Chapter 23

A client with schizophrenia is prescribed antipsychotic therapy. When developing the plan of care for the client, the nurse integrates understanding that the client is at risk for extrapyramidal syndrome. The nurse would expect to assess the client for this adverse reaction at which time? A) Once a week B) At the initiation of therapy C) When the dose is reduced D) Every 3 months E) When the dose is increased

Ans: B, C, E

When describing tardive dyskinesia (TD) associated with the use of antipsychotic medication, which of the following would the nurse integrate into the teaching plan? Select all that apply. A) TD is an early-appearing adverse reaction. B) TD involves rhythmic, involuntary movements of the facial structures. C) TD is a reversible adverse effect of antipsychotic drugs. D) TD is less likely to occur with the use of atypical psychotics. E) TD can occur after discontinuation of antipsychotic drug therapy.

Ans: B, D, E

A nurse should be able to differentiate between the typical and atypical antipsychotics. Which of the following would the nurse identify as an atypical antipsychotic? Select all that apply. A) Lithium (Eskalith) B) Aripiprazole (Abilify) C) Chlorpromazine (Thorazine) D) Prochlorperazine (Compazine) E) Clozapine (Clozaril)

Ans: B, E

A nurse assesses a client receiving antipsychotic drugs for which of the following adverse reactions? A) Hypertension B) Skin dryness C) Dry mouth D) Bradycardia

Ans: C

A nurse observes rhythmic, involuntary facial movements in a client who has been receiving antipsychotic drugs. The client also makes chewing movements and, at times, his tongue protrudes. The nurse interprets these findings as which of the following? A) Stevens-Johnson syndrome B) Neuroleptic malignant syndrome C) Tardive dyskinesia D) Extrapyramidal syndrome

Ans: C

After administering an antipsychotic to a client, the nurse would immediately report which of the following? A) Orthostatic hypotension B) Dry mouth C) Rigidity D) Drowsiness

Ans: C

Antipsychotic therapy with a conventional antipsychotic has been started for a client with schizophrenia. Assessment reveals that the client is experiencing drowsiness that is affecting his ability to function. The nurse notes that the client needs assistance with his activities of daily living and ambulating. Which nursing diagnosis would the nurse most likely identify? A) Risk for Infection B) Risk for Unstable Blood Glucose Level C) Risk for Injury D) Impaired Physical Mobility

Ans: C

A client is prescribed an antipsychotic drug that also has an antiemetic effect. Which of the following would the nurse identify as having this effect? Select all that apply. A) Lithium (Eskalith) B) Aripiprazole (Abilify) C) Chlorpromazine (Thorazine) D) Prochlorperazine (Compazine) E) Clozapine (Clozaril)

Ans: C, D

After teaching a group of nursing students about antipsychotics, the instructor determines that the teaching was successful when the students identify which of the following as a typical antipsychotic? Select all that apply. A) Lithium (Eskalith) B) Aripiprazole (Abilify) C) Chlorpromazine (Thorazine) D) Haloperidol (Haldol) E) Fluphenazine (Prolixin)

Ans: C, D, E

A nurse is caring for a client with schizophrenia. The physician has prescribed olanzapine in a disintegrating tablet form for the client. Which of the following points should the nurse include in the teaching plan for the client? A) Remove the tablet with dry hands. B) Take the tablet with a full glass of water. C) Add extra salt to food. D) Avoid tea or coffee.

Ans: A

The nurse is providing care to a client receiving clozapine (Clozaril). The nurse would be alert for an increased risk of bone marrow suppression if the client is also receiving which of the following? Select all that apply. A) Immunological agents B) Anticholinergics C) Opioids D) Anticoagulants

Ans: A

After teaching a group of nursing students about antipsychotic drugs, the instructor determines that the teaching was successful when the students identify aripiprazole (Abilify) as exerting its effect on which of the following in the brain? Select all that apply. A) Serotonin B) Dopamine C) Norepinephrine D) Muscarinic E) Nicotinic

Ans: A, B

When administering antipsychotic drugs, the nurse would need to keep in mind that which of the following atypical antipsychotics are most commonly associated with weight gain? Select all that apply. A) Olanzapine (Zyprexa) B) Risperidone (Risperdal) C) Ziprasidone (Geodon) D) Quetiapine (Seroquel) E) Clozapine (Clozaril)

Ans: A, B

A client is receiving antipsychotic therapy. As part of the client's plan of care, the nurse assesses the client for possible adverse reactions. Which of the following would lead the nurse to suspect that the client is experiencing extrapyramidal effects? Select all that apply. A) Mask-like facial appearance B) Increased motor activity C) Facial grimacing D) Delusions E) Flat affect

Ans: A, B, C

Which of the following are reasons a nurse may need to contact the client's physician to administer an antipsychotic drug intramuscularly instead of orally? Select all that apply. A) Client is combative. B) Client refuses the medication. C) Client won't allow the nurse to inspect the oral cavity. D) Client has difficulty swallowing. E) Client is elderly.

Ans: A, B, C

The nurse is providing care to an older adult who is receiving antipsychotic therapy. The primary health care provider prescribes an oral liquid concentrate. When administering the drug, the nurse would mix the drug with which of the following? Select all that apply. A) Fruit juice B) Milk C) Pudding D) Soup E) Green leafy vegetables

Ans: A, B, C, D

Before administering a prescribed antipsychotic drug to a client, the nurse observes the client for any behavior patterns that appear to be deviations from normal. Which of the following would the nurse identify as a deviation? Select all that apply. A) Poor eye contact B) Monotone speech pattern C) Inappropriate laughter D) Failure to answer questions completely E) Inappropriate crying

Ans: A, B, C, D, E

A nurse would assess a client treated with an antipsychotic medication for which of the following behaviors if the antipsychotic medication was stopped? Select all that apply. A) Hallucinations B) Anhedonia C) Delusions D) Dystonia E) Flattened affect

Ans: A, B, C, E

When teaching a client who is to receive antipsychotic therapy, the nurse would include which of the following as a common skin reaction that might occur when initiating therapy? Select all that apply. A) Urticaria B) Stevens-Johnson syndrome C) Photosensitivity D) Hyperpigmentation E) Toxic epidermal necrolysis

Ans: A, C

When assessing a client receiving antipsychotic drugs, the nurse would suspect that the client is experiencing extrapyramidal syndrome (EPS) based on assessment of which of the following? Select all that apply. A) Fine tremor B) Hypotension C) Akathisia D) Anhedonia E) Dystonia

Ans: A, C, E

A nurse is administering haloperidol to a client with schizophrenia. The nurse determines that the drug is effective when there is improvement in which of the following? Select all that apply. A) Agitation B) Alogia C) Concrete thinking D) Delusions E) Hallucinations

Ans: A, D, E

A client comes to the emergency department and tells the nurse, "I've been hiccoughing constantly for the past 6 or 7 hours and nothing I do to stop them seems to work." The nurse would expect the primary health care provider to prescribe which of the following? A) Prochlorperazine B) Chlorpromazine C) Haloperidol D) Olanzapine

Ans: B

A client is prescribed clozapine. The nurse instructs the client on the need for weekly laboratory testing for which of the following? A) Serum lithium B) WBC count C) Blood glucose D) pH level

Ans: B

A nurse is required to administer an antipsychotic agent parenterally. After administering the drug, the nurse would ensure that the client remains lying down for which time frame? A) 15 minutes B) 30 minutes C) 45 minutes D) 60 minutes

Ans: B

The caregiver of a client who is started on antipsychotic drug therapy asks the nurse when the client's symptoms will improve. Which response by the nurse would be most appropriate? A) "You should notice an improvement in the next day or two." B) "It might take about 6 weeks or so before the drug is most effective." C) "There's no way to tell but usually it takes about a week." D) "Look for movements of his face, mouth, or jaw and that's the sign."

Ans: B

A nurse caring for a client receiving clozapine (Clozaril) needs to be mindful of the symptoms that indicate bone marrow suppression. Assessment of which of the following would lead the nurse to suspect that the client is experiencing bone marrow suppression? Select all that apply. A) Hypertension B) Sore throat C) Fever D) Chills E) Weakness

Ans: B, C, D, E