Nokea
A patient prescribed a muscarinic-receptor blocker, will require assess for what side effect?
- A. Dry mouth
- B. Gynecomastia
- C. Pseudoparkinsonism
- D. Orthostatic hypotension
Correct Answer: A
Rationale: Muscarinic-receptor blockade includes atropine-like side effects such as dry mouth, blurred vision, and constipation. Gynecomastia is associated with decreased prolactin levels. Movement defects are associated with dopamine blockade. Orthostatic hypotension is associated with ?±??-receptor antagonism.
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A patient begins therapy with a first-generation antipsychotic medication. What teaching should a nurse provide related to the drug's strong dopaminergic effect?
- A. Chew sugarless gum.
- B. Increase dietary fiber.
- C. Arise slowly from bed.
- D. Report muscle stiffness.
Correct Answer: D
Rationale: First generation antipsychotic medications block dopamine receptors in both the limbic system and basal ganglia. Dystonia is likely to occur early in the course of treatment and is often heralded by sensations of muscle stiffness. Early intervention with an antiparkinsonian medication can increase the patient's comfort and prevent dystonic reactions. The incorrect responses apply to potential anticholinergic effects of first-generation antipsychotic medications.
A patient is hospitalized for major depressive disorder. A nurse can expect to likely provide the patient with teaching about which medication?
- A. Chlordiazepoxide
- B. Fluoxetine
- C. Clozapine
- D. Tacrine
Correct Answer: B
Rationale: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI), an antidepressant that blocks the reuptake of serotonin with few anticholinergic and sedating side effects; clozapine (Clozaril) is an antipsychotic medication; chlordiazepoxide (Librium) is an anxiolytic drug; and tacrine (Cognex) is used to treat Alzheimer's disease.
A patient demonstrates disorganized thinking associated related to a diagnosis of schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?
- A. Brainstem
- B. Cerebellum
- C. Temporal lobe
- D. Prefrontal cortex
Correct Answer: D
Rationale: The prefrontal cortex is responsible for intellectual functioning. The temporal lobe is responsible for the sensation of hearing. The cerebellum regulates skeletal muscle coordination and equilibrium. The brainstem regulates internal organs.
The nurse wants to assess for disturbances in circadian rhythms in a patient admitted for major depressive disorder. Which question best implements this assessment?
- A. Do you ever see or hear things that others do not?
- B. Do you have problems with short-term memory?
- C. How would you describe your sleep pattern?
- D. How would you describe your thinking?
Correct Answer: C
Rationale: Mood changes throughout the day are related to circadian rhythms. Questions about sleep pattern would also be relevant to circadian rhythms. The question about seeing or hearing things is relevant to the assessment for illusions and hallucinations. The question about thinking is relevant to the assessment of thought processes. The other question is relevant to assessment of memory.
A nurse can anticipate anticholinergic side effects are likely to occur when a patient is prescribed what medication?
- A. Lithium
- B. Buspirone
- C. Risperidone
- D. Fluphenazine
Correct Answer: D
Rationale: Fluphenazine, a first-generation antipsychotic medication, exerts muscarinic blockade, resulting in dry mouth, blurred vision, constipation, and urinary retention. Lithium therapy is more often associated with fluid balance problems, including polydipsia, polyuria, and edema. Risperidone therapy is more often associated with movement disorders, orthostatic hypotension, and sedation. Buspirone is associated with anxiety reduction without major side effects.