Chapter 5

Question 1

The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing?

Answer 1

Hallucinations

Question 2

A patient with schizophrenia has been nonadherent with his home medication regimen. He requires frequent admissions to the intensive psychiatric unit for treatment of acute psychotic episodes. Which medication regimen would be appropriate for this patient?

Answer 2

Administration of depot antipsychotic medication

Question 3

What is the most common cause of nonadherence to antipsychotic pharmacologic treatment?

Answer 3

Extrapyramidal effects

Question 4

Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis?

Answer 4

Dystonic reactions

Question 5

The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication?

Answer 5

Agranulocytosis

Question 6

A male patient becomes verbally aggressive and insists the nurse is poisoning him as she attempts to administer haloperidol (Haldol). Which action will the nurse take?

Answer 6

Firmly redirect the patient to take the medication.

Question 7

Which statement is true regarding the adverse effects associated with antipsychotic medications?

Answer 7

Painful dystonic reactions can occur in the first 72 hours of initiation of therapy.

Question 8

To what does potency of an antipsychotic medication refer?

Answer 8

Milligram doses used for the medication

Question 9

Dystonic reactions, pseudoparkinsonism, akathisia, and tardive dyskinesia are types of which effect?

Answer 9

Extrapyramidal symptoms

Question 10

Which is an appropriate nursing intervention for a patient who has recently been prescribed clozapine (Clozaril)?

Answer 10

Measure the patients waist circumference.

Question 11

A young male patient taking an antipsychotic is experiencing an oculogyric crisis. The nurse prepares to administer:

Answer 11

diphenhydramine

Question 12

A patient admitted to the hospital is exhibiting psychotic behavior. Which sign(s) and/or symptom(s) would support the diagnosis of psychosis? (Select all that apply.)
a. Constant eye contact during the admission history
b. Deterioration of social functioning
c. Reporting that the FBI has solicited important secret information from his phone conversations
d. Confirmation of hearing voices in his head
e. Changing the topic of conversation inappropriately

Answer 12

B, C, D, E

Question 13

Why is a combination of antipsychotic agents with benzodiazepines useful in initial treatment of the agitated patient? (Select all that apply.)
a. Antipsychotics are not effective for 2 days.
b. Benzodiazepines allow for lower dosages of antipsychotic agents to be used, thereby decreasing serious adverse effects seen with high dose therapy.
c. It assists in calming the psychotic patient.
d. It allows for rapid increase in dosing of the antipsychotic agents to expedite treatment of hallucinations.
e. It effectively treats extrapyramidal adverse effects associated with antipsychotic agents.

Answer 13

B, C

Question 14

Which is/are extrapyramidal adverse effect(s) of antipsychotic agents? (Select all that apply.)
a. Spasmodic movements of muscle groups
b. Masklike expression
c. Lip smacking
d. Inability to sit in one place for an extended period
e. Weight gain

Answer 14

A, B, C, D

Question 15

Which adverse effect(s) may occur as a result of antipsychotic drug
therapy? (Select all that apply.)
a. Acute dystonia
b. Akathisia
c. Weight loss
d. Neuroleptic malignant syndrome
e. Hypoglycemia
f. Tardive dyskinesia

Answer 15

A, B, D, F

Question 16

Which sign(s) and symptom(s) may occur in neuroleptic malignant syndrome? (Select all that apply.)
a. Fever
b. Hypertension
c. Severe extrapyramidal symptoms
d. Alterations in consciousness
e. Bradycardia

Answer 16

A, B, C, D

Question 17

A patient admitted to a psychiatric facility is hallucinating, pacing, and acting highly suspicious. Based on this information, the nurse will take which
action(s)? (Select all that apply.)
a. Use the most restrictive restraints available to subdue the patient.
b. Be open and direct when handling the patient.
c. Encourage a variety of interactions with others.
d. Provide high-protein, high-calorie foods.
e. Reinforce hallucinations.

Answer 17

B, D

Question 18

The psychiatric nurse is educating an elderly patient and family about antipsychotic drug therapy. When providing this education, the nurse will include which statement(s)? (Select all that apply.)
a. Hallucinations may be reduced within 1 week of starting.
b. Rapid increase in dosages will increase frequency of adverse effects.
c. Older patients should be observed for hypertension.
d. Tardive dyskinesia may be reversible in early stages
e. Full therapeutic response may require 6 to 8 weeks to be achieved.

Answer 18

B, D, E