Chap. 9 - SZO review questions

Question 1

The neurotransmitter deregulation theory of the etiology of psychotic disorders such as schizophrenia supports that psychosis is caused, in part, by
A - an excess of dopamine
B - A deficiency of dopamine
C - Poor acetylcholine regulation
D - Poor synaptic uptake of serotonin receptors

Answer 1

A - an excess of dopamine

Psychotic sx are partially caused by too much dopamine in the mesolimbic dopamine pathway

Question 2

The positive-negative model of classifying the symptoms of schizophrenia describes positive symptoms as
A - Symptoms that positively respond to antipsychotic medication
B - Symptoms that are less serious to experience
C - Symptoms that are less socially stigmatizing
D - Symptoms that positively correlate to drug abuse

Answer 2

A - Symptoms that positively respond to antipsychotic medication

This definition was initially developed prior to the invention of the 2nd generation antipsychotics

Question 3

Mrs Jay suffers from SZO and is taking Navane 15mg/day. During her appointment, she complains of feelings of inner restlessness, tremors, drooling, and stiff muscles. The best explanation for these is
A - EPS effects of Navane
B - Anticholinergic side effects of Navane
C - Atypical side effects of Navane
D - Psychosomatic side effects

Answer 3

A - EPS effects of Navane

EPS can include akathisia, postural tremors, dystonia, and drooling.

Question 4

As part of treatment planning, you place a note on Mrs Jay’s chart about seizure precautions. She notices the note and states that she doesn’t understand that the she has no history of seizures. You explain that
A - It is a clerical error, and you will correct it
B - Seizures are common in mental illness, and the note is just a precaution
C - Reactions to psychotropic medications are unpredictable
D - Typical antipsychotic medications can lower seizure threshold

Answer 4

D - Typical antipsychotic medications can lower seizure threshold

All antipsychotics lower the seizure threshold, therefore precautions should be taken

Question 5

Mrs Anders, a client with delusional disorder, has been started on Haldol 5 mg po bid, Tylenol 2 tabs po prn, Cogent 1 mg po prn, and Ativan 2 mg prn for agitation.  She is complaining of a sudden painful stiff neck and jaw muscles that started a few hours after she took her medication.  These symptoms are most likely related to 
A - Akinesia
B - Akathisia
C- Dystonia
D - Somatic delusiona

Answer 5

C- Dystonia

Destinies are brief or sustained contractions of muscles, spasms, thickened or slurred speech due to enlarged tongue, oculogyric crises, and unusual posturing of limbs

Question 6

The most appropriate action to help relieve Mrs Anders pain and stiff muscles is
A - Switch to an NSAID to control her pain
B - Increase the Cogentin dose
C - Teach her relaxation techniques
D - Work up for musculoskeletal labs

Answer 6

B - Increase the Cogentin dose

Anticholinergic drugs such as Cogentin are used for dystonias

Question 7

After a few weeks Mrs Anders returns for a follow up. She is refusing to take Haldol d/t continued stiff muscles and blurred vision. She says she has not taken her meds for 1 weeks, and the stiffness and blurred vision are better but still a problem. She says “Something must be wrong with me. I stopped the Haldol but I’m still not ok.” Your best explanation is that Mrs Anders is
A - Fixated on her meds
B - Experiencing an unusual reaction to Haldol
C - Experiencing a lipophilic reaction to Haldol
D - Experiencing some problem other than a side effect of Haldol

Answer 7

C - Experiencing a lipophilic reaction to Haldol

After the depot injection, the active ingredient is slowly absorbed in the bloodstream, and effects will last for 3-4 weeks following an injection.