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A patient has taken many conventional antipsychotic drugs over the years. The health care provider, who is concerned about early signs of tardive dyskinesia, prescribes risperidone. A nurse planning care for this patient understands what fact about second-generation antipsychotics?
- A. They are less costly.
- B. They have a higher potency.
- C. They are more readily available.
- D. They produce fewer motor side effects.
Correct Answer: D
Rationale: Second-generation antipsychotic drugs often exert their action on the limbic system rather than the basal ganglia. The limbic system is not involved in motor disturbances. Atypical antipsychotic medications are not more readily available. They are not considered to be of higher potency; rather, they have different modes of action. Second generation antipsychotic drugs tend to be more expensive.
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An individual is experiencing problems associated with memory. Which cerebral structures are most likely to be involved in this deficit? (Select all that apply.)
- A. Prefrontal cortex
- B. Occipital lobe
- C. Temporal lobe
- D. Parietal lobe
- E. Basal ganglia
Correct Answer: A,C,D
Rationale: The prefrontal cortex, parietal, and temporal lobes of the cerebrum play a key role in the storage and processing of memories. The occipital lobe is predominantly involved with vision. The basal ganglia influence the integration of physical movement, as well as some thoughts and emotions.
A patient's partner, who is a chemist, asks a nurse how serotonin reuptake inhibitors (SSRIs) lift depression. What response will the nurse provide?
- A. Destroys increased amounts of neurotransmitters.
- B. Makes more serotonin available at the synaptic gap.
- C. Increases production of acetylcholine and dopamine.
- D. Blocks muscarinic and ?±??-norepinephrine receptors.
Correct Answer: B
Rationale: Depression is thought to be related to the lowered availability of the neurotransmitter serotonin. SSRIs act by blocking the reuptake of serotonin, leaving a higher concentration available at the synaptic cleft. They actually prevent the destruction of serotonin, have no effect on acetylcholine and dopamine production, and do not block muscarinic or ?±??-norepinephrine receptors.
The laboratory report for a patient taking clozapine indicates the patient is experiencing agranulocytosis. The nurse should implement which intervention first?
- A. Report the laboratory results to the health care provider.
- B. Give the next dose of the medication as prescribed.
- C. Administer aspirin and force fluids.
- D. Repeat the laboratory tests.
Correct Answer: A
Rationale: These laboratory values indicate the possibility of agranulocytosis, a serious side effect of clozapine therapy. These results must be immediately reported to the health care provider. The drug should be withheld because the health care provider will discontinue it. The health care provider may repeat the laboratory test, but, in the meantime, the drug should be withheld. Giving aspirin and forcing fluids are measures that are less important than stopping the administration of the drug.
A patient is demonstrating signs of dementia. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarctions. Which diagnostic procedure should a nurse expect to prepare the patient for first?
- A. Computed tomography (CT) scan
- B. Positron emission tomography (PET) scan
- C. Functional magnetic resonance imaging (fMRI)
- D. Single-photon emission computed tomography (SPECT) scan
Correct Answer: A
Rationale: A CT scan shows the presence or absence of structural changes, including cortical atrophy, ventricular enlargement, and areas of infarction-information that will be helpful to the health care provider. The other tests focus on brain activity and are more expensive; they may be ordered later.
The nurse will order a special diet for the patient taking what medication?
- A. Buspirone
- B. Haloperidol
- C. Trazodone
- D. Phenelzine
Correct Answer: D
Rationale: Patients taking phenelzine, an MAOI, must be on a tyramine-free diet to prevent hypertensive crisis. None of the other medication require dietary restrictions.