Nokea
A nurse caring for a client receiving clozapine (Clozaril) needs to be mindful of the symptoms that indicate bone marrow suppression. Assessment of which of the following would lead the nurse to suspect that the client is experiencing bone marrow suppression? Select all that apply.
- A. Hypertension
- B. Sore throat
- C. Fever
- D. Chills
- E. Weakness
Correct Answer: B,C,D,E
Rationale: Symptoms that indicate bone marrow suppression include lethargy, weakness, fever, sore throat, malaise, mucous membrane ulceration, and 'flu-like' complaints.
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A nurse asses a client receiving antipsychotic drugs for which of the following adverse reactions?
- A. Hypertension
- B. Skin dryness
- C. Dry mouth
- D. Bradycardia
Correct Answer: C
Rationale: The nurse should monitor the client for mouth dryness. Antipsychotic drugs cause hypotension, not hypertension. Skin dryness and bradycardia are not adverse reactions related to the administration of antipsychotic drugs.
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.
A nurse observes rhythmic, involuntary facial movements in a client who has been receiving antipsychotic drugs. The client also makes chewing movements and, at times, his tongue protrudes. The nurse interprets these findings as which of the following?
- A. Stevens-Johnson syndrome
- B. Neuropeptic malignant syndrome
- C. Tardive dyskinesia
- D. Extrapyramidal syndrome
Correct Answer: C
Rationale: Tardive dyskinesia is characterized by rhythmic, involuntary movements of the tongue, face, mouth, or jaw and sometimes the extremities. The tongue may protrude, and there may be chewing movements, puckering of the mouth, and facial grimacing. Extrapyramidal syndrome (EPS), neuroleptic malignant syndrome (NMS), and Stevens-Johnson syndrome do not cause rhythmic, involuntary facial movements.
When administering antipsychotic drugs, the nurse would need to keep in mind that which of the following atypical antipsychotics are most commonly associated with weight gain? Select all that apply.
- A. Olanzapine (Zyprexa)
- B. Rispendone (Risperdal)
- C. Ziprasidone (Geodon)
- D. Quetiapine (Seroquel)
- E. Clozapine (Clozaril)
Correct Answer: A,B
Rationale: Olanzapine (Zyprexa) and risperidone (Risperdal) are atypical antipsychotics that are most commonly associated with weight gain. None of the other drugs are associated with weight gain.
A nurse is administering haloperidol to a client with schizophrenia. The nurse determines that the drug is effective when there is improvement in which of the following? Select all that apply.
- A. Agitation
- B. Alogia
- C. Concrete thinking
- D. Delusions
- E. Hallucinations
Correct Answer: A,D,E
Rationale: Haloperidol is a conventional antipsychotic that is used to control the positive symptoms of schizophrenia, such as agitation, delusions, and hallucinations. Effectiveness of the drug would lead to a decrease in these positive symptoms. Atypical antipsychotics help to diminish the negative symptoms such as alogia and problems with concrete thinking.