Chapter 56 PrepU

A nurse is working with a 29-year-old Asian American man who was recently diagnosed with schizophrenia and is starting to take haloperidol. The patient is currently working as a professional gardener. When developing a teaching plan for the patient, which of the following patient variables will the nurse consider most important when trying to minimize the risk of neuroleptic malignant syndrome? Dietary habits Work environment Daily fluid intake Ethnicity

Daily fluid intake

A client is taking antipsychotic medication and asks the nurse what dopamine is. What is a correct response by the nurse? "Dopamine is an enzyme that regulates your temperature." "Dopamine is a neurotransmitter that deals with pleasure and reward in the brain." "Dopamine is a medication that is given to fight infections and help with pain." "Dopamine is a part of the brain that controls your impulses and thoughts."

"Dopamine is a neurotransmitter that deals with pleasure and reward in the brain."

The parents of a child receiving a central nervous system stimulant for treatment of attention deficit disorder asks the nurse why they are stopping the drug for a time. Which statement by the nurse would be most appropriate? "He probably doesn't need the medication anymore since he is getting older." "We need to check and see if he still has symptoms that require drug therapy." "The drug should be used for a specified period of time and then switched to another." "He is prone to developing severe adverse effects if he stays on it any longer."

"We need to check and see if he still has symptoms that require drug therapy."

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? 15 minutes 30 minutes 45 minutes 60 minutes

30 minutes

What client is being treated with a typical antipsychotic? An agitated client who was given haloperidol during acute psychosis A client with schizophrenia who received paliperidone 6 mg PO daily A client whose thought disorder requires clozapine 25 mg PO b.i.d. A client who recently began taking ziprasidone

An agitated client who was given haloperidol during acute psychosis

The client is seen today in the clinic for mental evaluation. What existing illness would be a contraindication for a client to take an antipsychotic? Select all that apply. Bone marrow depression Osteoporosis Severe depression Liver impairment Kidney disease

Bone marrow depression Severe depression Liver impairment

The nurse expects to monitor a client's white blood count weekly when the client is prescribed: Aripiprazole Olanzapine Clozapine Quetiapine

Clozapine

A 7-year-old child is admitted to the emergency department with a diagnosis of an acute psychotic episode. Aripiprazole has been prescribed. Before administering the medication, what is the nurse's first priority? Weigh the client. Obtain baseline vital signs. Confirm the order with the prescriber. Establish IV access.

Confirm the order with the prescriber.

A male client's health care provider orders antipsychotic medications for him. He experiences little or no side effects from the medications and is able to function successfully in both his home and work environments. Six weeks later, he is diagnosed with hepatitis B. He begins to experience adverse reactions to his medications. A possible reason for the adverse reactions might be that, in the presence of liver disease, what may happen? Metabolism may be accelerated and drug elimination half-lives shortened, causing an increased risk of adverse effects. Metabolism may be slowed and drug elimination half-lives shortened, with resultant accumulation and increased risk of adverse effects. Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects. Metabolism may be accelerated and drug elimination half-lives prolonged, with resultant accumulati

Metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects.

A nurse is preparing to teach a client about the prescribed clozapine. Which potential adverse effects would the nurse prioritize for the client to report? Select all that apply. Muscle aches Sore throat Fever Chills Weakness

Sore throat Fever Chills Weakness

Which of the following is true regarding tardive dyskinesia (TD) associated with the use of antipsychotic medication? Select all that apply: TD is an early appearing adverse reaction. TD involves rhythmic, involuntary movements of the facial structures. TD is a reversible adverse effect of antipsychotic drugs. TD is less likely to occur with the use of atypical psychotics. TD can occur after discontinuation of antipsychotic drug therapy.

TD involves rhythmic, involuntary movements of the facial structures. TD is less likely to occur with the use of atypical psychotics. TD can occur after discontinuation of antipsychotic drug therapy.

A client who is experiencing withdrawal from alcohol has developed psychosis and is being treated with haloperidol. Which assessment findings should prompt the care team to assess the client for neuroleptic malignant syndrome? The client demonstrates a significant increase in agitation after being given haloperidol. The client develops muscle rigidity and a sudden, high fever. The client reports intense thirst and produces copious amounts of urine. The client develops yellowed sclerae and intense pruritis (itchiness).

The client develops muscle rigidity and a sudden, high fever.

The nurse is caring for a patient who is receiving drug therapy for a psychotic disorder. Which goals should the nurse include in a care plan for the patient following discharge from the hospital? The patient will return for follow-up appointments when the patient believes they are necessary. The patient will exhibit decreased symptoms of acute psychosis. The patient will take medications as prescribed. The patient will normalize sleeping and eating patterns.

The patient will take medications as prescribed.

The nurse is caring for a client who has been taking an oral neuroleptic medication for several years. What assessment should the nurse prioritize to best address the risk for adverse effects? assessment of bowel pattern and stool character monitoring the client's cranial nerve function assessing deep tendon reflexes monitoring the client for involuntary facial movements

monitoring the client for involuntary facial movements

The instructor is discussing psychosis with the nursing students. The instructor knows that teaching was effective when the students identify what behaviors are exhibited by people with psychosis? Disorganized and often bizarre thinking Slowed reaction time and poor coordination Short manic episodes followed by long depressive episodes Short- and long-term memory deficits

Disorganized and often bizarre thinking

A client is started on aripiprazole and the nurse notices the client is experiencing dry mouth and nasal congestion. What intervention does the nurse teach the client to minimize the side effects of the medication? Drinking frequent sips of water Consuming the medication with food Discussing feelings of nervousness or restlessness Calling the prescriber for an anticholinergic medication

Drinking frequent sips of water

Parents bring a 15-year-old male into the clinic. The parents tell the nurse that there is a family history of schizophrenia and they fear their son has developed the disease. What is an appropriate question to ask the parents? Which of your family members did not have schizophrenia? What symptoms should he have? What health care providers have you taken your son to? How long has your son been exhibiting symptoms?

How long has your son been exhibiting symptoms?

The nurse is conducting an ongoing assessment on a client with schizophrenia who is receiving chlorpromazine. Assessment findings include excessive drowsiness and the need for assistance with ADLs and ambulation. Which nursing diagnosis should the nurse prioritize for this client? Infection Risk Hyperglycemia Injury Risk Impaired Physical Mobility

Injury Risk

A nurse observing a client notices the client has developed muscle rigidity, altered mental status, tachycardia, and sweating. The nurse interprets these findings as suggesting which of the following? Neuroleptic malignant syndrome (NMS) Tardive dyskinesia Extrapyramidal syndrome Agranulocytosis

Neuroleptic malignant syndrome (NMS)

A nurse is preparing a teaching plan for a client with schizophrenia who is prescribed olanzapine in a disintegrating tablet form. Which instruction should the nurse include in the teaching? Remove the tablet with dry hands. Take the tablet with a full glass of water. Add extra salt to food. Avoid tea or coffee.

Remove the tablet with dry hands.

The nurse is teaching a caregiver about the antipsychotic which has been prescribed to the client. The nurse determines the session is successful when the caregiver correctly chooses which points concerning potential TD? Select all that apply. An early-appearing adverse reaction Rhythmic, involuntary movements of the facial structures Reversible adverse effect of antipsychotic drugs. Less likely to occur with the use of atypical psychotics. Can occur after discontinuation of antipsychotic drug therapy.

Rhythmic, involuntary movements of the facial structures Less likely to occur with the use of atypical psychotics. Can occur after discontinuation of antipsychotic drug therapy.

The nurse is teaching a client and caregiver about the antipsychotic medication which has been prescribed. The nurse determines the teaching is successful when they correctly choose which reaction should be reported immediately to the health care provider? Orthostatic hypotension Dry mouth Rigidity Drowsiness

Rigidity

A nurse is planning the care of a client who has been diagnosed with schizophrenia and who will begin treatment with a typical antipsychotic. The nurse should identify what nursing diagnosis? Risk for injury related to central nervous system depression Risk for impaired liver function related to hepatotoxicity Risk for imbalanced body temperature related to hypothalamic suppression Bowel incontinence related to gastrointestinal adverse effects

Risk for injury related to central nervous system depression

The nurse is preparing to teach a client with psychosis about clozapine. The nurse will point out the importance of which weekly laboratory test to this client? Serum lithium WBC count Blood glucose pH level

WBC count

The nurse works on an inpatient mental health unit. When administering antipsychotic medications, what client would the nurse expect to require a standard dosage? African American adolescent client diagnosed with schizophrenia Malaysian middle adult client diagnosed with bipolar disorder Saudi Arabian older adult client diagnosed with schizophrenia White young adult client diagnosed with bipolar disorder

White young adult client diagnosed with bipolar disorder

The nurse is preparing to give prescribed haloperidol to an acutely dehydrated client. After administration, the nurse should prioritize what nursing assessment? visual acuity blood pressure core body temperature deep tendon reflexes

blood pressure

A client's thought disorder has been treated with haloperidol. For what adverse effect should the nurse most closely monitor the client? bradycardia shortness of breath extrapyramidal effects hypoglycemia

extrapyramidal effects

A client with schizophrenia is prescribed clozapine. For which information in the medical record will the nurse question giving this medication to the client? history of seizure disorder vegetarian eating plan treatment for rheumatoid arthritis remote work in customer service

history of seizure disorder

While caring for a client who is receiving antipsychotic therapy, the nurse observes lip smacking, a darting tongue, and slow and aimless arm movements. The nurse interprets this as: tardive dyskinesia. akathisia. pseudoparkinsonism. dystonia.

tardive dyskinesia.

The nurse is providing health education to a client who has been newly diagnosed with schizophrenia. What subject should be the primary focus? maintenance of adequate nutrition potential therapeutic effects of medication the need for weekly blood coagulation testing the importance of adherence to prescribed treatment

the importance of adherence to prescribed treatment