Nokea
When a patient with paranoid schizophrenia has a recurrence of positive symptoms after stopping his antipsychotic medication because of its postural hypotension (orthostasis) side effect, he is readmitted to the mental health unit. What measure should the nurse suggest to help the patient address this side effect?
- A. Ask the doctor to prescribe an anticholinergic drug like trihexyphenidyl (Artane).
- B. Chew sugarless gum or use sugarless hard candy to moisten your mouth.
- C. Increase the amount of sleep you get, and try to take frequent rest breaks.
- D. Wear elastic support hose, drink adequate fluids, and change position slowly.
Correct Answer: D
Rationale: The correct answer is D because orthostatic hypotension is a common side effect of antipsychotic medications. Elastic support hose can help improve venous return, adequate fluids can prevent dehydration which worsens hypotension, and changing position slowly can prevent sudden drops in blood pressure. This measure directly addresses the side effect.
A: Anticholinergic drugs can worsen orthostatic hypotension.
B: Chewing gum or using candy does not address the physiological issue of orthostatic hypotension.
C: Increasing sleep and rest breaks may help overall well-being but does not directly address orthostatic hypotension.
You may also like to solve these questions
Which of the following is an example of a peri-natal cause of intellectual disability when there is a significant period without oxygen occurring during or immediately after delivery?
- A. Anoxia
- B. Pronoxia
- C. Anaphylaxia
- D. Dysnoxia
Correct Answer: A
Rationale: Anoxia: A peri-natal cause of intellectual disability due to a significant period without oxygen during or after delivery.
An elderly client who lives with her daughter and son-in-law and their three children reveals that her daughter sometimes slaps her when she does not move fast enough or spills things. The daughter is a mid-level business executive who is under considerable stress at work. The children are often left in the care of the elderly client. The husband is often out of town on business trips. The daughter states, 'I have so much to do that I become frustrated when my mother can't move fast enough or causes me extra work.' The nurse caring for the mother could appropriately suggest:
- A. Family therapy.
- B. Individual counseling for the daughter.
- C. Respite care for the elderly client.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Family therapy. Family therapy is the most appropriate suggestion because it addresses the dysfunctional dynamics within the family and provides an opportunity for all family members to work through their issues. In this scenario, the daughter's stress at work and lack of coping skills are contributing to the abuse of the elderly client. Family therapy can help the family communicate effectively, set boundaries, and address underlying issues causing the abuse.
Choice B (Individual counseling for the daughter) may help the daughter address her stress and coping mechanisms, but it does not address the family dynamics that are contributing to the abuse. Choice C (Respite care for the elderly client) provides temporary relief but does not address the root cause of the issue. Choice D (None of the above) is incorrect as family therapy is the most appropriate intervention in this case.
The signs and symptoms of schizophrenia must be present for at least _____ months before a diagnostic label is assigned.
- A. 3
- B. 6
- C. 12
- D. 18
Correct Answer: C
Rationale: The correct answer is C (12 months) because the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires symptoms to be present for at least 6 months before a diagnosis of schizophrenia can be made. This prolonged duration helps ensure that the symptoms are not due to temporary factors. Therefore, option C is the most appropriate choice. Options A (3 months), B (6 months), and D (18 months) do not align with the established diagnostic criteria for schizophrenia.
A client with paranoid schizophrenia has said she feels like throwing a chair. The nurse in the dayroom hears this and wishes to encourage verbalization as a desecalation technique. Which response by the nurse would fulfill this plan?
- A. Tell me what's going on.'
- B. If you throw something, you will be restrained.'
- C. Why are you so upset?'
- D. It's time for group therapy. You can talk there.'
Correct Answer: A
Rationale: The correct answer is A because it encourages the client to express their feelings verbally, promoting communication and potentially preventing escalation of behavior. By saying "Tell me what's going on," the nurse acknowledges the client's emotions and creates a safe space for them to talk. Option B threatens restraint, likely increasing tension. Option C may come off as confrontational. Option D distracts from the immediate need for the client to process their feelings.
An elderly client was well until 12 hours ago, when she reported to her family that during the evening she saw strange faces peering in her windows and in the middle of the night awakened to see a man standing at the foot of her bed. She admits to being very frightened. She is presently pacing and somewhat agitated in the examining room. The client's family reports that the client has recently been to the doctor, who made some medication changes, although they are unsure what the changes were. The nurse hearing this history will identify the history and symptoms as pointing to:
- A. Delirium related to drug toxicity
- B. Pick's disease
- C. Parkinson's dementia
- D. Amnestic disorder
Correct Answer: A
Rationale: The correct answer is A: Delirium related to drug toxicity. The client's sudden onset of visual hallucinations, fear, agitation, recent medication changes, and pacing behavior are indicative of delirium. Delirium is an acute change in mental status characterized by confusion, disorientation, and perceptual disturbances, often triggered by medication changes in the elderly. Pick's disease (B) is a type of frontotemporal dementia characterized by personality changes and language difficulties. Parkinson's dementia (C) is a type of dementia associated with Parkinson's disease, presenting with motor symptoms first. Amnestic disorder (D) is a memory impairment disorder, not consistent with the client's symptoms.