NCLEX RN Practice Question # 491

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What is Paranoid Disorders?  

  • Description
  • Paranoid disorder is a concrete, pervasive delusional system characterized by persecutory and grandiose beliefs.
  • The client exhibits suspiciousness and mistrust of others.
  • The client often is viewed by others as hostile, stubborn, and defensive.


  • Suspicious and mistrustful
  • Emotionally distant
  • Distortion of reality
  • Poor insight and poor judgments
  • Hypervigilance
  • Low self-esteem
  • Highly sensitive, difficulty in admitting own error, and taking pride in being correct
  • Hypercritical and intolerant of others
  • Hostile, aggressive, and quarrelsome
  • Evasive
  • Concrete thinking
  • Delusions
  • Delusions serve a purpose in establishing identity and self-esteem.
  • The client may have grandiose and persecutory delusions.
  • Process of delusion includes denial, projection, and rationalization.
  • As trust in others increases, the need for delusions decreases.

Types of paranoid disorders

  • Paranoid personality disorder (see later)
    • Suspicious
    • Nonpsychotic
    • No hallucinations or delusions
    • No symptoms of schizophrenia
  • Paranoia-induced state
    • Abrupt onset in response to stress; subsides when stress decreases
    • No hallucinations, but experiences paranoid delusions
    • May be sensitive and suspicious before the development of delusions


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