A client diagnosed with chronic schizophrenia presents in an emergency department
(ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The
nurse would expect the physician to recognize which condition and implement which
treatment?
A. Neuroleptic malignant syndrome and treat by discontinuing antipsychotic
medications
B. Agranulocytosis and treat by administration of clozapine (Clozaril)
C. Extrapyramidal symptoms and treat by administration of benztropine (Cogentin)
D. Tardive dyskinesia and treat by discontinuing antipsychotic medications
Give this one a try later!
, ANS: D
The nurse should expect that an ED physician would diagnose the client
with tardive dyskinesia and discontinue antipsychotic medications. Tardive
dyskinesia is a condition of abnormal involuntary movements of the mouth,
tongue, trunk, and extremities that can be an irreversible side effect of
typical antipsychotic medications.
A client diagnosed with paranoid schizophrenia states, "My psychiatrist is out to get
me. I'm sad that the voice is telling me to stop him." What symptom is the client
exhibiting, and what is the nurse's legal responsibility related to this symptom?
A. Magical thinking; administer an antipsychotic medication
B. Persecutory delusions; orient the client to reality
C. Command hallucinations; warn the psychiatrist
D. Altered thought processes; call an emergency treatment team meeting
Give this one a try later!
ANS: C
The nurse should determine that the client is exhibiting command
hallucinations. The nurse's legal responsibility is to warn the psychiatrist of
the potential for harm. A client who is demonstrating a risk for violence
could potentially become physically, emotionally, and/or sexually harmful
to others or to self.
A client states, "I hear voices that tell me that I am evil." Which outcome related to
these symptoms should the nurse expect this client to accomplish by discharge?
A. The client will verbalize the reason the voices make derogatory statements.
B. The client will not hear auditory hallucinations.
C. The client will identify events that increase anxiety and illicit hallucinations.
D. The client will positively integrate the voices into the client's personality structure.
, Give this one a try later!
ANS: C
It is unrealistic to expect the client to completely stop hearing voices. Even
when compliant with antipsychotic medications, clients may still hear
voices. It would be realistic to expect the client to associate stressful
events with an increase in auditory hallucinations. By this recognition the
client can anticipate symptoms and initiate appropriate coping skills.
After taking chlorpromazine (Thorazine) for 1 month, a client presents to an
emergency department (ED) with severe muscle rigidity, tachycardia, and a
temperature of 105oF (40.5C). The nurse expects the physician to recognize which
condition and implement which treatment?
A. Neuroleptic malignant syndrome and treat by discontinuing Thorazine and
administering dantrolene (Dantrium)
B. Neuroleptic malignant syndrome and treat by increasing Thorazine dosage and
administering an antianxiety medication
C. Dystonia and treat by administering trihexyphenidyl (Artane)
D. Dystonia and treat by administering bromocriptine (Parlodel)
Give this one a try later!
ANS: A
The nurse should expect that an ED physician would diagnose the client
with neuroleptic malignant syndrome and treat the client by discontinuing
chlorpromazine (Thorazine) and administering dantrolene (Dantrium).
Neuroleptic malignant syndrome is a potentially fatal condition
characterized by muscle rigidity, fever, altered consciousness, and
autonomic instability. The use of typical antipsychotics is largely being
replaced by atypical antipsychotics due to fewer side effects and lower
risks.
(ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The
nurse would expect the physician to recognize which condition and implement which
treatment?
A. Neuroleptic malignant syndrome and treat by discontinuing antipsychotic
medications
B. Agranulocytosis and treat by administration of clozapine (Clozaril)
C. Extrapyramidal symptoms and treat by administration of benztropine (Cogentin)
D. Tardive dyskinesia and treat by discontinuing antipsychotic medications
Give this one a try later!
, ANS: D
The nurse should expect that an ED physician would diagnose the client
with tardive dyskinesia and discontinue antipsychotic medications. Tardive
dyskinesia is a condition of abnormal involuntary movements of the mouth,
tongue, trunk, and extremities that can be an irreversible side effect of
typical antipsychotic medications.
A client diagnosed with paranoid schizophrenia states, "My psychiatrist is out to get
me. I'm sad that the voice is telling me to stop him." What symptom is the client
exhibiting, and what is the nurse's legal responsibility related to this symptom?
A. Magical thinking; administer an antipsychotic medication
B. Persecutory delusions; orient the client to reality
C. Command hallucinations; warn the psychiatrist
D. Altered thought processes; call an emergency treatment team meeting
Give this one a try later!
ANS: C
The nurse should determine that the client is exhibiting command
hallucinations. The nurse's legal responsibility is to warn the psychiatrist of
the potential for harm. A client who is demonstrating a risk for violence
could potentially become physically, emotionally, and/or sexually harmful
to others or to self.
A client states, "I hear voices that tell me that I am evil." Which outcome related to
these symptoms should the nurse expect this client to accomplish by discharge?
A. The client will verbalize the reason the voices make derogatory statements.
B. The client will not hear auditory hallucinations.
C. The client will identify events that increase anxiety and illicit hallucinations.
D. The client will positively integrate the voices into the client's personality structure.
, Give this one a try later!
ANS: C
It is unrealistic to expect the client to completely stop hearing voices. Even
when compliant with antipsychotic medications, clients may still hear
voices. It would be realistic to expect the client to associate stressful
events with an increase in auditory hallucinations. By this recognition the
client can anticipate symptoms and initiate appropriate coping skills.
After taking chlorpromazine (Thorazine) for 1 month, a client presents to an
emergency department (ED) with severe muscle rigidity, tachycardia, and a
temperature of 105oF (40.5C). The nurse expects the physician to recognize which
condition and implement which treatment?
A. Neuroleptic malignant syndrome and treat by discontinuing Thorazine and
administering dantrolene (Dantrium)
B. Neuroleptic malignant syndrome and treat by increasing Thorazine dosage and
administering an antianxiety medication
C. Dystonia and treat by administering trihexyphenidyl (Artane)
D. Dystonia and treat by administering bromocriptine (Parlodel)
Give this one a try later!
ANS: A
The nurse should expect that an ED physician would diagnose the client
with neuroleptic malignant syndrome and treat the client by discontinuing
chlorpromazine (Thorazine) and administering dantrolene (Dantrium).
Neuroleptic malignant syndrome is a potentially fatal condition
characterized by muscle rigidity, fever, altered consciousness, and
autonomic instability. The use of typical antipsychotics is largely being
replaced by atypical antipsychotics due to fewer side effects and lower
risks.
