Chapter 31: Antipsychotic Agents and Their Use in Schizophrenia

Chapter 31: Antipsychotic Agents and Their Use in Schizophrenia Test Bank MULTIPLE CHOICE 1. A patient with schizophrenia has been taking an antipsychotic drug for several days. The nurse enters the patient’s room to administer a dose of haloperidol (Haldol) and finds the patient having facial spasms. The patient’s head is thrust back, and the patient is unable to speak. What will the nurse do? a. Administer the haloperidol as ordered. b. Discuss increasing the haloperidol dose with the provider. c. Request an order to give diphenhydramine. d. Request an order to give levodopa. ANS: C An early reaction to antipsychotic drugs is acute dystonia. Initial treatment consists of an anticholinergic medication, such as diphenhydramine. Administering more antipsychotic medication would increase the symptoms and could be life threatening. Levodopa is not given for extrapyramidal symptoms, because it could counteract the beneficial effects of antipsychotic treatment. DIF: Cognitive Level: Application REF: First-Generation (Conventional) Antipsychotics | Extrapyramidal Symptoms | Acute Dystonia | Parkinsonism TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 2. A patient who is taking an antipsychotic drug for schizophrenia comes to the clinic for evaluation. The nurse observes that the patient has a shuffling gait and tremors and is drooling. The nurse will ask the patient’s provider about which course of action? a. Administering a direct dopamine antagonist b. Giving an anticholinergic medication c. Increasing the dose of the antipsychotic drug d. Stopping the antipsychotic drug ANS: B The patient is showing signs of parkinsonism, an extrapyramidal effect associated with antipsychotic medications. Anticholinergic medications are indicated. A direct dopamine antagonist would counter the effects of the antipsychotic and remove any beneficial effect it has. Increasing the dose of the antipsychotic medication would only worsen the extrapyramidal symptoms. Stopping the antipsychotic medication would cause the symptoms of schizophrenia to worsen. DIF: Cognitive Level: Application REF: First-Generation (Conventional) Antipsychotics | Extrapyramidal Symptoms | Acute Dystonia | Parkinsonism TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 3. A patient taking a first-generation antipsychotic (FGA) medication develops severe parkinsonism and is treated with amantadine (Symmetrel). The amantadine is withdrawn 2 months later, and the parkinsonism returns. The nurse will expect the provider to: This study source was downloaded