Nokea
A client is prescribed an antipsychotic drug that also has an antiemetic effect. Which of the following would the nurse identify as having this effect? Select all that apply.
- A. Lithium (Eskalith)
- B. Aripiprazole (Abilify)
- C. Chlorpromazine (Thorazine)
- D. Prochlorperazine (Compazine)
- E. Clozapine (Clozaril)
Correct Answer: C,D
Rationale: Chlorpromazine (Thorazine) and prochlorperazine (Compazine) are antipsychotic medications that have antiemetic effects. Lithium, aripiprazole, and clozapine do not.
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After teaching a group of nursing students about antipsychotic drugs, the instructor determines that the teaching was successful when the students identify aripiprazole (Abilify) as exerting its effect on which of the following in the brain? Select all that apply.
- A. Serotonin
- B. Dopamine
- C. Norepinephrine
- D. Muscarinic
- E. Nicotinic
Correct Answer: A,B
Rationale: Atypical antipsychotic drugs like aripiprazole (Abilify) are thought to act on serotonin and dopamine receptors in the brain. The conventional, or first-generation, antipsychotics (FGAs) work to diminish the positive symptoms by blocking dopamine transmission.
The nurse is providing care to a client receiving clozapine (Clozaril). The nurse would be alert for an increased risk of bone marrow suppression if the client is also receiving which of the following? Select all that apply.
- A. Immunological agents
- B. Anticholinergics
- C. Opioids
- D. Anticoagulants
Correct Answer: A
Rationale: The concomitant use of clozapine and immunological drugs can increase the severity of bone marrow suppression. The use of anticholinergics in combination with antipsychotics can increase the risk of tardive dyskinesia and psychotic symptoms. Opioids and anticoagulants are not associated with interactions involving antipsychotic drugs.
When describing tardive dyskinesia (TD) associated with the use of antipsychotic medication, which of the following would the nurse integrate into the teaching plan? Select all that apply.
- A. TD is an early-appearing adverse reaction.
- B. TD involves rhythmic, involuntary movements of the facial structures.
- C. TD is a reversible adverse effect of antipsychotic drugs.
- D. TD is less likely to occur with the use of atypical psychotics.
- E. TD can occur after discontinuation of antipsychotic drug therapy.
Correct Answer: B,D,E
Rationale: TD is a late-appearing reaction that is characterized by rhythmic, involuntary movements of the tongue, face, mouth, or jaw and sometimes the extremities, TD is nonreversible, can occur during antipsychotic drug therapy or after discontinuation, and is less likely to occur with the use of atypical antipsychotics.
A nurse is caring for a client with schizophrenia. The physician has prescribed olanzapine in a disintegrating tablet form for the client. Which of the following points should the nurse include in the teaching plan for the client?
- A. Remove the tablet with dry hands.
- B. Take the tablet with a full glass of water.
- C. Add extra salt to food.
- D. Avoid tea or coffee.
Correct Answer: A
Rationale: The nurse should instruct the client to remove the olanzapine tablet with dry hands and place the entire tablet in his or her mouth. Wet or damp hands may cause the medication to begin disintegrating prior to entering the client's mouth. There is no need to add extra salt to food. The client is required to take orally disintegrating olanzapine, so there is no need to take any fluid with the drug. Also, there is no need to avoid tea or coffee.
After administering an antipsychotic to a client, the nurse would immediately report which of the following?
- A. Orthostatic hypotension
- B. Dry mouth
- C. Rigidity
- D. Drowsiness
Correct Answer: C
Rationale: The nurse should immediately report to the primary health care provider if the client displays signs of rigidity. Dry mouth, episodes of orthostatic hypotension, and drowsiness are reactions that are considered normal during drug therapy and need not be reported unless severe.