Nokea
When teaching a client who is to receive antipsychotic therapy, the nurse would include which of the following as a common skin reaction that might occur when initiating therapy? Select all that apply.
- A. Urticaria
- B. Stevens-Johnson syndrome
- C. Photosensitivity
- D. Hyperpigmentation
- E. Toxic epidermal necrolysis
Correct Answer: A,C
Rationale: Urticaria and photosensitivity are common skin reactions a nurse should warn a client about when the client is initiated on antipsychotic therapy.
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A nurse would assess a client treated with an antipsychotic medication for which of the following behaviors if the antipsychotic medication was stopped? Select all that apply.
- A. Hallucinations
- B. Anhedonia
- C. Delusions
- D. Dystonia
- E. Flattened affect
Correct Answer: A,B,C,E
Rationale: Antipsychotic medications help control symptoms associated with psychotic disorders such as hallucinations, delusions, disorganized speech, behavior disturbances, social withdrawal, flattened affect, and anhedonia. Dystonia would be noted as an adverse reaction with antipsychotic drugs.
The caregiver of a client who is started on antipsychotic drug therapy asks the nurse when the client's symptoms will improve. Which response by the nurse would be most appropriate?
- A. You should notice an improvement in the next day or two.'
- B. It might take about 6 weeks or so before the drug is most effective.'
- C. There's no way to tell but usually it takes about a week.'
- D. Look for movements of his face, mouth, or jaw and that's the sign.'
Correct Answer: B
Rationale: Antipsychotics take time to produce the optimal effect, sometimes 6 to 10 weeks. Evidence of tongue, facial, or mouth movements suggest tardive dyskinesia, a late-appearing reaction that requires discontinuation of the drug.
A nurse caring for a client receiving clozapine (Clozaril) needs to be mindful of the symptoms that indicate bone marrow suppression. Assessment of which of the following would lead the nurse to suspect that the client is experiencing bone marrow suppression? Select all that apply.
- A. Hypertension
- B. Sore throat
- C. Fever
- D. Chills
- E. Weakness
Correct Answer: B,C,D,E
Rationale: Symptoms that indicate bone marrow suppression include lethargy, weakness, fever, sore throat, malaise, mucous membrane ulceration, and 'flu-like' complaints.
A nurse is administering haloperidol to a client with schizophrenia. The nurse determines that the drug is effective when there is improvement in which of the following? Select all that apply.
- A. Agitation
- B. Alogia
- C. Concrete thinking
- D. Delusions
- E. Hallucinations
Correct Answer: A,D,E
Rationale: Haloperidol is a conventional antipsychotic that is used to control the positive symptoms of schizophrenia, such as agitation, delusions, and hallucinations. Effectiveness of the drug would lead to a decrease in these positive symptoms. Atypical antipsychotics help to diminish the negative symptoms such as alogia and problems with concrete thinking.
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.