Question 1

The client has been admitted to the hospital for the treatment of schizophrenia. The client's mother says to the nurse "This is all so confusing. How did he get this? Did I do something"? What is (are) the best response(s) of the nurse? Select all that apply.

A) "Research indicates that a very stressful environment causes schizophrenia."
B) "Schizophrenia is due to too much dopamine in certain parts of the brain."
C) "Research indicates that schizophrenia is a genetic disorder."
D) "Schizophrenia is linked to drinking alcohol during pregnancy."
E) "Schizophrenia is a biological brain disorder."

"Schizophrenia is due to too much dopamine in certain parts of the brain."
"Research indicates that schizophrenia is a genetic disorder."
"Schizophrenia is a biological brain disorder."

Accepted Answer

Schizophrenia is understood to be a complex condition with a biological basis, involving neurotransmitter imbalances, including dopamine (B), genetic factors (C), and overall brain structure and function (E). Stressful environments and prenatal alcohol exposure are not primary causes of schizophrenia, although environmental factors can influence the severity and presentation of the disorder.

Question 2

The physician prescribes haloperidol (Haldol) for the client. The client says to the nurse "My doctor said this medication is high potency, what does that mean"? What is the best response of the nurse?

A) "High potency means you might have some muscle spasms while taking this medication."
B) "High potency means this medication might make you really sleepy for a while after you begin taking it."
C) "High potency means it is best in decreasing symptoms such as the voices you have been hearing."
D) "High potency means you might have low blood pressure while taking this medication."

"High potency means you might have some muscle spasms while taking this medication."

Accepted Answer

High potency antipsychotics like haloperidol are more likely to cause extrapyramidal side effects, such as muscle spasms.

Question 3

For any client receiving clozapine (Clozaril), which laboratory result should be reported to the physician?&#10;A) white blood cell (WBC) below 3.5&#10;B) red blood cell (RBC) of 4.8&#10;C) red blood cell (RBC) of 3.8&#10;D) white blood cell (WBC) of 15,000

Accepted Answer

Clozapine can cause agranulocytosis, which is a severe decrease in the number of white blood cells (specifically neutrophils). A WBC count below 3.5 indicates a risk for infection, and the physician should be notified immediately. A RBC count of 4.8 or 3.8 and a WBC count of 15,000 are both within normal ranges and would not be a cause for concern related to clozapine therapy.

Question 4

The client is receiving risperidone (Risperdal). During morning assessment, the nurse notes that the client has a temperature of 38.5 degrees C. What is the priority nursing intervention?&#10;A) Contact the physician, as this could be a symptom of a bacterial pneumonia.&#10;B) Contact the physician, as this could be a symptom of extrapyramidal side effects.&#10;C) Contact the physician, as this could be a symptom of neuroleptic malignant syndrome.&#10;D) Contact the physician, as this could be a symptom of an acute urinary infection.

Accepted Answer

A temperature of 38.5 degrees C in a client receiving risperidone could be a symptom of neuroleptic malignant syndrome (NMS), a potentially life-threatening complication of antipsychotic medication. NMS is characterized by fever, muscle rigidity, and autonomic instability. Therefore, the priority nursing intervention would be to contact the physician immediately to report the client's symptoms and to initiate appropriate treatment. Options A, B, and D are not directly related to the client's symptoms and are not the priority at this time.

Question 5

The nurse is managing the care of a group of clients with schizophrenia. The clients are receiving conventional antipsychotic medications. When assessing for anticholinergic side effects, which would the nurse immediately report to the physician?

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

Accepted Answer

Urinary retention is a significant anticholinergic side effect that requires immediate medical attention to prevent complications.

Question 6

The client is receives clozapine (Clozaril) for the treatment of schizophrenia. The nurse evaluates the effectiveness of this medication when the client makes which statement?&#10;A) &#34;I will start going to group therapy.&#34;&#10;B) &#34;I promise not to skip breakfast anymore.&#34;&#10;C) &#34;I am not hearing the voices anymore.&#34;&#10;D) &#34;I think I am ready for discharge, as I feel better.&#34;

Accepted Answer

Clozapine is an antipsychotic medication used to treat schizophrenia. One of the primary goals of treatment is to reduce or eliminate psychotic symptoms such as hallucinations and delusions. The fact that the client is no longer hearing voices indicates that the medication is effective in treating their condition. Choices A and B may be positive steps, but they do not directly address the effectiveness of the medication. Choice D is not necessarily an indication of the medication's effectiveness and may require further evaluation by the healthcare team.

Question 7

The client is receiving clozapine (Clozaril). What is a priority outcome for this client?&#10;A) The client reports any narrowing of the field of vision.&#10;B) The client reports any signs of a sore throat or an infection.&#10;C) The client reports any yellowish halos around lights.&#10;D) The client reports any joint pain or swelling.

Accepted Answer

Clozapine has a significant risk for agranulocytosis, a rare but serious blood disorder that can lead to infections. Therefore, monitoring for signs of infection, such as a sore throat, is a priority outcome for a client receiving clozapine. The other options may be side effects of the medication but are not as urgent as monitoring for infection.

Question 8

The client who is receiving antipsychotic medication complains of having a dry mouth. The client refused the morning dose of the medication. What is the best response by the nurse?&#10;A) &#34;I can give you benztropine (Apo - Benztropine) for your dry mouth.&#34;&#10;B) &#34;I will let your doctor know about your dry mouth.&#34;&#10;C) &#34;Why are you refusing the medicine?&#34;&#10;D) &#34;A dry mouth is common, but drinking more water will help.&#34;

Accepted Answer

A dry mouth is a common side effect of antipsychotic medications. Encouraging the client to drink more water can help alleviate this symptom. While notifying the client's doctor of the symptom is also important, it may not address the immediate concern of the client refusing medication. Offering a medication (benztropine) to address the side effect may not be necessary at this time and should be discussed with the prescribing healthcare provider. Asking why the client is refusing medication may be important, but addressing the dry mouth symptom and reasons for refusal separately may be more effective.

Question 9

The nurse has completed diet education for a group of clients who are receiving antipsychotic medications. If the medication education has been effective, clients will eliminate what choice from their menu selection?

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

Accepted Answer

Clients receiving antipsychotic medications should avoid beverages with caffeine as caffeine can exacerbate the side effects of these medications. While it is important to limit intake of shellfish and peanuts for clients with allergies or sensitivities, this is not directly related to antipsychotic medication management. Similarly, while it is generally recommended to limit intake of refined breads and desserts and meats with a high-fat content for overall health, eliminating these foods from the menu is not specifically related to antipsychotic medication management.

Question 10

The client is receiving antipsychotic medications and tells the nurse he has not had a bowel movement for two days. What is the best initial action of the nurse?&#10;A) Contact the physician for an order for a Fleet Enema.&#10;B) Hold the medication until the client has a bowel movement.&#10;C) Contact the physician for an order for a stool softener.&#10;D) Have the client drink prune juice and additional fluids.

Accepted Answer

Antipsychotic medications can cause constipation as a side effect. The best initial action is to encourage non-pharmacological interventions such as increasing fluid intake and consuming foods that can help with bowel movements, like prune juice, before escalating to medical interventions or altering medication regimens.

Question 11

The client with schizophrenia is sitting quietly in a chair. The client does not respond much to what is happening, and has a lack of interest in the environment. What best describes the result of the nurse's assessment?

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

Accepted Answer

The answer of The client with schizophrenia is sitting quietly...

Question 12

The client receives quetiapine (Seroquel) and asks the nurse how the medication works. What is the best response by the nurse?&#10;A) &#34;Quetiapine (Seroquel) decreases dopamine in your brain and that decreases your symptoms.&#34;&#10;B) &#34;Quetiapine (Seroquel) decreases norepinephrine in your brain and that decreases your auditory hallucinations.&#34;&#10;C) &#34;Quetiapine (Seroquel) increases norepinephrine in your brain and that decreases your feelings of depression.&#34;&#10;D) &#34;Quetiapine (Seroquel) increases dopamine in your brain and that helps you to think more clearly.&#34;

Accepted Answer

The answer of The client receives quetiapine (Seroquel) and asks...

Question 13

The physician has prescribed haloperidol (Haldol) for the client with schizophrenia. What is the priority client outcome?&#10;A) The client will report symptoms of restlessness.&#10;B) The client will be compliant with taking the medication as prescribed.&#10;C) The client will report a decrease in auditory hallucinations.&#10;D) The client will consume adequate fluids and a high -fibre diet.

Accepted Answer

The answer of The physician has prescribed haloperidol (Haldol) for...

Question 14

The nurse has completed medication education with the client who is receiving clozapine (Clozaril). The nurse evaluates that the education has been effective when the client makes which statement?&#10;A) &#34;I must call my doctor if I notice any unusual bruising.&#34;&#10;B) &#34;I must call my doctor if I start to lose a lot of weight.&#34;&#10;C) &#34;I must have my blood work done while taking this medication.&#34;&#10;D) &#34;I must call my doctor if I start to have a lot of nightmares.&#34;

Accepted Answer

The answer of The nurse has completed medication education with...

Question 15

The client has been receiving chlorpromazine (Apo -chlorpromazine) for the treatment of schizophrenia. The nurse assesses that the client has tardive dyskinesia. What describes the result of the nurse's assessment?

A) unusual facial movements and lip smacking
B) tremor, muscle rigidity, and a shuffling gait
C) an inability to rest or relax, and restlessness
D) severe muscle spasms of the back, neck, and tongue

Accepted Answer

The answer of The client has been receiving chlorpromazine (Apo...

Deck 17: Drugs for Psychoses