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A patient who has been taking clozapine for 6 weeks visits the clinic complaining of fever, sore throat, and mouth sores. The nurse notifies the patient?s physician because the nurse suspects which of the following?
- A. Severe anemia
- B. Neuroleptic malignant syndrome
- C. Encephalitis
- D. Agranulocytosis
Correct Answer: D
Rationale: Fever, sore throat, and mouth sores in a patient taking clozapine suggest agranulocytosis, a serious side effect involving a dangerous drop in white blood cells, requiring immediate medical attention. Anemia, neuroleptic malignant syndrome, and encephalitis have different symptom profiles.
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A nurse administers a prescribed dose of lithium at 8 PM. The nurse would schedule a specimen to be obtained for a blood level at which time?
- A. 10:00 PM
- B. 12:00 AM
- C. 4:00 AM
- D. 8:00 AM
Correct Answer: D
Rationale: Lithium levels are typically drawn 12 hours after the last dose to measure trough levels, ensuring steady-state concentration. A dose at 8 PM would require a blood draw at 8 AM. Earlier times (10 PM, 12 AM, 4 AM) do not align with this timing.
A patient is experiencing hallucinations and delusions. The nurse would expect the physician to order which class of drug?
- A. Mood stabilizer
- B. Antipsychotic
- C. Antianxiety agent
- D. Stimulant
Correct Answer: B
Rationale: Hallucinations and delusions are hallmark symptoms of psychosis, treated primarily with antipsychotics. Mood stabilizers address bipolar disorder, antianxiety agents treat anxiety, and stimulants are used for ADHD, not psychosis.
The nurse is reviewing the medical records of several patients receiving antipsychotic agents. Which factors, if noted, would the nurse identify as placing a patient at greater risk for tardive dyskinesia?
- A. Male gender
- B. Age 30 to 45 years
- C. History of depression
- D. Short duration of treatment
Correct Answer: None
Rationale: Tardive dyskinesia risk factors include older age, female gender, longer treatment duration, and certain conditions, not depression. None of the options (male gender, age 30?45, depression, short duration) are primary risk factors, suggesting a possible test error, but none apply.
A group of nursing students are reviewing information related to drug therapy for mood disorders. The students demonstrate understanding of the information when they identify which agent as the gold standard for treating bipolar disorder?
- A. Carbamazepine
- B. Lithium
- C. Valproate
- D. Lamotrigine
Correct Answer: B
Rationale: Lithium is the gold standard for bipolar disorder due to its proven efficacy in stabilizing mood and preventing manic episodes. Carbamazepine, valproate, and lamotrigine are used but are not considered the primary standard.
A patient is prescribed medication for a psychiatric disorder. After 3 days, the patient tells the nurse that he or she has been constipated. Which instruction would the nurse give the patient?
- A. You need to eat more high-protein foods such as meat and peanut butter.
- B. You need to eat more fruits and vegetables and drink more water.
- C. Ask your psychiatrist to prescribe a stool softener for you.
- D. This side effect should disappear within a week or so.
Correct Answer: B
Rationale: Constipation, a common side effect of psychiatric medications, can be managed by increasing dietary fiber (fruits and vegetables) and hydration (water). High-protein foods may worsen constipation, a stool softener may be premature without dietary changes, and waiting for resolution dismisses the patient?s discomfort.