Nokea
The nurse is providing care to a client receiving clozapine (Clozaril). The nurse would be alert for an increased risk of bone marrow suppression if the client is also receiving which of the following? Select all that apply.
- A. Immunological agents
- B. Anticholinergics
- C. Opioids
- D. Anticoagulants
Correct Answer: A
Rationale: The concomitant use of clozapine and immunological drugs can increase the severity of bone marrow suppression. The use of anticholinergics in combination with antipsychotics can increase the risk of tardive dyskinesia and psychotic symptoms. Opioids and anticoagulants are not associated with interactions involving antipsychotic drugs.
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A nurse asses a client receiving antipsychotic drugs for which of the following adverse reactions?
- A. Hypertension
- B. Skin dryness
- C. Dry mouth
- D. Bradycardia
Correct Answer: C
Rationale: The nurse should monitor the client for mouth dryness. Antipsychotic drugs cause hypotension, not hypertension. Skin dryness and bradycardia are not adverse reactions related to the administration of antipsychotic drugs.
A nurse observes rhythmic, involuntary facial movements in a client who has been receiving antipsychotic drugs. The client also makes chewing movements and, at times, his tongue protrudes. The nurse interprets these findings as which of the following?
- A. Stevens-Johnson syndrome
- B. Neuropeptic malignant syndrome
- C. Tardive dyskinesia
- D. Extrapyramidal syndrome
Correct Answer: C
Rationale: Tardive dyskinesia is characterized by rhythmic, involuntary movements of the tongue, face, mouth, or jaw and sometimes the extremities. The tongue may protrude, and there may be chewing movements, puckering of the mouth, and facial grimacing. Extrapyramidal syndrome (EPS), neuroleptic malignant syndrome (NMS), and Stevens-Johnson syndrome do not cause rhythmic, involuntary facial movements.
Before administering a prescribed antipsychotic drug to a client, the nurse observes the client for any behavior patterns that appear to be deviations from normal. Which of the following would the nurse identify as a deviation? Select all that apply.
- A. Poor eye contact
- B. Monotone speech pattern
- C. Inappropriate laughter
- D. Failure to answer questions completely
- E. Inappropriate crying
Correct Answer: A,B,C,D,E
Rationale: Examples of deviation from normal include poor eye contact, failure to answer questions completely, inappropriate answers to questions, a monotone speech pattern, and inappropriate laughter, sadness, or crying.
A nurse is caring for a client with schizophrenia. The physician has prescribed olanzapine in a disintegrating tablet form for the client. Which of the following points should the nurse include in the teaching plan for the client?
- A. Remove the tablet with dry hands.
- B. Take the tablet with a full glass of water.
- C. Add extra salt to food.
- D. Avoid tea or coffee.
Correct Answer: A
Rationale: The nurse should instruct the client to remove the olanzapine tablet with dry hands and place the entire tablet in his or her mouth. Wet or damp hands may cause the medication to begin disintegrating prior to entering the client's mouth. There is no need to add extra salt to food. The client is required to take orally disintegrating olanzapine, so there is no need to take any fluid with the drug. Also, there is no need to avoid tea or coffee.
After teaching a group of nursing students about antipsychotics, the instructor determines that the teaching was successful when the students identify which of the following as a typical antipsychotic? Select all that apply.
- A. Lithium (Eskalith)
- B. Aripiprazole (Abilify)
- C. Chlorpromazine (Thorazine)
- D. Haloperidol (Haldol)
- E. Fluphenazine (Prolixin)
Correct Answer: C,D,E
Rationale: Chlorpromazine, haloperidol, and fluphenazine are classified as typical antipsychotics.