Deck 49: Antipsychotics

Question 1

The primary care nurse practitioner (NP)is performing a physical examination on a patient who has been taking mesoridazine (Serentil)for several weeks to treat schizophrenia.The patient is exhibiting rhythmic movements of the face and jaw.The NP should be concerned that the patient may:

A) need a higher dose of mesoridazine.
B) need to change to thioridazine (Mellaril).
C) have developed neuroleptic malignant syndrome.
D) be exhibiting signs of an irreversible adverse effect.

Answer 1

be exhibiting signs of an irreversible adverse effect.

Question 2

A patient comes to the clinic for a physical examination 2 weeks after a last dose of clozapine (Clozaril).The primary care NP should:

A) order a CBC with differential.
B) obtain serum lipids and LFTs.
C) obtain a serum clozapine level.
D) assess for orthostatic hypotension.

Answer 2

order a CBC with differential.

Question 3

A patient with a recent diagnosis of schizophrenia is taking thioridazine (Mellaril)to treat psychotic symptoms.The patient's family member is concerned that the patient continues to have little interest in activities and has difficulty beginning even simple tasks.The primary care NP should contact the patient's psychiatrist to discuss changing to:

A) fluphenazine (Prolixin).
B) risperidone (Risperdal).
C) chlorpromazine (Thorazine).
D) prochlorperazine (Compazine).

Answer 3

risperidone (Risperdal).

Question 4

An elderly patient with dementia exhibits hostility and uncooperativeness.The primary care NP prescribes clozapine (Clozaril)and should counsel the family about:

A) a decreased risk of extrapyramidal symptoms.
B) improved cognitive function.
C) the need for long-term use of the medication.
D) a possible increased risk of heart disease and stroke.

Question 5

A patient has been taking olanzapine (Zyprexa)for 3 weeks to treat schizophrenia.The primary care NP notes that the patient has more coherent speech and improved initiative and attentiveness but continues to have delusional ideation.The NP should:

A) increase the dose of olanzapine.
B) decrease the dose of olanzapine.
C) maintain the same dose of olanzapine.
D) change from olanzapine to chlorpromazine.

Question 6

A 22-year-old male patient who has dropped out of college has increasingly disorganized behavior and delusional thinking.His parents report that he lives at home and has no desire to find a job or help around the house.The primary care NP has ruled out organic causes and has referred the patient to a psychiatrist for treatment.To prepare for the referral visit,the NP should:

A) begin therapy with a low-potency antipsychotic.
B) begin therapy with a high-potency antipsychotic.
C) obtain a complete blood count (CBC), serum lipids, and hemoglobin A1c.
D) order liver function tests (LFTs), a CBC, an electrocardiogram (ECG), and a urinalysis.

Question 7

A patient who is newly diagnosed with schizophrenia is overweight and has a positive family history for type 2 diabetes mellitus.The primary care NP should consider initiating antipsychotic therapy with:

A) ziprasidone (Geodon).
B) olanzapine (Zyprexa).
C) risperidone (Risperdal).
D) chlorpromazine (Thorazine).

Question 8

A patient who takes 150 mg of clozapine (Clozaril)twice daily calls the primary care NP at 10:00 AM one day to report forgetting to take the 8:00 AM dose.The NP should counsel the patient to:

A) take the missed dose now.
B) take 75 mg of clozapine now.
C) wait and take the evening dose at the usual time.
D) take the evening dose 2 hours earlier than usual.

Question 9

A patient who is overweight is diagnosed with schizophrenia.The primary care NP should consider prescribing:

A) olanzapine (Zyprexa).
B) ziprasidone (Geodon).
C) quetiapine (Seroquel).
D) aripiprazole (Abilify).