Nokea
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.
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After teaching a group of nursing students about antipsychotics, the instructor determines that the teaching was successful when the students identify which of the following as a typical antipsychotic? Select all that apply.
- A. Lithium (Eskalith)
- B. Aripiprazole (Abilify)
- C. Chlorpromazine (Thorazine)
- D. Haloperidol (Haldol)
- E. Fluphenazine (Prolixin)
Correct Answer: C,D,E
Rationale: Chlorpromazine, haloperidol, and fluphenazine are classified as typical antipsychotics.
A client is prescribed an antipsychotic drug that also has an antiemetic effect. Which of the following would the nurse identify as having this effect? Select all that apply.
- A. Lithium (Eskalith)
- B. Aripiprazole (Abilify)
- C. Chlorpromazine (Thorazine)
- D. Prochlorperazine (Compazine)
- E. Clozapine (Clozaril)
Correct Answer: C,D
Rationale: Chlorpromazine (Thorazine) and prochlorperazine (Compazine) are antipsychotic medications that have antiemetic effects. Lithium, aripiprazole, and clozapine do not.
After administering an antipsychotic to a client, the nurse would immediately report which of the following?
- A. Orthostatic hypotension
- B. Dry mouth
- C. Rigidity
- D. Drowsiness
Correct Answer: C
Rationale: The nurse should immediately report to the primary health care provider if the client displays signs of rigidity. Dry mouth, episodes of orthostatic hypotension, and drowsiness are reactions that are considered normal during drug therapy and need not be reported unless severe.
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.
When assessing a client receiving antipsychotic drugs, the nurse would suspect that the client is experiencing extrapyramidal syndrome (EPS) based on assessment of which of the following? Select all that apply.
- A. Fine tremor
- B. Hypotension
- C. Akathisia
- D. Anhedonia
- E. Dystonia
Correct Answer: A,C,E
Rationale: The signs of EPS include fine tremors, muscle rigidity, mask-like appearance of the face, slowness of movement, slurred speech, unsteady gait, akathisia, and dystonia. Anhedonia is a manifestation of schizophrenia.