Nokea
A client is seen in the clinic with clinical manifestations of an inability to sit still and a rigid posture. These side effects would be correctly identified as which of the following?
- A. Tardive dyskinesia
- B. Neuroleptic malignant syndrome
- C. Dystonia
- D. Akathisia
Correct Answer: D
Rationale: Akathisia is characterized by an intense need to move about, restlessness, and rigid posture, matching the described symptoms.
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The nurse is preparing a patient for an MRI scan of the head. The nurse should ask the patient.
- A. Have you ever had an allergic reaction to radioactive dye?
- B. Have you had anything to eat in the last 24 hours?
- C. Does your insurance cover the cost of this scan?
- D. Are you anxious about being in tight spaces?
Correct Answer: D
Rationale: The person undergoing an MRI must lie in a small, closed chamber and remain motionless during the procedure, which takes about 45 minutes. Those who feel claustrophobic or have increased anxiety may require sedation before the procedure. PET scans, not MRIs, require radioactive substances. Fasting is not required for brain imaging studies, and verifying insurance is not a primary nursing role.
Which of the following increases the risk for neuroleptic malignant syndrome (NMS)?
- A. Overhydration
- B. Intake of vitamins
- C. Dehydration
- D. Vegetarian diet
Correct Answer: C
Rationale: Dehydration increases the risk for NMS, a potentially fatal reaction to antipsychotics. Overhydration, vitamins, and vegetarian diets do not directly contribute to NMS risk.
A patient with depression has been taking paroxetine (Paxil) for the last 3 months and has noticed improvement of symptoms. Which of the following side effects would the nurse expect the patient to report?
- A. A headache after eating wine and cheese
- B. A decrease in sexual pleasure during intimacy
- C. An intense need to move about
- D. Persistent runny nose
Correct Answer: B
Rationale: Sexual dysfunction is a common side effect of SSRIs like paroxetine due to enhanced serotonin transmission. Headaches from tyramine interactions are associated with MAOIs, not SSRIs. An intense need to move about is an extrapyramidal side effect of antipsychotics, and runny nose is not typical.
How should the nurse respond to a family member who asks how Alzheimer's disease is diagnosed?
- A. It is impossible to know for certain that a person has Alzheimer's disease until the person dies and his or her brain can be examined via autopsy.
- B. Positron emission tomography (PET) scans can identify the amyloid plaques and tangles of Alzheimer's disease in living clients.
- C. Alzheimer's disease can be diagnosed by using chemical markers that demonstrate decreased cerebral blood flow.
- D. It will be necessary for the patient to undergo positron emission tomography (PET) scans regularly for a long period of time to know if the patient has Alzheimer's disease.
Correct Answer: B
Rationale: Positron emission tomography (PET) scans can identify the amyloid plaques and tangles of Alzheimer's disease in living clients, allowing diagnosis without autopsy. Decreased cerebral blood flow is not specific to Alzheimer's, and regular PET scans are not necessary for diagnosis.
Which one of the following types of antipsychotic medications is most likely to produce extrapyramidal effects?
- A. Atypical antipsychotic drugs
- B. First-generation antipsychotic drugs
- C. Third-generation antipsychotic drugs
- D. Dopamine system stabilizers
Correct Answer: B
Rationale: First-generation antipsychotic drugs are potent antagonists of D2, D3, and D4 receptors, making them effective but producing many extrapyramidal side effects due to D2 receptor blockade. Atypical antipsychotics have a lower incidence of these effects.