Nokea
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.
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Before administering a prescribed antipsychotic drug to a client, the nurse observes the client for any behavior patterns that appear to be deviations from normal. Which of the following would the nurse identify as a deviation? Select all that apply.
- A. Poor eye contact
- B. Monotone speech pattern
- C. Inappropriate laughter
- D. Failure to answer questions completely
- E. Inappropriate crying
Correct Answer: A,B,C,D,E
Rationale: Examples of deviation from normal include poor eye contact, failure to answer questions completely, inappropriate answers to questions, a monotone speech pattern, and inappropriate laughter, sadness, or crying.
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 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.
Which of the following are reasons a nurse may need to contact the client's physician to administer an antipsychotic drug intramuscularly instead of orally? Select all that apply.
- A. Client is combative.
- B. Client refuses the medication.
- C. Client won't allow the nurse to inspect the oral cavity.
- D. Client has difficulty swallowing.
- E. Client is elderly.
Correct Answer: A,B,C
Rationale: A nurse may need to contact the client's physician to administer an antipsychotic drug intramuscularly instead of orally because the client is combative, refuses the medication, or refuses to allow the nurse to inspect the oral cavity. Clients who have difficulty swallowing may be given an oral liquid in lieu of an IM injection.
A client is prescribed clozapine. The nurse instructs the client on the need for weekly laboratory testing for which of the following?
- A. Serum lithium
- B. WBC count
- C. Blood glucose
- D. pH level
Correct Answer: B
Rationale: Use of the drug clozapine has been associated with severe agranulocytosis (i.e., decreased white blood cells), so weekly WBC count tests are scheduled. Serum lithium tests are taken for clients who have been administered lithium, not clozapine. There is no need to check blood glucose or pH level.