WGU PSYCH - C476: PSYCHOSIS MEDS 2022/2023 REVIEW
For the past year, a pt has received haloperidol (Haldol). The nurse administering the pt's next dose
notes a twitch on the right side of the pt's face & tongue movements. Which nursing intervention takes
priority?
Give haloperidol (Haldol) and benzatropine (Cogentin) 1mg IM prn per order.
2. Assess for other signs of hyperglycemia resulting from the use of haloperidol.
3. Check the pt's temperature and assess for mental status.
4. Hold the haloperidol, and call the physician. (correct answers)Haloperidol (Haldol), is a typical
antipsychotic used in the treatment of thought disorders. A side effect is tardive dyskinesia (TD) the s/s
are: bizarre facial, & tongue movements , stiff neck, and difficulty swallowing. Long-term treatment w/
antipsychotics poses risk. The symptoms can be irreversible.
1. Benzatropine (Cogentin) may be given to reduce s/s of TD. However, because TD is potentially
irreversible, it is important that the nurse hold the medication and talk to the prescriber before giving
the next dose of haloperidol .
2. Antipsychotic medications such as haloperidol can cause metabolic changes, and the pt would need
monitoring. However, the symptoms in the question do not reflect hyperglycemia.
3. Another s/e of antipsychotic medications is neuroleptic malignant syndrome (NMS). The s/s of NMS
are muscle rigidity, hyperpyrexia, (107 degrees F), tachycardia, tachypnea, fluctuations in blood
pressures, diaphoresis, and rapid deterioration of ,mental status to stupor or coma. The symptoms in
the question do not reflect NMS.
A pt has been prescribed ziprasidone (Geodon) 40mg bid. Which of the following interventions are
important r/t to this medication? Select all that apply.
,1. Obtain a baseline EKG initially and periodically throughout treatment.
2. Teach the pt to take the medication with meals.
3. Monitor the pt's pulse because of the possibility of palpitations.
4. Institute seizure precautions, and monitor closely.
5. Watch for signs and symptoms and of manic episode. (correct answers)Answers - 1, 2, 3:
1. Geodon has the potential, in rare cases, to elongate the QT interval; a baseline and periodic EKG
would be necessary.
2. Geodon needs to be taken with meals for it to be absorbed effectively. It is important for the nurse to
teach the pt the need to take Geodon with meals.
3. Palpitations can be a side effect of Geodon and would need to be monitored.
Ziprasidone (Geodon) is an atypical antipsychotic used to treat symptoms related to altered thought
process.
4. Seizure precautions are needed with bupropion (Wellbutrin) and clozapine (Clozaril), not ziprasidone
(Geodon).
5. A manic episode is not a side effect of Geodon.
, A pt prescribed quetiapine (Seroquel) 50mg bid has a nursing diagnosis of risk for injury r/t sedation.
Which nursing intervention appropriately addressed this pt's problem?
1. Assess for homicidal and suicidal ideations.
2. Remove clutter from the environment to prevent injury.
3. Monitor orthostatic changes in pulse or BP.
4. Evaluate for auditory and visual hallucinations. (correct answers)Answer:
2. Removing cutter from the pt's environment would assist the pt in avoiding injury due to tripping and
falling. It is important for the nurse to ensure the environment is cutter-free especially when the pt may
be sedated.
Quetiapine (Seroquel) is an atypical antipsychotic in the treatment of thought disorders. A significant s/e
of Seroquel is sedation.
1. Although the nurse should monitor for homicidal & suicidal ideation, this answer does not r/t the
nursing diagnosis noted in the question.
3. There is a potential for orthostatic changes when a pt is prescribed quetiapine. However, orthostatic
changes are not r/t the sedation described in the nursing diagnosis.
4. Although, it is important for the nurse to evaluate for auditory & visual hallucinations while a pt is
taking Seroquel, such evaluation does not r/t the stated nursing diagnosis.
A pt is newly prescribed hydroxyzine (Atarax) 50mg q hs and clozapine (Clozaril) 25mg bid. Which is an
appropriate nursing diagnosis for this pt?
For the past year, a pt has received haloperidol (Haldol). The nurse administering the pt's next dose
notes a twitch on the right side of the pt's face & tongue movements. Which nursing intervention takes
priority?
Give haloperidol (Haldol) and benzatropine (Cogentin) 1mg IM prn per order.
2. Assess for other signs of hyperglycemia resulting from the use of haloperidol.
3. Check the pt's temperature and assess for mental status.
4. Hold the haloperidol, and call the physician. (correct answers)Haloperidol (Haldol), is a typical
antipsychotic used in the treatment of thought disorders. A side effect is tardive dyskinesia (TD) the s/s
are: bizarre facial, & tongue movements , stiff neck, and difficulty swallowing. Long-term treatment w/
antipsychotics poses risk. The symptoms can be irreversible.
1. Benzatropine (Cogentin) may be given to reduce s/s of TD. However, because TD is potentially
irreversible, it is important that the nurse hold the medication and talk to the prescriber before giving
the next dose of haloperidol .
2. Antipsychotic medications such as haloperidol can cause metabolic changes, and the pt would need
monitoring. However, the symptoms in the question do not reflect hyperglycemia.
3. Another s/e of antipsychotic medications is neuroleptic malignant syndrome (NMS). The s/s of NMS
are muscle rigidity, hyperpyrexia, (107 degrees F), tachycardia, tachypnea, fluctuations in blood
pressures, diaphoresis, and rapid deterioration of ,mental status to stupor or coma. The symptoms in
the question do not reflect NMS.
A pt has been prescribed ziprasidone (Geodon) 40mg bid. Which of the following interventions are
important r/t to this medication? Select all that apply.
,1. Obtain a baseline EKG initially and periodically throughout treatment.
2. Teach the pt to take the medication with meals.
3. Monitor the pt's pulse because of the possibility of palpitations.
4. Institute seizure precautions, and monitor closely.
5. Watch for signs and symptoms and of manic episode. (correct answers)Answers - 1, 2, 3:
1. Geodon has the potential, in rare cases, to elongate the QT interval; a baseline and periodic EKG
would be necessary.
2. Geodon needs to be taken with meals for it to be absorbed effectively. It is important for the nurse to
teach the pt the need to take Geodon with meals.
3. Palpitations can be a side effect of Geodon and would need to be monitored.
Ziprasidone (Geodon) is an atypical antipsychotic used to treat symptoms related to altered thought
process.
4. Seizure precautions are needed with bupropion (Wellbutrin) and clozapine (Clozaril), not ziprasidone
(Geodon).
5. A manic episode is not a side effect of Geodon.
, A pt prescribed quetiapine (Seroquel) 50mg bid has a nursing diagnosis of risk for injury r/t sedation.
Which nursing intervention appropriately addressed this pt's problem?
1. Assess for homicidal and suicidal ideations.
2. Remove clutter from the environment to prevent injury.
3. Monitor orthostatic changes in pulse or BP.
4. Evaluate for auditory and visual hallucinations. (correct answers)Answer:
2. Removing cutter from the pt's environment would assist the pt in avoiding injury due to tripping and
falling. It is important for the nurse to ensure the environment is cutter-free especially when the pt may
be sedated.
Quetiapine (Seroquel) is an atypical antipsychotic in the treatment of thought disorders. A significant s/e
of Seroquel is sedation.
1. Although the nurse should monitor for homicidal & suicidal ideation, this answer does not r/t the
nursing diagnosis noted in the question.
3. There is a potential for orthostatic changes when a pt is prescribed quetiapine. However, orthostatic
changes are not r/t the sedation described in the nursing diagnosis.
4. Although, it is important for the nurse to evaluate for auditory & visual hallucinations while a pt is
taking Seroquel, such evaluation does not r/t the stated nursing diagnosis.
A pt is newly prescribed hydroxyzine (Atarax) 50mg q hs and clozapine (Clozaril) 25mg bid. Which is an
appropriate nursing diagnosis for this pt?
