Deck 17: Drugs for Psychoses

Question 1

The nurse has completed the dietary education for a patient prescribed an antipsychotic. Which food identified by the client has to be eliminated indicates an understanding of the teaching?

A) Meats with a high-fat content
B) Beverages with caffeine
C) Refined breads and desserts
D) Shellfish and peanuts

Answer 1

Beverages with caffeine

Question 2

The nurse is assessing a client with schizophrenia prescribed a phenothiazine for anticholinergic side effects. Which finding should the nurse immediately report to the healthcare provider?

A) Acute dystonia
B) Complaint of a severe headache
C) Hypertension
D) Urinary retention

Answer 2

Urinary retention

Question 3

A client prescribed quetiapine (Seroquel) asks the nurse how the prescription works. Which response should the nurse provide the client?

A) "Quetiapine (Seroquel) decreases norepinephrine in the brain, which decreases your auditory hallucinations."
B) "Quetiapine (Seroquel) increases norepinephrine in the brain, which decreases the feelings of depression."
C) "Quetiapine (Seroquel) decreases dopamine in the brain, which decreases your symptoms."
D) "Quetiapine (Seroquel) increases dopamine in the brain, which helps to think more clearly."

Answer 3

"Quetiapine (Seroquel) decreases dopamine in the brain, which decreases your symptoms."

Question 4

A client with schizophrenia sits quietly in a chair and minimally responds to the environment. Which of the following assessment findings should the nurse interpret?

A) The client is most likely very depressed.
B) The client is most likely hearing voices.
C) The client is experiencing positive symptoms.
D) The client is experiencing negative symptoms.

Question 5

The educator is discussing the symptoms of schizophrenia with a nurse. Which receptor site should the educator associate with the symptoms?

A) Dopamine type 2
B) Adrenergic
C) Beta 2
D) Cholinergic

Question 6

A client with a psychiatric history is attempting to communicate with the nurse using made-up words. Which condition is the client most likely exhibiting?

A) Symptom of depression
B) Positive symptom of schizophrenia
C) Negative symptom of schizophrenia
D) Symptom of bipolar disorder

Question 7

A client prescribed haloperidol (Haldol) is observed making wormlike movements with their tongue. Which should the nurse associate this finding with?

A) An adverse effect likely caused by the medication
B) A normal reaction to the medication that will resolve within a few weeks
C) An indication that the patient has not taken the prescription
D) A symptom of the underlying psychosis

Question 8

A client refuses his or her antipsychotic and tells the nurse he or she frequently experiences a dry mouth. Which response should the nurse provide?

A) "Can you tell me why you are refusing the medicine?"
B) "I can give you another prescription to help with the dry mouth."
C) "I will let your healthcare provider know about your dry mouth."
D) "A dry mouth is common, but drinking more water will help."

Question 9

During an assessment, the nurse notes that the client prescribed risperidone (Risperdal) has a temperature of 102°F. Which should the nurse suspect has occurred?

A) Neuroleptic malignant syndrome
B) Acute urinary infection
C) Bacterial pneumonia
D) Extrapyramidal side effects

Question 10

Which atypical antipsychotic should the nurse anticipate a client with schizophrenia demonstrating both positive and negative symptoms will be prescribed?

A) Thioridazine HCL (Mellaril)
B) Haloperidol (Haldol)
C) Clozapine (Clozaril)
D) Chlorpromazine (Thorazine)

Question 11

A client with schizophrenia whose symptoms have been controlled with a liquid prescription has reported both positive and negative symptoms have returned over the last week. Which questions should the nurse ask the patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Have you mixed your prescription in any liquids?"
B) "Have you changed pharmacies?"
C) "What was your last fasting blood glucose?"
D) "Have you the started smoking again?"
E) "Are you consuming more dairy products than usual?"

Question 12

A client has been receiving clozapine (Clozaril) for the treatment of schizophrenia. Which statement made by the client indicates the prescription is effective?

A) "I will start going to group therapy."
B) "I think I am ready for discharge, as I feel better."
C) "I am not hearing the voices anymore."
D) "I promise not to skip breakfast anymore."

Question 13

The nurse provided education for a client prescribed risperidone (Risperdal). Which statement made by the client indicates an understanding of the teaching?

A) "I must call my healthcare provider if I start to have a lot of nightmares."
B) "I must have my blood work done while taking this medication."
C) "I must call my healthcare provider if I start to lose a lot of weight."
D) "I must call my healthcare provider if I notice any a metallic taste in my mouth."

Question 14

The nurse observes a client with extrapyramidal symptoms having difficulty relaxing. Which should the nurse record in the client's record?

A) Dystonia
B) Tardive dyskinesia
C) Akathisia
D) Secondary parkinsonism

Question 15

Which is a priority outcome for a client with schizophrenia that has been prescribed haloperidol (Haldol)?

A) The client will consume adequate fluids and a high-fiber diet.
B) The client will be compliant with taking the medication as prescribed.
C) The client will report a decrease in auditory hallucinations.
D) The client will report symptoms of restlessness.

Question 16

A client asks the nurse what causes schizophrenia. Which contributing factors should the nurse include in the client teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Biological brain disorder
B) Alcohol use during pregnancy
C) Stressful environment
D) Genetic link
E) Abnormal levels of neurotransmitters in the brain

Question 17

The nurse is preparing the education for a client prescribed risperidone (Risperdal). For which condition should the nurse inform the client to immediately notify the healthcare provider?

A) Narrowing of the field of vision
B) Joint pain or swelling
C) Sore throat or an infection
D) Yellowish halos around lights

Question 18

Which existing pharmacological treated condition should the nurse be most concerned about for a client prescribed haloperidol (Haldol)?

A) Severe depression
B) Hypothyroidism
C) Diabetes mellitus
D) Urinary tract infection

Question 19

A client prescribed an antipsychotic tells the nurse he or she has not had a bowel movement for 2 days. Which initial action should the nurse take?

A) Hold the prescription until the client has a bowel movement.
B) Have the client drink prune juice and additional fluids.
C) Request a prescription for a Fleet Enema.
D) Obtain a prescription for a stool softener.

Question 20

The nurse is preparing to assess a client suspected of experiencing tardive dyskinesia. Which findings should the nurse anticipate that support the diagnosis?

A) Tremor, muscle rigidity, and a shuffling gait
B) Severe muscle spasms of the back, neck, and tongue
C) An inability to rest or relax, and restlessness
D) Unusual facial movements and lip smacking

Question 21

Which statements made by the client indicate he or she may be experiencing psychosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "The servants need to be disciplined."
B) "The voice told me to cut myself."
C) "I have not had an appetite for weeks."
D) "Close the door so that man can't get to me."
E) "I have not been able to get any sleep for months."

Question 22

While conducting a health history for a client with schizophrenia, which behaviors associated with positive signs of schizophrenia should the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Disorganized sentence structure
B) Kicking the nurse
C) Not responding to questions
D) Difficulty following instructions
E) Stating that God wants the patient to go home

Question 23

A client taking risperidone (Risperdal) for schizophrenia is experiencing signs of hypotension with certain activities. Which information should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Avoid being outside in the heat of the day.
B) Avoid hot baths or hot showers.
C) Avoid vitamin C-containing preparations.
D) Change positions slowly, especially from lying or sitting to standing.
E) Take frequent naps during the day.

Question 24

A client overdosed approximately 20 minutes prior on risperidone (Risperdal). Which intervention should the nurse be prepared to perform?

A) Administer a CNS depressant
B) Administer anticholinergic
C) Administer activated charcoal
D) Provide symptom management

Question 25

The nurse is preparing to administer chlorpromazine intramuscularly. Which anatomical location should the nurse administer the medication?

A) Gluteal
B) Deltoid
C) Vastus lateralis
D) Ventrogluteal

Question 26

The nurse is admitting a client that hears voices telling him to harm himself. Which questions should the nurse ask the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Do you have a family history of first-degree relative with schizophrenia?"
B) "Do you use any street drugs?"
C) "Have you recently experienced any episodes of anxiety?"
D) "Do you have a family history of heart disease?"
E) "Have you experienced any emotional or physical abuse?"

Question 27

Which barriers make it difficult to treat a client with schizophrenia demonstrating negative symptoms? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The client feels that their behavior is normal.
B) Family members feel the client is going through a period of depression.
C) The client is suspicious of the motives of the healthcare provider.
D) Family members have labeled the patient as lazy.
E) The client is indifferent to obtaining help.

Question 28

The nurse is assessing a female client who has been taking chlorpromazine. Which should the nurse include in the assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Ask the client if she is taking any herbal medicine.
B) Obtain a lipid profile.
C) Ask the client questions regarding amount of alcohol intake.
D) Determine the date of her last menstrual period.
E) Assess thyroid function with laboratory work.

Question 29

A client with a history of schizophrenia has stopped his or her prescribed clozapine (Clozaril) after 4 weeks of therapy. Which should the nurse recognize may have contributed to the client abruptly stopping their prescription? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Feeling sedated
B) Significant weight gain
C) Agitation
D) Fatigue and headache
E) Uncontrollable sexual urges

Question 30

A client who has been treated with an antipsychotic agent develops an elevated blood pressure, dyspnea, and an elevated temperature. Which disorder should the nurse suspect has occurred?

A) Akathisia
B) Extrapyramidal side effects
C) Acute dystonia
D) Neuroleptic malignant syndrome