Age Specific Populations

Age Specific Populations Related

Review Age Specific Populations related questions and content

When a patient diagnosed with paranoid schizophrenia was discharged from the unit 6 months ago, the plan was for him to take chlorpromazine (Thorazine), a conventional (first generation) antipsychotic medication, 300 mg po daily. He tells the nurse he stopped taking his pills after a few months because they made him feel like a 'zombie.' What other common side effects should the nurse determine if the patient experienced?

  • A. Sweating, nausea, and weight gain
  • B. Sedation, tremor, and muscle stiffness
  • C. Headache, watery eyes, and runny nose
  • D. Mild fever, sore throat, and skin rash
Correct Answer: B

Rationale: The correct answer is B: Sedation, tremor, and muscle stiffness. This is because chlorpromazine, being a first-generation antipsychotic, commonly causes sedation, tremors, and muscle stiffness as side effects. Sedation is a common effect due to the drug's ability to block dopamine receptors in the brain. Tremors and muscle stiffness are also common due to the drug's action on the central nervous system. Choices A, C, and D are incorrect as they do not align with the expected side effects of chlorpromazine. Sweating, nausea, weight gain, headache, watery eyes, runny nose, mild fever, sore throat, and skin rash are not typically associated with this medication.

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The physician and advanced practice nurse are considering which antipsychotic medication to prescribe for a patient with schizophrenia who demonstrates auditory hallucinations, apathy, anhedonia, and poor social functioning. The patient is overweight and has hypertension. Bearing these facts in mind, the drug the nurse should advocate would be:

  • A. clozapine (Clozaril).
  • B. haloperidol (Haldol).
  • C. olanzapine (Zyprexa).
  • D. aripiprazole (Ability).
Correct Answer: D

Rationale: The correct answer is D: aripiprazole (Ability). Aripiprazole is a second-generation antipsychotic that is less likely to cause weight gain and metabolic side effects compared to other antipsychotics like clozapine (A), olanzapine (C), and haloperidol (B). Given that the patient is overweight and has hypertension, aripiprazole would be a better choice to minimize the risk of exacerbating these conditions. Additionally, aripiprazole has a lower risk of sedation, which can be beneficial for a patient with apathy and anhedonia, allowing for improved social functioning. Aripiprazole's unique mechanism of action as a partial dopamine agonist can also be advantageous for managing auditory hallucinations in schizophrenia. Therefore, aripiprazole is the most suitable choice for this patient based on their clinical presentation and comorbidities.

Diet, exercise and establishing a regular sleep cycle are all effective treatments for many mental disorders in teenagers

  • A. TRUE
  • B. FALSE
Correct Answer: A

Rationale: Lifestyle interventions like diet, exercise, and sleep hygiene are evidence-based adjuncts for managing many mental disorders.

The nurse reports to the interdisciplinary team that an antisocial patient lies to other patients, verbally abuses a patient with Alzheimer's disease, flatters his primary nurse, and is detached and superficial during counseling sessions. Which behavior should be the priority focus of limit setting?

  • A. Lying to other patients
  • B. Flattering the nursing staff
  • C. Verbally abusing other patients
  • D. Superficiality during counseling
Correct Answer: C

Rationale: The correct answer is C: Verbally abusing other patients should be the priority focus of limit setting. This behavior poses a direct threat to the safety and well-being of other patients. By addressing verbal abuse first, the nurse can establish boundaries and maintain a safe environment for all patients. Lying to other patients (A) may be addressed but is not as immediate a concern. Flattering the nursing staff (B) is manipulative but not as harmful as verbal abuse. Superficiality during counseling sessions (D) may indicate other issues but is not as urgent as addressing the verbal abuse.

The wife of a client who is being seen in the sleep clinic states that her husband snores terribly at night and that she has to shake him to get him to stop. The client complains of a headache upon wakening and often falls asleep during the day when he sits for long periods. This client is exhibiting signs and symptoms characteristic of:

  • A. Narcolepsy.
  • B. Parasomnia.
  • C. Sleep apnea.
  • D. None of the above.
Correct Answer: C

Rationale: The correct answer is C: Sleep apnea. This client is showing classic signs of obstructive sleep apnea, including loud snoring, waking up with headaches, and excessive daytime sleepiness. Snoring and the need for physical stimulation to stop snoring are common in sleep apnea. The headaches may be due to disrupted sleep patterns and oxygen deprivation. Excessive daytime sleepiness is a result of poor quality sleep.

Choice A (Narcolepsy) is incorrect because narcolepsy is characterized by sudden, uncontrollable episodes of falling asleep during the day, often accompanied by cataplexy and sleep paralysis, which are not mentioned in the scenario.

Choice B (Parasomnia) is incorrect because parasomnias involve abnormal behaviors during sleep, such as sleepwalking or night terrors, which are not described in the scenario.

Choice D (None of the above) is incorrect because the symptoms described align with obstructive sleep apnea.

An elderly patient must be physically restrained. Who is responsible for the patients safety?

  • A. The nurse assigned to care for the patient
  • B. Unlicensed assistive personnel who apply the restraint
  • C. Family member who agrees to application of the restraint
  • D. Health care provider who prescribed application of restraint
Correct Answer: A

Rationale: Although restraint is prescribed by a health care provider, the restraint is a measure carried out by nursing staff. The nurse caring for the patient is responsible for safe application of restraining devices and for providing safe care while the patient is restrained. Nurses may delegate the application of restraining devices and the care of the patient in restraint, but the nurse remains responsible for outcomes. Even when family agree to restraint, nurses are responsible for providing safe outcomes.

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