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A hospitalized patient who has been taking an antipsychotic medication for 2 weeks begins pacing and walking throughout the unit. He tells the nurse that he cannot sit still. The nurse documents this finding as which of the following?
- A. Akinesia
- B. Dystonia
- C. Pseudoparkinsonism
- D. Akathisia
Correct Answer: D
Rationale: Akathisia is characterized by restlessness and an inability to sit still, common with antipsychotics. Akinesia involves reduced movement, dystonia causes muscle spasms, and pseudoparkinsonism mimics Parkinson?s symptoms like tremor, not restlessness.
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A patient is prescribed medication for a psychiatric disorder. After 3 days, the patient tells the nurse that he or she has been constipated. Which instruction would the nurse give the patient?
- A. You need to eat more high-protein foods such as meat and peanut butter.
- B. You need to eat more fruits and vegetables and drink more water.
- C. Ask your psychiatrist to prescribe a stool softener for you.
- D. This side effect should disappear within a week or so.
Correct Answer: B
Rationale: Constipation, a common side effect of psychiatric medications, can be managed by increasing dietary fiber (fruits and vegetables) and hydration (water). High-protein foods may worsen constipation, a stool softener may be premature without dietary changes, and waiting for resolution dismisses the patient?s discomfort.
The nurse observes an older adult patient who has been taking antipsychotic medications for 8 months. The patient is smacking her lips and blinking her eyes rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate?
- A. Ask if the patient has been experiencing side effects.
- B. Contact the patient?s physician for a different medication order.
- C. Document the patient?s symptoms of tardive dyskinesia.
- D. Instruct the patient to begin tapering off the medication.
Correct Answer: C
Rationale: Lip smacking, rapid blinking, and tongue protrusion indicate tardive dyskinesia, a serious side effect of long-term antipsychotic use. Documenting these symptoms is the most appropriate initial action to ensure accurate reporting and prompt physician review. Asking about side effects is vague, contacting the physician follows documentation, and tapering is premature without medical orders.
A nurse administers a prescribed dose of lithium at 8 PM. The nurse would schedule a specimen to be obtained for a blood level at which time?
- A. 10:00 PM
- B. 12:00 AM
- C. 4:00 AM
- D. 8:00 AM
Correct Answer: D
Rationale: Lithium levels are typically drawn 12 hours after the last dose to measure trough levels, ensuring steady-state concentration. A dose at 8 PM would require a blood draw at 8 AM. Earlier times (10 PM, 12 AM, 4 AM) do not align with this timing.
A nurse is preparing a continuing education presentation for a group of psychiatric-mental health nurses about various psychopharmacologic agents. The nurse is planning to discuss selective serotonin reuptake inhibitors. Which agents would the nurse include in this group? Select all that apply.
- A. Fluoxetine
- B. Duloxetine
- C. Sertraline
- D. Venlafaxine
- E. Bupropion
- F. Amoxapine
Correct Answer: A,C
Rationale: SSRIs include fluoxetine (A) and sertraline (C), which selectively inhibit serotonin reuptake. Duloxetine and venlafaxine are SNRIs, bupropion is an NDRI, and amoxapine is a tricyclic antidepressant, not SSRIs.
During the stabilization phase of drug therapy for a patient who is hospitalized with a psychiatric disorder, which action would be most appropriate?
- A. Discussing the timing of tapering the medication
- B. Instructing the patient about relapse prevention
- C. Determining if the medication is losing its effect
- D. Assessing the patient for target symptoms and side effects
Correct Answer: D
Rationale: The stabilization phase focuses on optimizing medication to control symptoms while monitoring for side effects. Assessing target symptoms and side effects ensures efficacy and safety. Tapering, relapse prevention, and loss of effect are addressed in later phases, such as maintenance or discontinuation.