinations, with relatively preserved cognitive functioning and affect. The listed motor symptoms are not characteristic of this subtype.
- Option D: Residual Schizophrenia is diagnosed when a person has a history of at least one schizophrenic episode but is currently not exhibiting prominent positive symptoms (like delusions, hallucinations, or catatonia). Instead, negative symptoms like emotional blunting, social withdrawal, and eccentric behavior are present.
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 subtypes of Schizophrenia as background academic context rather than a clinical decision trigger.
- Recognizing catatonia is a critical nursing skill as it indicates a severe psychiatric state that can have life-threatening physical complications.
- Patients in a catatonic stupor are at high risk for malnutrition, dehydration, pressure sores, and deep vein thrombosis due to immobility. Nurses must provide comprehensive physical care, including nutrition, hydration, and regular repositioning.
- Safety is a primary concern. While patients in a stupor are immobile, they can suddenly switch to a state of catatonic excitement, becoming agitated and potentially violent. The environment must be managed to ensure the safety of the patient and staff.
How to Approach the Question
- First, carefully read the list of symptoms provided in the question stem: mutism, negativism, waxy flexibility, bizarre posture, and stupor.
- Recognize that these are all related to motor function and reactivity to the environment.
- Systematically evaluate each option (schizophrenia subtype) based on its known primary characteristics.
- Hebephrenic (Disorganized) Schizophrenia is about disorganized thought and affect. This doesn't match.
- Paranoid Schizophrenia is about delusions and hallucinations. This doesn't match.
- Catatonic Schizophrenia is defined by these exact motor disturbances. This is a strong match.
Concept Tested & Keywords
- Concept Tested: Clinical features of different subtypes of Schizophrenia.
- Stem keywords: Mutism, negativism, waxy flexibility, bizarre posture, stupor
- Lead-in keywords: are symptoms of
- Negative lead-in flag: false
Question ID
QfyrfAJZhY-wnLUonbD49t
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 UP CHO - 2018
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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