Nokea
When administering antipsychotic drugs, the nurse would need to keep in mind that which of the following atypical antipsychotics are most commonly associated with weight gain? Select all that apply.
- A. Olanzapine (Zyprexa)
- B. Rispendone (Risperdal)
- C. Ziprasidone (Geodon)
- D. Quetiapine (Seroquel)
- E. Clozapine (Clozaril)
Correct Answer: A,B
Rationale: Olanzapine (Zyprexa) and risperidone (Risperdal) are atypical antipsychotics that are most commonly associated with weight gain. None of the other drugs are associated with weight gain.
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Which of the following are reasons a nurse may need to contact the client's physician to administer an antipsychotic drug intramuscularly instead of orally? Select all that apply.
- A. Client is combative.
- B. Client refuses the medication.
- C. Client won't allow the nurse to inspect the oral cavity.
- D. Client has difficulty swallowing.
- E. Client is elderly.
Correct Answer: A,B,C
Rationale: A nurse may need to contact the client's physician to administer an antipsychotic drug intramuscularly instead of orally because the client is combative, refuses the medication, or refuses to allow the nurse to inspect the oral cavity. Clients who have difficulty swallowing may be given an oral liquid in lieu of an IM injection.
A client is receiving antipsychotic therapy. As part of the client's plan of care, the nurse assesses the client for possible adverse reactions. Which of the following would lead the nurse to suspect that the client is experiencing extrapyramidal effects? Select all that apply.
- A. Mask-like facial appearance
- B. Increased motor activity
- C. Facial grimacing
- D. Delusions
- E. Flat affect
Correct Answer: A,B,C
Rationale: Manifestations of extrapyramidal syndrome include Parkinson-like symptoms-fine tremors, muscle rigidity, mask-like appearance of the face, slowness of movement, slurred speech, and unsteady gait; akathisia - extreme restlessness and increased motor activity; and dystonia - facial grimacing and twisting of the neck into unnatural positions. Delusions and flat affect are manifestations associated with schizophrenia.
A client comes to the emergency department and tells the nurse, 'I've been hiccoughing constantly for the past 6 or 7 hours and nothing I do to stop them seems to work.' The nurse would expect the primary health care provider to prescribe which of the following?
- A. Prochlorperazine
- B. Chlorpromazine
- C. Haloperidol
- D. Olanzapine
Correct Answer: B
Rationale: Chlorpromazine may be used to treat uncontrolled hiccoughs. Prochlorperazine may be used as an antiemetic. Haloperidol and olanzapine are not indicated for uncontrolled hiccoughs.
When describing tardive dyskinesia (TD) associated with the use of antipsychotic medication, which of the following would the nurse integrate into the teaching plan? Select all that apply.
- A. TD is an early-appearing adverse reaction.
- B. TD involves rhythmic, involuntary movements of the facial structures.
- C. TD is a reversible adverse effect of antipsychotic drugs.
- D. TD is less likely to occur with the use of atypical psychotics.
- E. TD can occur after discontinuation of antipsychotic drug therapy.
Correct Answer: B,D,E
Rationale: TD is a late-appearing reaction that is characterized by rhythmic, involuntary movements of the tongue, face, mouth, or jaw and sometimes the extremities, TD is nonreversible, can occur during antipsychotic drug therapy or after discontinuation, and is less likely to occur with the use of atypical antipsychotics.
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.