Nokea
One week after beginning therapy with thiothixene (Navane), the client demonstrates muscle rigidity, a temperature of 39.5?°C, and altered mental status. The nurse should notify the physician because these symptoms are indicative of
- A. Acute dystonia
- B. Extrapyramidal side effects
- C. Neuroleptic malignant syndrome
- D. Tardive dyskinesia
Correct Answer: C
Rationale: These symptoms "muscle rigidity, high fever, and altered mental status "are classic signs of neuroleptic malignant syndrome, a potentially fatal reaction requiring immediate medical attention.
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A client has a lithium level of 1.2 mEq/L. Which of the following interventions by the nurse is indicated?
- A. Call the physician for an increase in dosage.
- B. Do not give the next dose, and call the physician.
- C. Increase fluid intake for the next week.
- D. No intervention is necessary at this time.
Correct Answer: D
Rationale: A lithium level of 1.2 mEq/L is within the therapeutic range (0.5-1.5 mEq/L), so no intervention is necessary.
A client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. The nurse observes that the client's behavior includes repetitive movements of the mouth and tongue, facial grimacing, and rocking back and forth. The nurse recognizes these behaviors as indicative of
- A. Extrapyramidal side effects
- B. Loss of voluntary muscle control
- C. Posturing
- D. Tardive dyskinesia
Correct Answer: D
Rationale: These behaviors are classic signs of tardive dyskinesia, a syndrome of permanent involuntary movements commonly caused by long-term use of conventional antipsychotic drugs.
Which of the following is an inhibitory neurotransmitter?
- A. Dopamine
- B. GABA
- C. Norepinephrine
- D. Epinephrine
Correct Answer: B
Rationale: GABA is the major inhibitory neurotransmitter in the brain and has been found to modulate other neurotransmitter systems rather than to provide a direct stimulus. Dopamine, norepinephrine, and epinephrine are excitatory neurotransmitters.
An abnormality of which of the following structures of the cerebrum would be associated with schizophrenia?
- A. Parietal lobes
- B. Frontal lobe
- C. Occipital lobe
- D. Temporal lobes
Correct Answer: B
Rationale: Abnormalities in the frontal lobes are associated with schizophrenia, attention deficit hyperactivity disorder (ADHD), and dementia. The parietal lobes interpret sensations of taste and touch and assist in spatial orientation. The temporal lobes are centers for the senses of smell and hearing and for memory and emotional expression. The occipital lobe assists in coordinating language generation and visual interpretation, such as depth perception.
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.