C HAPTER 17: D RUGS U SED FOR P SYCHOSES
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which action will the nurse take when a patient becomes verball y
aggressive and insists the nurse is poisoning him as she attempts to
administer haloperidol (Haldol)?
a. Support the patient ’s decision to refuse the medication.
b. Discreetl y ask an assistant to put the med ication in the patient ’s
food.
c. Firml y redirect the patient to take the medication.
d. Speak privatel y with the patient and reinforce medication action.
ANS: C
During episodes of acute psychosis, the patient is out of touch with realit y
and often does not understand the need for medication in stabilizing his or
her condition. Target symptoms such as agitation, suspicion, and paranoia are
common. Healthcare providers must be supportive yet firm in their
expectations. An open and direct manner in handling pa tients who are highl y
suspicious is critical. Delusions should not be supported. The patient is not
competent to determine his need for medication. It is dishonest to hide
medication in a patient ’s food and destroys a trusting relationship. Reasoning
with the patient is unlikel y to change his mind; he needs external structure
for making decisions when he is aggressive and paranoid.
DIF: Cognitive Level: Application REF: p. 271 | p. 272
OBJ: 1 NAT: NCLEX Client Needs Category: Psychosocial
Integrit y
, TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Psychosis | Safet y
2. Which statement is true regarding the adverse effects associated with
antips ychotic medications?
a. Tardive dyskinesia is a common, reversible condition.
b. Painful dystonic reac tions can occur in the first 72 hours of initiation
of therapy.
c. Neuroleptic malignant syndrome (NMS) is a common adverse effect.
d. Pseudoparkinsonian symptoms can cause Parkinson ’s disease.
ANS: B
Approximatel y 90% of all dystonic reactions occur in the first 72 hours of
antips ychotic therapy. These symptoms are often frightening and painful.
Tardive dyskinesia is present in 20% to 25% of patients and may become
irreversible. NMS is not a common adverse effect. Pseudoparkinsonism is not
related to Parkinson’s disease.
DIF: Cognitive Level: Comprehension REF: p. 268 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Evaluation CON: Clinical Judgment
3. Which rationale explains the meaning of potency of an antipsyc hotic
medication?
a. Severit y of adverse effects associated with the drug
b. Length of time that it takes to reach a therapeutic blood level of the
drug
c. Milligram doses used for the medication
d. Effectiveness of the drug in alleviating psychotic behavior
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which action will the nurse take when a patient becomes verball y
aggressive and insists the nurse is poisoning him as she attempts to
administer haloperidol (Haldol)?
a. Support the patient ’s decision to refuse the medication.
b. Discreetl y ask an assistant to put the med ication in the patient ’s
food.
c. Firml y redirect the patient to take the medication.
d. Speak privatel y with the patient and reinforce medication action.
ANS: C
During episodes of acute psychosis, the patient is out of touch with realit y
and often does not understand the need for medication in stabilizing his or
her condition. Target symptoms such as agitation, suspicion, and paranoia are
common. Healthcare providers must be supportive yet firm in their
expectations. An open and direct manner in handling pa tients who are highl y
suspicious is critical. Delusions should not be supported. The patient is not
competent to determine his need for medication. It is dishonest to hide
medication in a patient ’s food and destroys a trusting relationship. Reasoning
with the patient is unlikel y to change his mind; he needs external structure
for making decisions when he is aggressive and paranoid.
DIF: Cognitive Level: Application REF: p. 271 | p. 272
OBJ: 1 NAT: NCLEX Client Needs Category: Psychosocial
Integrit y
, TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Psychosis | Safet y
2. Which statement is true regarding the adverse effects associated with
antips ychotic medications?
a. Tardive dyskinesia is a common, reversible condition.
b. Painful dystonic reac tions can occur in the first 72 hours of initiation
of therapy.
c. Neuroleptic malignant syndrome (NMS) is a common adverse effect.
d. Pseudoparkinsonian symptoms can cause Parkinson ’s disease.
ANS: B
Approximatel y 90% of all dystonic reactions occur in the first 72 hours of
antips ychotic therapy. These symptoms are often frightening and painful.
Tardive dyskinesia is present in 20% to 25% of patients and may become
irreversible. NMS is not a common adverse effect. Pseudoparkinsonism is not
related to Parkinson’s disease.
DIF: Cognitive Level: Comprehension REF: p. 268 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Evaluation CON: Clinical Judgment
3. Which rationale explains the meaning of potency of an antipsyc hotic
medication?
a. Severit y of adverse effects associated with the drug
b. Length of time that it takes to reach a therapeutic blood level of the
drug
c. Milligram doses used for the medication
d. Effectiveness of the drug in alleviating psychotic behavior
