Adaptive Quizzing for Anti psychotic Agents

A patient with schizophrenia begins a course of first-generation antipsychotic medications. What should the nurse teach the patient? "Assess your weight daily." "Your blood pressure may increase significantly. " "Full effects of this drug may not be seen for 4 weeks or more." "Call the healthcare provider if you do not feel better right away."

"Full effects of this drug may not be seen for 4 weeks or more."

Which statement made by a patient demonstrates understanding of patient teaching regarding phenothiazine drug therapy? Select all that apply. "I need to change positions slowly to prevent dizziness." "This is an older drug and has very few risks of side effects." "I will need to wear sunscreen and protective clothing when outdoors." "It is okay to take this drug with a small glass of wine to help me relax." "I should call my provider if I notice any uncontrollable movements of my tongue."

"I need to change positions slowly to prevent dizziness." "I will need to wear sunscreen and protective clothing when outdoors." "I should call my provider if I notice any uncontrollable movements of my tongue."

A patient with schizophrenia presents to a clinic with a poorly healing leg ulcer and hyperglycemia. Which side effect of antipsychotic therapy would increase the patient's risk of this complication? Hypovolemia Metabolic syndrome Neuroleptic syndrome Extra pyramidal effects

Metabolic syndrome (Metabolic syndrome includes effects such as weight gain, increased blood glocse, diabetes, and dyslipidemia.)

The nurse administers slow-release haloperidol decanoate [Haldol] to a patient every 2 weeks. What precaution should the nurse take during this procedure? Use a 25-gauge needle to administer the drug. Administer by deep intramuscular (IM) injection. Keep the drug in a plastic syringe for 30 minutes. Ensure rotation of sites, and massage the site after injection.

Administer by deep intramuscular (IM) injection. (The nurse uses deep intramuscular (IM) injection to inject haloperidol decanoate [Haldol] into the deep muscles with a large-gauge needle because the drug irritates fat tissues. )

The nurse should assess a patient for what potentially fatal complication of clozapine [Clozaril] therapy? Agranulocytosis Self-destructive behavior Allergy to phenothiazines Failed antipsychotic therapy

Agranulocytosis (Clozapine [Clozaril] can cause potentially fatal agranulocytosis. Regular blood tests are mandatory, and the drug should be reserved for patients who have not responded to other antipsychotics.)

is restless and unable to stand still.

Akathisia

is restless and unable to stand still.

Tardive dyskinesia

A patient started on olanzapine [Zyprexa] should have what fact included in the teaching plan about this new medication? "There are no contraindications to this medication." "This medication does not carry a risk of any side effects." "This medication can cause angina. Please call your healthcare provider if you have chest pain." "This medication can cause sleepiness. You should not drive until you know how this medication affects you. "

"This medication can cause sleepiness. You should not drive until you know how this medication affects you. " (There is a risk of somnolence with this medication in a quarter of the patients who take it. Alpha adrenergic blockade also causes orthostatic hypotension. Constipation, leukopenia, and neutropenia are other potential side effects.)

The nurse is working with a 27-year-old female patient who has recently been started on a conventional antipsychotic. What is the nurse's highest priority instruction to the patient? "The drug causes osteoporosis." "This medication may cause menstrual irregularity." "This medication will cause spontaneous abortions." "This will cause severe fetal malformations if taken in the third trimester."

"This medication may cause menstrual irregularity." (Conventional antipsychotics are known to cause menstrual irregularities. It can also cause gynecomastia and galactorrhea, even in males. It is not associated with abortions or osteoporosis. Fetal malformations, if they occur, do so during the early development of the first trimester. When taken in the third trimester, first-generation antipsychotics can cause extrapyramidal symptoms (EPS) and withdrawal.)

The nurse is caring for a patient who is treated with phenothiazines. Which class of drugs reduces the efficacy of phenothiazines and should be avoided? Opioids Beta blockers Anticholinergics Thiazide diuretics

Anticholinergics (Anticholinergics reduce the efficacy of phenothiazines. Beta blockers cause additive effects with the drug. Thiazide diuretics reduce the clearance of the drug and cause drug accumulation. Opioids cause additive effects similar to that of beta blockers.)

The nurse is caring for a patient who is starting clozapine [Clozaril]. Which nursing intervention is a priority for this patient? Evaluate suicidal tendencies. Evaluate creatinine clearance. Take a baseline electroencephalography (EEG). Assess baseline white blood cell count and absolute neutrophil count.

Assess baseline white blood cell count and absolute neutrophil count. (Patients taking clozapine [Clozaril] must be monitored for the life-threatening side effect of agranulocytosis. A baseline white blood cell count and absolute neutrophil count must be taken. Patients started on this medication are chronically and severely ill.)

A patient receiving clozapine [Clozaril] is complaining of increased urination and thirst. What nursing intervention is essential for this patient? Holding the medication Assessing blood pressure Measuring potassium levels Assessing blood glucose level

Assessing blood glucose level (Clozapine [Clozaril] and other second-generation antipsychotics can cause obesity, diabetes, and dyslipidemia. Assessment of blood glucose level is essential for this patient. )

The nurse should teach a patient who is prescribed a neuroleptic to avoid what other medications? Aspirin Benzodiazepines Antidiarrheal medications Non-steroidal anti-inflammatory drugs

Benzodiazepines (Neuroleptics cause central nervous system depression that can be intensified with benzodiazepines.)

The patient with schizophrenia has tried several antipsychotic medications without success. The nurse would anticipate the provider prescribing which medication for this patient? Clozapine [Clozaril] Haloperidol [Haldol] Thiothixene [Navane] Fluphenazine [Prolixin]

Clozapine [Clozaril] (Clozapine is a second-generation antipsychotic (SGA) medication used to treat schizophrenia when other SGAs have failed. Haldol, Navane, and Prolixin are all first-generation antipsychotic medications and are used far less frequently than second-generation medications due to their adverse effects.)

Which laboratory test should be monitored frequently to assess for a potential life-threatening adverse reaction to clozapine [Clozaril]? Renal panel Liver function tests Complete blood count Immunoglobulin levels

Complete blood count

A patient is receiving thiothixene [Navane]. What symptoms indicate the patient may be having an adverse effect? Hives Convulsions Severe confusion Severe headaches

Convulsions (Adverse reactions to thiothixene [Navane] include convulsions, although rare. The other listed symptoms are not reported side effects. Other side effects include galactorrhea, gynecomastia, menstrual irregularity, sedation, orthostatic hypotension, and tardive dyskensia as well as dystonia, parkinsonism, and akathisia. )

The nurse is caring for a patient who has been prescribed haloperidol [Haldol]. What should the nurse teach the patient? Extrapyramidal reactions may occur. Expect to have cloudy urine while taking the medication. Take an antacid 1 hour before or after taking the medication. Take the medication on an empty stomach for quick absorption.

Extrapyramidal reactions may occur. (The nurse must teach the patient that extrapyramidal reactions including acute dystonia, parkinsonism, and akathisia occur frequently. Hypotension and sedation may occur infrequently.)

The nurse monitors a patient taking an antipsychotic medication for extrapyramidal side effects. What should the nurse assess for in the patient? Dystonia Orthostatic hypotension Dry mouth and constipation Neuroleptic malignant syndrome

Dystonia (Dystonia, an impairment of muscle tone, is the only extrapyramidal side effect listed. The other side effects also occur but are not extrapyramidal effects.)

Which interventions should the nurse implement for a patient who is prescribed a first-generation antipsychotic? Select all that apply. Instruct the patient to change positions slowly. Instruct the patient to avoid alcohol during therapy. Monitor the patient's weight to look for urinary retention. Teach relaxation methods after the drug is discontinued. Instruct the patient not to drive until the effects of the drug are known.

Instruct the patient to change positions slowly. Instruct the patient to avoid alcohol during therapy. Instruct the patient not to drive until the effects of the drug are known.

A patient is prescribed haloperidol [Haldol]. Why should the nurse ask the patient to avoid alcohol during therapy? It increases sedation. It increases toxicity. It decreases effects. It increases dystonia. `

It increases sedation. ( [Haldol] causes sedation by blocking dopamine receptors, which alters the effects of dopamine. When alcohol is consumed during therapy, the patient experiences increased sedation aloperidol [Haldol] increases toxicity when combined with anticholinergics. The effects of haloperidol [Haldol] are decreased when taken with phenobarbital, carbamazepine, and caffeine. Side effects of haloperidol [Haldol] may include extrapyramidal symptoms (EPS), such as dystonia. )

Which statement about aripiprazole [Abilify] would the nurse identify as true? Gynecomastia is a common adverse effect. It must be administered on an empty stomach. It is safe to use in older adult patients with dementia-related psychosis. It is the first representative of a unique class of antipsychotic drugs called dopamine system stabilizers.

It is the first representative of a unique class of antipsychotic drugs called dopamine system stabilizers. (Aripiprazole is well absorbed in the presence and absence of food, and gynecomastia is not a side effect. Increased mortality is seen when aripiprazole is used in the treatment of older adult patients with dementia-related psychosis.)

The nurse is monitoring a patient receiving ziprasidone [Geodon]. Which assessment findings indicate the medication should be stopped? Nausea Bruising Leg pain Low white blood cell (WBC) count

Low white blood cell count (Ziprasidone [Geodon] can cause leukopenia and neutropenia and increase the risk of infection. For patients at high risk, complete blood counts should be conducted often during the first few months of treatment.)

The nurse notes olanzapine [Zyprexa] on a patient's drug history upon admission. The nurse should plan to teach the patient about which disorder? Metabolic syndrome Paranoid schizophrenia Obsessive-compulsive disorder Schizophrenia positive symptoms

Metabolic syndrome (Olanzapine [Zyprexa] is approved for monotherapy of acute mania in patients with bipolar disorder. This drug has a high risk of metabolic effects, and patients should be taught about assessing for potential weight gain, diabetes, and dyslipidemia.)

The nurse is preparing to administer the aripiprazole [Abilify] extended-release 400-mg injection. The nurse is aware that this medication is scheduled to be given how often? Daily Weekly Monthly As needed

Monthly

Which is the most important benefit of a parenteral formulation of an antipsychotic medication? Patient consent for treatment is avoided. Parenteral administration is faster than oral administration. Parenteral formulation is more effective than oral formulations. Parenteral formulation improves adherence for acutely psychotic patients.

Parenteral formulation improves adherence for acutely psychotic patients.

Which assessment finding in a patient's history places the patient at greatest risk of seizures from antipsychotic agents? Smoking Headaches Cardiac disease Past history of seizures

Past history of seizures (Past history of seizures is the greatest risk factor for patients to develop seizures when taking antipsychotic agents. Patients may need anti-seizure medications.)

The nurse observes that a patient has hallucinations, delusions, and agitation. The nurse determines that the patient most likely will be treated for what condition? Depression Complex anxiety Positive symptoms of schizophrenia Negative symptoms of schizophrenia

Positive symptoms of schizophrenia (Hallucinations, delusions, and agitation, along with combativeness and paranoia, describe positive symptoms of schizophrenia.)

he nurse is caring for a patient who is receiving chlorpromazine. Which finding indicates to the nurse that the patient may be experiencing adverse effects? Increased urination Presence of seizures Elevated red blood cell (RBC) count Elevated white blood cell (WBC) count

Presence of seizures (The most common adverse effects are sedation, orthostatic hypotension, and anticholinergic effects. This medication lowers seizure thresholds, making the patient prone to seizures.)

s characterized by stooped posture, is a major side effect of typical antipsychotic drugs

Pseudoparkinsonism

A male patient tells the nurse that he wants to stop taking a first-generation agent for schizophrenia because of the sexual side effects. Which instruction should the nurse provide while educating the patient to help relieve the patient's sexual dysfunction? Change the medication. Decrease the drug dosage. Discontinue the medication. Report complaints to the psychiatrist

Report complaints to the psychiatrist (Drug induced sexual dysfunction can make treatment unacceptable. A reducton in dosage or switching to a different first-generation antipsychotic agent may reduce adverse sexual effects; however, the nurse cannot make dosage decisions. Therefore, the best answer is to report the patient's concerns to the psychiatrist, who can alter the drug schedule or dosage to reduce this problem.)

The nurse notes that the patient taking antipsychotics has difficulty sitting still. The patient reports feeling "restless." Which intervention is correct? Administer benztropine as ordered. Stay with the patient and offer reassurance. Request an order for a beta blocker, benzodiazepine, or anticholinergic drug. Stop the antipsychotic medication immediately and notify the healthcare provider.

Request an order for a beta blocker, benzodiazepine, or anticholinergic drug.

Which nursing diagnosis has the highest priority for an older adult patient who has received a first-generation antipsychotic? Risk for falls Risk for infection Risk for acute confusion Sleep pattern disturbance

Risk for falls

Thiothixene [Navane] has been prescribed for a patient. The nurse should recognize that the patient is most likely experiencing which condition?' Seizures Insomnia Schizophrenia Alcohol withdrawal

Schizophrenia (Thiothixene [Navane] is known to be effective in treating schizophrenia. This is the only approved use for this agent.)

The nurse monitors a patient during early treatment with typical antipsychotic agents. What sign or symptom in the patient would indicate acute dystonia? Stooped posture Spasms of the neck Inability to stand still Protrusion of the tongue

Spasms of the neck (Acute dystonia is an adverse extrapyramidal reaction that may occur during early treatment with typical antipsychotic agents. The patient develops spasms of the tongue, neck, face, and back.)

The nurse has just administered the first dose of haloperidol [Haldol] to a patient with schizophrenia. Which finding, if present, is the most important for the nurse to report to the healthcare provider before administering the next dose of medication? Fatigue Dry mouth Temperature of 102°F Blood pressure of 104/72 mm Hg

Temperature of 102°F (Sudden high fever is a symptom of neuroleptic malignant syndrome, a rare but serious complication of high-potency, first-generation antipsychotics such as haloperidol. The other findings are potential side effects of the drug but would not necessarily need to be reported to the healthcare provider.)

Which assessment finding indicates a patient may be having a common side effect of levodopa? Heart rate 88 beats/min The patient has delusions Blood pressure 90/50 mm Hg Respiratory rate 10 breaths/min

The patient has delusions. (Psychosis is a common side effect of levodopa use. Delusions are one symptom of psychosis. Vital sign changes do not signal a common side effect of levodopa therapy.)

The nurse is working with a patient who is receiving a low potency first-generation antipsychotic medication. What is the patient's risk for sedative effects from this medication? There is no risk for sedative effects. There is low risk for sedative effects. There is high risk for sedative effects. There is medium risk for sedative effects.

There is high risk for sedative effects.

The nurse is caring for a patient with dementia who is prescribed a neuroleptic. What is the primary indication for neuroleptics? To treat sleep disorders To supplement anesthesia To modify psychotic behavior To treat withdrawal symptoms

To modify psychotic behavior (A neuroleptic, or antipsychotic, is a drug that modifies psychotic behavior and exerts an antipsychotic effect. Some antipsychotics may also be used for anesthesia supplementation or conscious sedation. Antipsychotics are also used to treat symptoms of withdrawal from alcohol or other substances of abuse. )

Which should the nurse assess to determine whether a patient has metabolic effects from risperidone [Risperdal] therapy? Select all that apply. Weight Lipid profile Fasting blood glucose Complete blood count Kidney function studies

Weight Lipid profile Fasting blood glucose

The nurse is caring for a patient receiving clozapine [Clozaril]. Which assessment finding is most indicative of an adverse effect of this drug? Bilirubin level of 2.5 mg/dL Blood glucose level of 60 mg/dL White blood cell (WBC) count of 2000/mm3 Blood urea nitrogen (BUN) level of 25 mg/dL

White blood cell (WBC) count of 2000/mm3 (Clozapine, an atypical antipsychotic, carries a risk of fatal agranulocytosis. For this reason, the WBC count should be monitored and should be greater than 3500/mm3. Renal function (blood urea nitrogen) should not be affected by clozapine. Clozapine may cause metabolic effects including diabetes that would result in an increased blood glucose level (greater than 110 mg/dL). Elevated bilirubin indicates liver disease and is not commonly an adverse effect of clozapine.)

A patient was recently prescribed fluphenazine for schizophrenia. Once the patient's symptoms are being controlled, what should the nurse tell the patient? You will be tapered off therapy. Your medication will be discontinued. You will have a second drug added to your regimen. Your healthcare provider will lower your dose of medication

Your healthcare provider will lower your dose of medication