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The nurse is caring for an elderly client who has been taking an antipsychotic medication for 1 week. The nurse notifies the physician when he observes that the client has muscle rigidity that resembles Parkinson?s disease. Which agent would the nurse expect the physician to prescribe?
- A. Anticholinergic
- B. Anxiolytic
- C. Benzodiazepine
- D. Beta-blocker
Correct Answer: A
Rationale: Anticholinergic agents (A), such as benztropine, are used to treat extrapyramidal symptoms (EPS) like parkinsonian muscle rigidity caused by antipsychotics, by balancing acetylcholine and dopamine. Anxiolytics (B) and benzodiazepines (C) address anxiety, not EPS, and beta-blockers (D) treat akathisia or other symptoms, not rigidity.
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Which of the following would be most important for the nurse to keep in mind when establishing the nurse-patient relationship with a client with schizophrenia to promote recovery?
- A. The relationship typically develops over a short period of time.
- B. Decisions about care are the responsibility of interdisciplinary team.
- C. Short, time-limited interactions are best for the client experiencing psychosis.
- D. Typically, clients with schizophrenia readily engage in a therapeutic relationship.
Correct Answer: C
Rationale: Short, time-limited interactions (C) are most effective for clients with schizophrenia experiencing psychosis, as they reduce overstimulation and build trust gradually. Relationships take time (A), interdisciplinary teams share decisions (B), and engagement is often challenging (D), not readily achieved.
As part of an interdisciplinary team, a nurse is assisting in developing the plan of care for a client with a delusional disorder. Which of the following would the team be least likely to include in the plan?
- A. Insight-oriented therapy
- B. Psychoeducation
- C. Cognitive therapy
- D. Support therapy
Correct Answer: A
Rationale: Insight-oriented therapy (A) is least likely for delusional disorder, as clients often lack insight into their delusions, making this approach less effective. Psychoeducation (B), cognitive therapy (C), and support therapy (D) are more practical for managing symptoms and coping.
A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer?
- A. Diphenhydramine (Benadryl)
- B. Propranolol (Inderal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: A
Rationale: Diphenhydramine (A), an antihistamine with anticholinergic properties, is commonly used to treat acute dystonic reactions caused by antipsychotics, relieving muscle spasms. Propranolol (B) treats akathisia, while risperidone (C) and aripiprazole (D) are antipsychotics that could worsen dystonia.
A client with schizophrenia tells the nurse, I?m being watched constantly by the FBI because of my job. Which response by the nurse would be most appropriate?
- A. Tell me more about how you are being watched.
- B. It must be frightening to feel like you?re always been watched.
- C. You?re not being watched; it?s all in your mind.
- D. You are experiencing a delusion because of your illness.
Correct Answer: B
Rationale: Empathizing with the client?s fear (B) validates their emotions without reinforcing the delusion, fostering trust. Asking for more details (A) may entrench the delusion, while dismissing (C) or labeling it (D) could alienate the client.
The nurse is interviewing a client with schizophrenia when the client begins to say, Kite, night, right, height, fright. The nurse documents this as which of the following?
- A. Clang association
- B. Stilted language
- C. Verbigeration
- D. Neologisms
Correct Answer: A
Rationale: Clang association (A) describes speech patterns where words are chosen for their sound (e.g., rhyming), as seen in the client?s list, common in schizophrenia. Stilted language (B) is overly formal, verbigeration (C) is repetitive phrases, and neologisms (D) are invented words, none of which fit.