Question 1

A client is prescribed Haldol LA, IM, to be administered once a month for treatment of schizophrenia. The nurse will instruct the client to notify the health care provider for which manifestation?

Accepted Answer

Involuntary and unusual tongue and face movements are indications of tardive dyskinesia, a potentially irreversible side effect of Haldol. Prompt notification of the healthcare provider is necessary to prevent further complications. Nausea, vomiting, weight gain, constipation, and dry mouth are common but less severe side effects that do not require immediate attention unless they become severe or persistent.

Question 2

A client being treated for schizophrenia admits to occasionally skipping medication doses. Based on this information, what questions will the nurse include in the client assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A client being treated for schizophrenia admits...

Question 3

A client being treated for chronic schizophrenia develops tardive dyskinesia. Which interventions will the nurse prepare to perform for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A client being treated for chronic schizophrenia...

Question 4

A client is experiencing fever, diaphoresis, muscle rigidity, and tachycardia for 4 hours. Current medications include aripiprazole (Abilify), enalapril (Vasotec), and atenolol (Tenormin). What will the nurse prepare to administer to this client?

Accepted Answer

The answer of A client is experiencing fever, diaphoresis, muscle...

Question 5

The nurse is explaining to a client the imbalance of neurotransmitters in Parkinson disease. How will the nurse describe the relationship between acetylcholine and dopamine in the area of the brain that affects balance, posture, and involuntary muscle movement?

Accepted Answer

In Parkinson's disease, there is a decrease in dopamine production, which normally inhibits excessive movement. Acetylcholine, on the other hand, stimulates movement. The imbalance with reduced dopamine allows acetylcholine to be relatively unopposed, leading to the symptoms of Parkinson's disease.

Question 6

The nurse is concerned that a client being treated with antipsychotic medication for schizophrenia is developing extrapyramidal symptoms. Which assessment findings support the nurse's concern? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is concerned that a client...

Question 7

The nurse is assessing a female client who is prescribed chlorpromazine for schizophrenia. Based on this information, what will the nurse include in the client assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

A) Chlorpromazine can cause ocular changes, such as decreased visual acuity and difficulty focusing. Therefore, an eye exam and asking about changes in vision should be included in the client assessment.
C) Chlorpromazine can cause CNS depression, and when used in combination with alcohol, can lead to increased sedation and decreased cognitive function. Hence, questioning the client regarding alcohol intake can help identify potential adverse effects.
D) Chlorpromazine can cause menstrual irregularities, including amenorrhea, menorrhagia, and galactorrhea. Therefore, asking about the date of the client's last menstrual period should be included in the assessment. Conversely, B and E are unnecessary for assessing the client on chlorpromazine as both checks do not relate to the medication's associated side effects. Hence, options B and E should be eliminated.

Question 8

A client is being evaluated for appropriate medication treatment for a new onset of psychosis. Which information in the history would indicate that haloperidol (Haldol) is contraindicated for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A client is being evaluated for appropriate...

Question 9

A client with Parkinson disease asks the nurse why dopamine is not given as a neurotransmitter replacement. Which response by the nurse is the most appropriate?

Accepted Answer

Exogenous dopamine cannot cross the blood-brain barrier and therefore cannot effectively replace the dopamine that is lost in Parkinson's disease. Other medications, such as levodopa, can be used to increase dopamine levels in the brain.

Question 10

A client prescribed aripiprazole (Abilify) for schizophrenia is experiencing signs of hypotension with certain activities since starting this medication. What should the nurse teach the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Aripiprazole can cause orthostatic hypotension, leading to dizziness or fainting when changing positions. Avoiding heat and hot baths or showers can help prevent vasodilation and further drops in blood pressure. Changing positions slowly allows the body time to adjust, reducing the risk of hypotension symptoms.

Question 11

A client prescribed an atypical antipsychotic medication for bipolar disorder reports difficulty sleeping. What might the nurse want to discuss with the client?

Accepted Answer

Valerian is an herbal supplement that may interact with atypical antipsychotic medication and increase the risk of side effects. Therefore, the nurse should advise the client to avoid valerian. Additionally, the nurse may suggest non-pharmacological sleep aids such as implementing a regular sleep routine, avoiding caffeine and alcohol, and practicing relaxation techniques. If these strategies are not effective, the nurse may discuss the possibility of adjusting the medication regimen with the prescribing provider. Increasing fluid intake and trying St. John's wort are not appropriate interventions for difficulty sleeping in this situation.

Question 12

The nurse explains to the family of a client with Alzheimer disease that memory loss and confusion occur because of the disease's effect on which neurotransmitter?

Accepted Answer

Memory loss and confusion in Alzheimer disease occur due to the disease's effect on the neurotransmitter acetylcholine.

Question 13

The nurse is instructing a client on the importance of having routine blood work preformed while taking a prescribed antipsychotic medication. Which symptoms would warrant the client to notify the health care provider immediately? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

Accepted Answer

Abdominal pain and change in stool color could indicate a possible adverse reaction to the medication or a possible liver problem. Increased thirst and urination could be a sign of hyperglycemia or diabetes, which can be a side effect of antipsychotic medications. Frequent infections could indicate a weakened immune system, which can also be a side effect of antipsychotic medications. Dry mouth is a common side effect of antipsychotic medications but does not necessarily require immediate notification of the healthcare provider.

Question 14

A client prescribed clozapine (Clozaril) for treatment of schizophrenia is complaining of drowsiness after the first 2 weeks of therapy. Which response by the nurse is the most appropriate for this situation?

Accepted Answer

Taking clozapine at bedtime can help alleviate drowsiness as it can facilitate sleep. It is important to not discontinue the medication without consulting with the healthcare provider, as this medication requires close monitoring and abrupt discontinuation can lead to serious adverse effects. Advising the client to discuss their concerns with the healthcare provider is also appropriate, but not the best choice in this situation as it does not provide immediate relief for the client's symptoms. The statement about the drowsiness subsiding in 6-8 weeks is not accurate, as individual responses can vary and the period of adjustment can take longer or shorter than this range.

Question 15

A student caring for a client with Parkinson's disease asks her instructor how medications help with the symptoms of the disease. What is the best response of the instructor?

Accepted Answer

The medications used for Parkinson's disease work by increasing dopamine in the brain, which helps to facilitate movement and coordination. This can make it easier for clients to perform activities of daily living such as walking, dressing, and eating. Option A is incorrect as serotonin is not a primary neurotransmitter involved in Parkinson's disease. Option B is incorrect as muscle wasting is not a primary symptom of Parkinson's disease. Option C is incorrect as Parkinson's disease does not typically affect energy or appetite.

Question 16

When explaining the pathophysiology of Parkinson disease to a client, the nurse would explain that it is a degenerative disorder of the nervous system caused by the death of neurons that produce which substance?

Accepted Answer

Parkinson disease is caused by the death of neurons in the substantia nigra, which produce dopamine. The loss of dopamine leads to impairment of movement control and the characteristic symptoms of Parkinson disease.

Question 17

A student nurse, caring for a client diagnosed with schizophrenia asks how medications work to help control the client's symptoms. Which responses by the nurse are appropriate in this situation? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of A student nurse, caring for a client...

Question 18

A client prescribed Chlorpromazine medication for chronic schizophrenia abruptly stops taking the medication and is in the emergency department. Which findings does the nurse anticipate when assessing this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Abruptly stopping Chlorpromazine medication can lead to withdrawal symptoms such as nausea, dizziness, vomiting, and tremors. Paralysis is not a common withdrawal symptom of Chlorpromazine.

Question 19

A client prescribed olanzapine (Zyprexa) for mania associated with bipolar disorder is being discharged. Which client statement indicates more teaching is necessary about this medication?

Accepted Answer

St. John's wort should not be taken with olanzapine as it may decrease the effectiveness of the medication. Therefore, more teaching is necessary to inform the client of this potential interaction. The other statements demonstrate understanding of potential side effects and the need to monitor for them.

Question 20

A client with acute symptoms of schizophrenia is prescribed clozapine (Clozaril). Which of the following drugs the client is currently taking would require additional monitoring? \ Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Clozapine can interact with Lanoxin (digoxin) and Warfarin, requiring additional monitoring. Lanoxin can affect heart function, and clozapine can cause cardiac side effects. Warfarin is an anticoagulant, and clozapine can affect blood cell counts, increasing bleeding risk.

Quiz 5: Pharmacology of Alterations in the Central Nervous System