Nokea
The nurse is caring for a 24-year-old client newly diagnosed with schizophrenia. The client asks: 'How could this be happening? What is wrong with my brain?' The nurse is most correct to identify which neurotransmitter as having the highest imbalance?
- A. Acetylcholine
- B. Dopamine
- C. Serotonin
- D. Gamma-aminobutyric acid
Correct Answer: B
Rationale: Schizophrenia is characterized as a psychobiologic disease because of findings in brain and neurotransmitter chemistry. Dopamine excess is believed to be the major cause of symptoms, with imbalance of norepinephrine, serotonin, and gamma-aminobutyric acid also playing a role.
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The nurse is caring for a client diagnosed with delirium. What does the nurse know to be true of delirium?
- A. It is incurable.
- B. It is a sudden, transient state.
- C. It has a gradual onset.
- D. It is considered permanent.
Correct Answer: B
Rationale: Delirium is a sudden, transient state of confusion. The period of confusion depends on the cause of the delirium. Treating the underlying medical condition usually restores mental function.
Which of the following is the primary reason for monitoring food and fluid intake and toilet patterns of a client with mental disabilities?
- A. Regular checkup
- B. To identify problems
- C. To determine common symptoms
- D. Physician's record
Correct Answer: B
Rationale: The nurse monitors food and fluid intake and toilet patterns because data collection facilitates problem identification, not as part of a regular checkup or for determining common symptoms. The physician may refer to these records whenever required.
A family brings a parent to the physician's office to discuss the parent's decline in cognitive status. The family states that the parent is forgetful and needs reminders to be able to live alone. Following assessment, which stage of Alzheimer disease does the nurse anticipate?
- A. Preclinical
- B. Post clinical
- C. Mild cognitive impairment
- D. Alzheimer dementia
Correct Answer: C
Rationale: The nurse is most correct to anticipate that the client will be diagnosed at the mild cognitive impairment stage of Alzheimer disease. At this stage, the client has noticeable memory problems, however, the memory loss is not serious enough to interfere with independent living.
During a multidisciplinary meeting, the group discussed potential signs of tardive dyskinesia noted sporadically in a client. Following the meeting, symptoms progressed for the client. Which medical order does the nurse anticipate?
- A. Reduce the medication dose.
- B. Discontinue the medication.
- C. Provide an adjunct medication.
- D. Begin alternate treatments.
Correct Answer: B
Rationale: Nurses and the multidisciplinary team consistently assess the client taking antipsychotic medications to check for tardive dyskinesia. When symptoms progress, the nurse should report the symptoms immediately because the drug must be discontinued. Reducing the dose, adjunct medications, and alternative treatments would not be the medical orders issued.
The nurse is providing discharge instructions to the client being prescribed antipsychotic medications. Which discharge instruction(s) should be included? Select all that apply.
- A. Stop the medication for any side effects.
- B. Double the next dose if you forget one dose.
- C. Report any rhythmic, involuntary movements of the tongue, face, mouth, jaw, or extremities immediately.
- D. Take all antipsychotic medications as directed.
- E. Notify the health care provider if you have hypertension or severe muscle stiffness.
Correct Answer: C,D,E
Rationale: When providing discharge instructions to a client prescribed antipsychotic medications, the nurse should instruct the client to take all medications as directed and notify the health care provider for any side effects including a high fever, increased confusion, dyspnea, tachycardia, hypertension, severe muscle weakness, or loss of bladder control, because these are signs of neuroleptic malignant syndrome. Similarly, the client should immediately report any rhythmic, involuntary movements of the tongue, face, mouth, jaw, or extremities, because these are signs of tardive dyskinesia. The client should not abruptly stop medications or double the dosage at any time.