Question 1

A client is prescribed aripiprazole (Abilify)to treat both the positive and negative symptoms of schizophrenia.What will the nurse explain as the medication's mechanism of action?

Accepted Answer

Aripiprazole is a partial agonist at dopamine type 2 (D2) and serotonin type 2 (5-HT2A) receptors, meaning it can both stimulate and block these receptors to balance out the levels of these neurotransmitters in the brain. This mechanism helps to treat both the positive and negative symptoms of schizophrenia.

Question 2

An adolescent client diagnosed with a psychosis is having difficulty maintaining friendships at school.Which behavior does the nurse suspect is the cause of the client's difficulty with peer relationships?

Accepted Answer

Laughing inappropriately at sad events may be a symptom of the client's psychosis, which may make it difficult for the client to form and maintain relationships with peers. This behavior may be seen as strange or off-putting to others, causing them to distance themselves from the client. The other options are describing physical symptoms or symptoms of depression, which may not directly impact the client's ability to form peer relationships.

Question 3

A young adult client is demonstrating a lack of interest in personal hygiene and routine social activities,a sudden drop in school grades,and a recent unwillingness to get out of bed to go to school.The nurse will assess for which health problem?

Accepted Answer

The client's lack of interest in personal hygiene, routine activities, and unwillingness to get out of bed are indicative of negative symptoms of schizophrenia, such as avolition, alogia, and anhedonia. The sudden drop in school grades also suggests a negative symptom, such as diminished cognition. However, depression may also be present, as these symptoms can be seen in individuals with major depressive disorder, which often co-occurs with schizophrenia. Therefore, options A and B may also be considered, but D is the most specific and accurate answer. Option C is less likely, as the client's reluctance to get out of bed suggests hypersomnia or fatigue, rather than insomnia.

Question 4

A client with a history of suicidal behavior and schizophrenia stopped taking clozapine (Clozaril)after four weeks of therapy.The client is currently experiencing a return of hallucinations.What might the nurse assess when determining the reason the client stopped taking the medication?
Select all that apply.

Accepted Answer

Clozapine can cause sedation, weight gain, and agitation, which may lead to non-compliance. Fatigue and headache are also common side effects. Lack of desire to consume alcohol is not typically associated with clozapine.

Question 5

The nurse is preparing discharge instructions for a client being treated with medication and psychotherapy for schizophrenia.What should the nurse address with the client prior to discharge?

Accepted Answer

Alcohol consumption can interfere with medication effectiveness and exacerbate symptoms of schizophrenia, so it is important to address this with the client prior to discharge.

Question 6

A client was prescribed olanzapine (Zyprexa)four weeks ago to treat symptoms of schizophrenia.The client's family has noted only a small improvement in symptoms and asks about changing to another treatment.Which response by the nurse is the most appropriate?

Accepted Answer

Olanzapine (Zyprexa), like many antipsychotic medications, often requires 6-8 weeks to see a significant improvement in symptoms of schizophrenia. This timeframe allows the medication to achieve its full therapeutic effect.

Question 7

The nurse is performing the initial assessment on a client admitted to the psychiatric unit.The client hears voices saying to cut the client's arms with razor blades until they bleed.What should the nurse assess this client for based on these initial findings?
Select all that apply.

Accepted Answer

A) Family history of first-degree relatives with schizophrenia is relevant because schizophrenia and other psychotic disorders can have a genetic component. B) Use of illegal substances is important to assess because certain substances can induce psychotic symptoms, including auditory hallucinations. E) History of a dysfunctional family is relevant because environmental factors, including family dynamics, can influence the development or exacerbation of psychiatric conditions.

Question 8

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?
Select all that apply.

Accepted Answer

Chlorpromazine, an antipsychotic medication, can cause various side effects including vision changes, hence the need for an eye exam. It can also interact with alcohol, making it important to assess alcohol intake. Additionally, it can affect the menstrual cycle, making it relevant to determine the date of the last menstrual period.

Question 9

The nurse suspects a client is demonstrating negative symptoms of schizophrenia and will be a challenge to treat because of which barriers?
Select all that apply.

Accepted Answer

The answer of The nurse suspects a client is demonstrating...

Question 10

The nurse is providing discharge instructions to a client who is prescribed ziprasidone (Geodon)for acute mania associated with bipolar disorder.Which statement by the client indicates the need for further education regarding this medication?

Accepted Answer

The statement "I hope that I can discontinue this medicine after I go back to see my doctor" indicates a misunderstanding about the nature of treatment for bipolar disorder, which often requires long-term medication management. This shows a need for further education on the part of the client regarding the duration and commitment to medication therapy for bipolar disorder.

Question 11

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 the medication at bedtime may help relieve drowsiness since the medication has a sedative effect. It is important to advise the client to continue taking the medication as prescribed and not to discontinue it without consulting with the health care provider. It may also take several weeks for the drowsiness to subside, so the client should be encouraged to be patient and persist with the medication in the meantime. Option B is not recommended because discontinuing the medication without the health care provider's approval can be harmful to the client's health.

Question 12

A client who was prescribed trifluoperazine (Stelazine)2 days ago presents with muscle spasms of the tongue.The health care provider orders diphenhydramine (Benadryl)50 mg IV.What is the rationale for this medication?

Accepted Answer

Diphenhydramine is an antihistamine that can be used to reverse acute dystonia, which is a potential side effect of trifluoperazine (Stelazine). The muscle spasms of the tongue are indicative of acute dystonia, and diphenhydramine can help alleviate this symptom.

Question 13

A client with a history of benign prostatic hyperplasia is beginning treatment for schizophrenia.Which medication might be contraindicated for this client?

Accepted Answer

Chlorpromazine is a typical antipsychotic that can cause anticholinergic side effects, including urinary retention, which can be problematic for someone with benign prostatic hyperplasia (BPH).

Question 14

A client in the emergency department tells the nurse about being chased by a serial killer." The client is currently paranoid and is aggressively fighting against any treatment.Which medication does the nurse anticipate will be prescribed for this client?

Accepted Answer

Lorazepam (Ativan) is a common medication used for acute agitation and aggression in clients with paranoia or delusions. It can help to calm the individual and allow for further assessment and treatment. Antipsychotic medications like clozapine, risperidone, and loxapine may also be used for long-term management of paranoia or psychotic symptoms, but they may not be effective immediately and are usually administered orally. IM injections of these medications may be necessary for clients who cannot tolerate oral medications or require rapid symptom control, but they are not the first line option for acute agitation and paranoia.

Question 15

A client is treated in the emergency department for injuries received after running through thick brush in the woods.The client relates being followed by a large man in dark clothing.A witness to this event claims there was no one chasing the client into the woods.Which item should the nurse further assess this client for based on the information provided?

Accepted Answer

The nurse should assess the client's current prescription medications to determine if any could cause hallucinations or delusions, which might explain the client's perception of being chased.

Question 16

A client's medication regimen is being determined by the health care provider.Currently,the medications haloperidol (Haldol),a high-potency drug,and chlorpromazine,a low-potency drug,are being considered.Which doses of the medications does the nurse anticipate for this client?

Accepted Answer

The question is asking for the anticipated doses of chlorpromazine and haloperidol for a client, but does not provide any information about the specific client or their condition. Generally, when choosing between high-potency and low-potency antipsychotic medications, the healthcare provider will consider the severity of the client's symptoms and the potential side effects of the medications. If the client has severe symptoms, a higher dose of a low-potency drug like chlorpromazine may be needed to achieve therapeutic benefit. However, this can increase the risk of sedation and other side effects. Haloperidol is a high-potency drug that is typically used in lower doses than chlorpromazine, as it can be more effective at lower doses and has a lower risk of sedation. Based on this information, it is possible that the client may receive a dose of 100 mg of chlorpromazine (a higher dose for more severe symptoms) along with 2 mg of haloperidol (a lower dose due to the potency of the medication). Therefore, choice B is the best answer.

Question 17

A client is prescribed fluphenazine (Prolixin)and is experiencing muscle spasms of the neck.The client is grimacing and having difficulty speaking.Which action should the nurse take?

Accepted Answer

The client is experiencing symptoms of acute dystonia, which is a side effect of fluphenazine. Diphenhydramine is an antihistamine and can be used as an antidote for acute dystonia. Therefore, the nurse should call the health care provider and prepare to give diphenhydramine to the client. Option A is not the best option as chlorpromazine has the potential to worsen extrapyramidal symptoms. Option B is not appropriate as it assumes the client is faking their symptoms, and option D does not address the urgent need to treat the acute dystonia.

Question 18

A client prescribed haloperidol (Haldol)is not demonstrating an improvement of psychotic behavior after taking the medication for 5 days.The nurse would anticipate which dose change for the medication?

Accepted Answer

Haloperidol (Haldol) can take 2-4 weeks for significant improvement in psychotic symptoms to be noted, so no immediate changes to the medication regimen are typically necessary after only 5 days.

Question 19

A client is prescribed haloperidol decanoate (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, unusual tongue and face movements, such as lip smacking or rapid eye blinking, are indicative of tardive dyskinesia, a serious side effect of Haldol LA. The healthcare provider should be notified immediately if the client experiences this manifestation. Nausea, weight gain, constipation, and dry mouth are common side effects of Haldol LA and may not require immediate intervention unless they are severe or persistent.

Question 20

The nurse is caring for a client with severe cardiovascular disease and schizophrenia.Which antipsychotic medication would be the safest treatment for this client?

Accepted Answer

The answer of The nurse is caring for a client...

Quiz 20: Pharmacotherapy of Psychoses

A client is prescribed aripiprazole (Abilify) to treat both the positive and negative symptoms of schizophrenia.What will the nurse explain as the medication's mechanism of action?

An adolescent client diagnosed with a psychosis is having difficulty maintaining friendships at school.Which behavior does the nurse suspect is the cause of the client's difficulty with peer relationships?

A young adult client is demonstrating a lack of interest in personal hygiene and routine social activities,a sudden drop in school grades,and a recent unwillingness to get out of bed to go to school.The nurse will assess for which health problem?

The nurse is preparing discharge instructions for a client being treated with medication and psychotherapy for schizophrenia.What should the nurse address with the client prior to discharge?

A client was prescribed olanzapine (Zyprexa) four weeks ago to treat symptoms of schizophrenia.The client's family has noted only a small improvement in symptoms and asks about changing to another treatment.Which response by the nurse is the most appropriate?

The nurse is performing the initial assessment on a client admitted to the psychiatric unit.The client hears voices saying to cut the client's arms with razor blades until they bleed.What should the nurse assess this client for based on these initial findings? Select all that apply.

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? Select all that apply.

The nurse suspects a client is demonstrating negative symptoms of schizophrenia and will be a challenge to treat because of which barriers? Select all that apply.

The nurse is providing discharge instructions to a client who is prescribed ziprasidone (Geodon) for acute mania associated with bipolar disorder.Which statement by the client indicates the need for further education regarding this medication?

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?

A client who was prescribed trifluoperazine (Stelazine) 2 days ago presents with muscle spasms of the tongue.The health care provider orders diphenhydramine (Benadryl) 50 mg IV.What is the rationale for this medication?

A client with a history of benign prostatic hyperplasia is beginning treatment for schizophrenia.Which medication might be contraindicated for this client?

A client in the emergency department tells the nurse about being chased by a serial killer." The client is currently paranoid and is aggressively fighting against any treatment.Which medication does the nurse anticipate will be prescribed for this client?

A client's medication regimen is being determined by the health care provider.Currently,the medications haloperidol (Haldol) ,a high-potency drug,and chlorpromazine,a low-potency drug,are being considered.Which doses of the medications does the nurse anticipate for this client?

A client is prescribed fluphenazine (Prolixin) and is experiencing muscle spasms of the neck.The client is grimacing and having difficulty speaking.Which action should the nurse take?

A client prescribed haloperidol (Haldol) is not demonstrating an improvement of psychotic behavior after taking the medication for 5 days.The nurse would anticipate which dose change for the medication?

A client is prescribed haloperidol decanoate (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?

The nurse is caring for a client with severe cardiovascular disease and schizophrenia.Which antipsychotic medication would be the safest treatment for this client?