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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.
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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.
A nurse is caring for a psychiatric patient who is receiving an antacid that contains aluminum salts. Which action by the nurse would be most appropriate?
- A. Give the antacid 1 hour before the antipsychotic medication.
- B. Give the antacid at the same time as the antipsychotic medication.
- C. Administer the antacid 1 hour after the antipsychotic medication.
- D. Administer the antacid just before the patient goes to sleep.
Correct Answer: A
Rationale: Aluminum-containing antacids can bind with antipsychotics in the gut, reducing absorption. Administering the antacid 1 hour before the antipsychotic ensures proper absorption of the medication. Giving them together or after may interfere, and bedtime administration is irrelevant to absorption timing.
An older adult is complaining of anxiety is prescribed diazepam (Valium) by a family physician. The physician asks the office nurse to explain the problematic side effects of this medication to the patient. Which instruction would be most important for the nurse to emphasize about this drug?
- A. You may experience minor urine incontinence from time to time.
- B. You may find that you have temporary memory disturbances.
- C. You need to use this medication cautiously because it can cause dependence.
- D. You may feel dizzy and be prone to falls after taking this medication.
Correct Answer: D
Rationale: Diazepam, a benzodiazepine, poses a significant risk of dizziness and falls in older adults due to sedation and impaired coordination, which is critical to emphasize for safety. Incontinence is not a common side effect, memory disturbances are less immediate, and dependence, while important, is a longer-term concern.
A nurse is preparing a patient for electroconvulsive therapy. Which of the following would the nurse include in the patient?s plan of care? Select all that apply.
- A. Ensuring that there is a signed informed consent on the patient?s chart
- B. Telling the patient he can have fluids but no food before the procedure
- C. Alerting the patient to the possibility of confusion after the treatment
- D. Informing the patient that he can leave his dentures in place for the treatment
- E. Ensuring that the patient is closely supervised for at least the first 12 hours afterward
Correct Answer: A,C,E
Rationale: ECT requires informed consent (A), warning about post-procedure confusion (C), and close supervision afterward (E) due to risks like disorientation. Patients must be NPO (no food or fluids) before ECT, and dentures must be removed to prevent airway obstruction, making B and D incorrect.
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.