Nokea
A patient is seen for frequent exacerbation of schizophrenia due to nonadherence to medication regimen. The nurse should assess for which of the following common contributors to nonadherence?
- A. The patient is symptom-free and therefore does not need to adhere to the medication regimen.
- B. The patient cannot clearly see the instructions written on the prescription bottle.
- C. The patient dislikes the weight gain associated with antipsychotic therapy.
- D. The patient sells the antipsychotics to addicts in the neighborhood.
Correct Answer: C
Rationale: Weight gain is a common side effect of antipsychotics and a frequent reason for nonadherence, as patients may struggle with body image and health concerns.
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Which of the following medications rarely causes extrapyramidal side effects (EPS)?
- A. Ziprasidone (Geodon)
- B. Chlorpromazine (Thorazine)
- C. Haloperidol (Haldol)
- D. Fluphenazine (Prolixin)
Correct Answer: A
Rationale: Atypical antipsychotics like ziprasidone rarely cause EPS compared to first-generation antipsychotics like chlorpromazine, haloperidol, and fluphenazine.
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.
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 drugs should the nurse expect the patient to require serum level monitoring?
- A. Anticonvulsants
- B. Wellbutrin
- C. Lithium
- D. Prozac
Correct Answer: C
Rationale: Toxicity is closely related to serum lithium levels and can occur at therapeutic doses, necessitating periodic monitoring. Anticonvulsants also require monitoring, but lithium is the primary focus here.
A client who is taking paroxetine (Paxil) reports to the nurse that he has been nauseated since beginning the medication. Which of the following actions is indicated initially?
- A. Instruct the client to stop the medication for a few days to see if the nausea goes away.
- B. Reassure the client that this is an expected side effect that will improve with time.
- C. Suggest that the client take the medication with food.
- D. Tell the client to contact the physician for a change in medication.
Correct Answer: C
Rationale: Taking SSRIs like paroxetine with food usually eliminates nausea, making this the initial recommended action.