Adams4e Tif Ch17

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 17
Question 1 Type: MCMA The patient has been admitted to the hospital for the treatment of schizophrenia. The patient's mother says to the nurse, "This is all so confusing. How did he get this !id " do something " #hat is $are% the best response$s% of the nurse &ote' Credit will be gi(en only if all correct choices and no incorrect choices are selected. Standard Text: )elect all that apply. 1. ")chizophrenia is a biological brain disorder." 2. ")chizophrenia is lin*ed to drin*ing alcohol during pregnancy." 3. "+esearch indicates that a (ery stressful en(ironment causes schizophrenia." 4. "+esearch indicates that schizophrenia is a genetic disorder." . ")chizophrenia is due to too much dopamine in certain parts of the brain." Corre!t Ans"er: ,,-,. #ationa$e 1' Theories e/plaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and o(eracti(e dopaminergic pathways in the basal nuclei. There isn't any e(idence to support that schizophrenia is lin*ed to alcohol consumption during pregnancy. A stressful en(ironment will e/acerbate the symptoms of schizophrenia, but does not cause the illness. #ationa$e 2' Theories e/plaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and o(eracti(e dopaminergic pathways in the basal nuclei. There isn't any e(idence to support that schizophrenia is lin*ed to alcohol consumption during pregnancy. A stressful en(ironment will e/acerbate the symptoms of schizophrenia, but does not cause the illness. #ationa$e 3' Theories e/plaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and o(eracti(e dopaminergic pathways in the basal nuclei. There isn't any e(idence to support that schizophrenia is lin*ed to alcohol consumption during pregnancy. A stressful en(ironment will e/acerbate the symptoms of schizophrenia, but does not cause the illness. #ationa$e 4' Theories e/plaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and o(eracti(e dopaminergic pathways in the basal nuclei. There isn't any e(idence to support that schizophrenia is lin*ed to alcohol consumption during pregnancy. A stressful en(ironment will e/acerbate the symptoms of schizophrenia, but does not cause the illness.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -01 Copyright 23,- by 4earson 1ducation, "nc.
#ationa$e ' Theories e/plaining the cause of schizophrenia include a genetic component, imbalances in neurotransmitters in specific areas of the brain, and o(eracti(e dopaminergic pathways in the basal nuclei. There isn't any e(idence to support that schizophrenia is lin*ed to alcohol consumption during pregnancy. A stressful en(ironment will e/acerbate the symptoms of schizophrenia, but does not cause the illness. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' "mplementation )earnin' ,ut!ome: ,56, Question 2 Type: MC)A The patient with schizophrenia is sitting 7uietly in a chair. The patient does not respond much to what is happening, and has a lac* of interest in the en(ironment. #hat best describes the result of the nurse's assessment 1. The patient is most li*ely (ery depressed. 2. The patient is most li*ely hearing (oices. 3. The patient is e/periencing positi(e symptoms. 4. The patient is e/periencing negati(e symptoms. Corre!t Ans"er: #ationa$e 1' &egati(e symptoms are those that subtract from normal beha(ior. These symptoms include a lac* of interest, moti(ation, responsi(eness, or pleasure in daily acti(ities. 4ositi(e symptoms include hallucinations, delusions, and a disorganized thought or speech pattern. There isn't any e(idence to support that the patient is hearing (oices. There isn't any e(idence to support that the patient is (ery depressed. #ationa$e 2' &egati(e symptoms are those that subtract from normal beha(ior. These symptoms include a lac* of interest, moti(ation, responsi(eness, or pleasure in daily acti(ities. 4ositi(e symptoms include hallucinations, delusions, and a disorganized thought or speech pattern. There isn't any e(idence to support that the patient is hearing (oices. There isn't any e(idence to support that the patient is (ery depressed. #ationa$e 3' &egati(e symptoms are those that subtract from normal beha(ior. These symptoms include a lac* of interest, moti(ation, responsi(eness, or pleasure in daily acti(ities. 4ositi(e symptoms include hallucinations, delusions, and a disorganized thought or speech pattern. There isn't any e(idence to support that the patient is hearing (oices. There isn't any e(idence to support that the patient is (ery depressed. #ationa$e 4' &egati(e symptoms are those that subtract from normal beha(ior. These symptoms include a lac* of interest, moti(ation, responsi(eness, or pleasure in daily acti(ities. 4ositi(e symptoms include hallucinations, delusions, and a disorganized thought or speech pattern. There isn't any e(idence to support that the patient is hearing (oices. There isn't any e(idence to support that the patient is (ery depressed.
%$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,562 Question 3 Type: MC)A The physician has prescribed haloperidol $Haldol% for the patient with schizophrenia. #hat is the priority patient outcome 1. The patient will consume ade7uate fluids and a high6fiber diet. 2. The patient will be compliant with ta*ing the medication as prescribed. 3. The patient will report a decrease in auditory hallucinations. 4. The patient will report symptoms of restlessness. Corre!t Ans"er: 2 #ationa$e 1' Medication compliance is a priority for patients with schizophrenia. +elapse of symptoms will occur without the medications. The symptom of restlessness is *nown as a*athisia. This would be important to report, but is not the priority outcome. Ade7uate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an e/pected effect of haloperidol $Haldol%, but this is not the priority outcome. #ationa$e 2' Medication compliance is a priority for patients with schizophrenia. +elapse of symptoms will occur without the medications. The symptom of restlessness is *nown as a*athisia. This would be important to report, but is not the priority outcome. Ade7uate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an e/pected effect of haloperidol $Haldol%, but this is not the priority outcome. #ationa$e 3' Medication compliance is a priority for patients with schizophrenia. +elapse of symptoms will occur without the medications. The symptom of restlessness is *nown as a*athisia. This would be important to report, but is not the priority outcome. Ade7uate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an e/pected effect of haloperidol $Haldol%, but this is not the priority outcome. #ationa$e 4' Medication compliance is a priority for patients with schizophrenia. +elapse of symptoms will occur without the medications. The symptom of restlessness is *nown as a*athisia. This would be important to report, but is not the priority outcome. Ade7uate fluids and fiber will decrease the side effect of constipation, but this is not the priority outcome. A decrease in auditory hallucinations is an e/pected effect of haloperidol $Haldol%, but this is not the priority outcome.
%$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' 4lanning )earnin' ,ut!ome: ,56Question 4 Type: MC)A The nurse is managing the care of a group of patients with schizophrenia. The patients are recei(ing con(entional antipsychotic medications. #hen assessing for anticholinergic side effects, which would the nurse immediately report to the physician 1. Acute dystonia 2. Complaint of a se(ere headache 3. Hypertension 4. 8rinary retention Corre!t Ans"er: #ationa$e 1' 8rinary retention is an anticholinergic side effect of con(entional antipsychotics. This must be reported immediately to the physician. Hypotension, not hypertension is a cardiac side effect, not an anticholinergic side effect. Headaches are not anticholinergic side effects. Acute dystonia must be reported immediately to the physician, but this is not an anticholinergic side effect. #ationa$e 2' 8rinary retention is an anticholinergic side effect of con(entional antipsychotics. This must be reported immediately to the physician. Hypotension, not hypertension is a cardiac side effect, not an anticholinergic side effect. Headaches are not anticholinergic side effects. Acute dystonia must be reported immediately to the physician, but this is not an anticholinergic side effect. #ationa$e 3' 8rinary retention is an anticholinergic side effect of con(entional antipsychotics. This must be reported immediately to the physician. Hypotension, not hypertension is a cardiac side effect, not an anticholinergic side effect. Headaches are not anticholinergic side effects. Acute dystonia must be reported immediately to the physician, but this is not an anticholinergic side effect. #ationa$e 4' 8rinary retention is an anticholinergic side effect of con(entional antipsychotics. This must be reported immediately to the physician. Hypotension, not hypertension is a cardiac side effect, not an anticholinergic side effect. Headaches are not anticholinergic side effects. Acute dystonia must be reported immediately to the physician, but this is not an anticholinergic side effect. %$o&a$ #ationa$e:
Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,56. Question Type: MC)A The patient has been recei(ing chlorpromazine $Thorazine% for the treatment of schizophrenia. The nurse assesses that the patient has tardi(e dys*inesia. #hat describes the result of the nurse's assessment 1. Tremor, muscle rigidity, and a shuffling gait 2. )e(ere muscle spasms of the bac*, nec*, and tongue 3. An inability to rest or rela/, and restlessness 4. 8nusual facial mo(ements and lip smac*ing Corre!t Ans"er: #ationa$e 1' Tardi(e dys*inesia is characterized by unusual tongue and face mo(ements such as lip smac*ing, and wormli*e motions of the tongue. )e(ere muscle spasms of the bac*, nec*, and tongue are *nown as acute dystonia, not tardi(e dys*inesia. An inability to rest or rela/, and restlessness are *nown as a*athisia, not tardi(e dys*inesia. Tremor, muscle rigidity, and a shuffling gait are *nown as 4ar*insonism, not tardi(e dys*inesia. #ationa$e 2' Tardi(e dys*inesia is characterized by unusual tongue and face mo(ements such as lip smac*ing, and wormli*e motions of the tongue. )e(ere muscle spasms of the bac*, nec*, and tongue are *nown as acute dystonia, not tardi(e dys*inesia. An inability to rest or rela/, and restlessness are *nown as a*athisia, not tardi(e dys*inesia. Tremor, muscle rigidity, and a shuffling gait are *nown as 4ar*insonism, not tardi(e dys*inesia. #ationa$e 3' Tardi(e dys*inesia is characterized by unusual tongue and face mo(ements such as lip smac*ing, and wormli*e motions of the tongue. )e(ere muscle spasms of the bac*, nec*, and tongue are *nown as acute dystonia, not tardi(e dys*inesia. An inability to rest or rela/, and restlessness are *nown as a*athisia, not tardi(e dys*inesia. Tremor, muscle rigidity, and a shuffling gait are *nown as 4ar*insonism, not tardi(e dys*inesia. #ationa$e 4' Tardi(e dys*inesia is characterized by unusual tongue and face mo(ements such as lip smac*ing, and wormli*e motions of the tongue. )e(ere muscle spasms of the bac*, nec*, and tongue are *nown as acute dystonia, not tardi(e dys*inesia. An inability to rest or rela/, and restlessness are *nown as a*athisia, not tardi(e dys*inesia. Tremor, muscle rigidity, and a shuffling gait are *nown as 4ar*insonism, not tardi(e dys*inesia. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&:
*ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,569 Question Type: MC)A The patient is recei(ing risperidone $+isperdal%. !uring morning assessment, the nurse notes that the patient has a temperature of ,32 degrees :. #hat is the priority nursing inter(ention 1. Contact the physician, as this could be a symptom of neuroleptic malignant syndrome. 2. Contact the physician, as this could be a symptom of an acute urinary infection. 3. Contact the physician, as this could be a symptom of a bacterial pneumonia. 4. Contact the physician, as this could be a symptom of e/trapyramidal side effects. Corre!t Ans"er: , #ationa$e 1' &euroleptic malignant syndrome includes symptoms of ele(ated temperature, unstable blood pressure, profuse sweating, dyspnea, muscle rigidity, and incontinence. 4atients with acute urinary infections do run ele(ated temperatures; howe(er, when the patient is recei(ing an antipsychotic drug and runs an ele(ated temperature, neuroleptic malignant syndrome must always be suspected. 4atients with bacterial pneumonias do run ele(ated temperatures; howe(er, when the patient is recei(ing an antipsychotic drug and runs an ele(ated temperature, neuroleptic malignant syndrome must always be suspected. An ele(ated temperature is not an e/trapyramidal side effect. #ationa$e 2' &euroleptic malignant syndrome includes symptoms of ele(ated temperature, unstable blood pressure, profuse sweating, dyspnea, muscle rigidity, and incontinence. 4atients with acute urinary infections do run ele(ated temperatures; howe(er, when the patient is recei(ing an antipsychotic drug and runs an ele(ated temperature, neuroleptic malignant syndrome must always be suspected. 4atients with bacterial pneumonias do run ele(ated temperatures; howe(er, when the patient is recei(ing an antipsychotic drug and runs an ele(ated temperature, neuroleptic malignant syndrome must always be suspected. An ele(ated temperature is not an e/trapyramidal side effect. #ationa$e 3' &euroleptic malignant syndrome includes symptoms of ele(ated temperature, unstable blood pressure, profuse sweating, dyspnea, muscle rigidity, and incontinence. 4atients with acute urinary infections do run ele(ated temperatures; howe(er, when the patient is recei(ing an antipsychotic drug and runs an ele(ated temperature, neuroleptic malignant syndrome must always be suspected. 4atients with bacterial pneumonias do run ele(ated temperatures; howe(er, when the patient is recei(ing an antipsychotic drug and runs an ele(ated temperature, neuroleptic malignant syndrome must always be suspected. An ele(ated temperature is not an e/trapyramidal side effect. #ationa$e 4' &euroleptic malignant syndrome includes symptoms of ele(ated temperature, unstable blood pressure, profuse sweating, dyspnea, muscle rigidity, and incontinence. 4atients with acute urinary infections do run ele(ated temperatures; howe(er, when the patient is recei(ing an antipsychotic drug and runs an ele(ated temperature, neuroleptic malignant syndrome must always be suspected. 4atients with bacterial pneumonias do run ele(ated temperatures; howe(er, when the patient is recei(ing an antipsychotic drug and runs an ele(ated
temperature, neuroleptic malignant syndrome must always be suspected. An ele(ated temperature is not an e/trapyramidal side effect. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' "mplementation )earnin' ,ut!ome: ,565 Question 7 Type: MC)A The patient is recei(ing clozaril $Clozapine% for the treatment of schizophrenia. The nurse e(aluates the effecti(eness of this medication when the patient ma*es which statement 1. "" will start going to group therapy." 2. "" thin* " am ready for discharge, as " feel better." 3. "" am not hearing the (oices anymore." 4. "" promise not to s*ip brea*fast anymore." Corre!t Ans"er: < #ationa$e 1' Therapeutic effects of clozapine $Clozaril% include remission of a range of psychotic symptoms to include delusions, paranoia, auditory hallucinations, and irrational beha(ior. A patient stating he feels better and is ready for discharge does not indicate the remission of any psychotic symptoms. A patient stating he will go to group therapy does not indicate the remission of any psychotic symptoms. A patient stating he will not s*ip brea*fast does not indicate the remission of any psychotic symptoms. #ationa$e 2' Therapeutic effects of clozapine $Clozaril% include remission of a range of psychotic symptoms to include delusions, paranoia, auditory hallucinations, and irrational beha(ior. A patient stating he feels better and is ready for discharge does not indicate the remission of any psychotic symptoms. A patient stating he will go to group therapy does not indicate the remission of any psychotic symptoms. A patient stating he will not s*ip brea*fast does not indicate the remission of any psychotic symptoms. #ationa$e 3' Therapeutic effects of clozapine $Clozaril% include remission of a range of psychotic symptoms to include delusions, paranoia, auditory hallucinations, and irrational beha(ior. A patient stating he feels better and is ready for discharge does not indicate the remission of any psychotic symptoms. A patient stating he will go to group therapy does not indicate the remission of any psychotic symptoms. A patient stating he will not s*ip brea*fast does not indicate the remission of any psychotic symptoms. #ationa$e 4' Therapeutic effects of clozapine $Clozaril% include remission of a range of psychotic symptoms to include delusions, paranoia, auditory hallucinations, and irrational beha(ior. A patient stating he feels better and is ready for discharge does not indicate the remission of any psychotic symptoms. A patient stating he will go to
group therapy does not indicate the remission of any psychotic symptoms. A patient stating he will not s*ip brea*fast does not indicate the remission of any psychotic symptoms. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' 1(aluation )earnin' ,ut!ome: ,56= Question . Type: MC)A The nurse has completed medication education with the patient who is recei(ing clozapine $Clozaril%. The nurse e(aluates that the education has been effecti(e when the patient ma*es which statement 1. "" must call my doctor if " start to ha(e a lot of nightmares." 2. "" must ha(e my blood wor* done while ta*ing this medication." 3. "" must call my doctor if " start to lose a lot of weight." 4. "" must call my doctor if " notice any unusual bruising." Corre!t Ans"er: 2 #ationa$e 1' Agranulocytosis can be a life6threatening side effect of clozapine $Clozaril%, which may also suppress bone marrow, and lower infection6fighting ability. "t is (ery important, therefore, that the patient ha(e regular blood wor* done while on this medication. >ruising is not a side effect of clozapine $Clozaril%. #eight gain, not weight loss, is a serious side effect of clozapine $Clozaril%. &ightmares are not a side effect of clozapine $Clozaril%. #ationa$e 2' Agranulocytosis can be a life6threatening side effect of clozapine $Clozaril%, which may also suppress bone marrow, and lower infection6fighting ability. "t is (ery important, therefore, that the patient ha(e regular blood wor* done while on this medication. >ruising is not a side effect of clozapine $Clozaril%. #eight gain, not weight loss, is a serious side effect of clozapine $Clozaril%. &ightmares are not a side effect of clozapine $Clozaril%. #ationa$e 3' Agranulocytosis can be a life6threatening side effect of clozapine $Clozaril%, which may also suppress bone marrow, and lower infection6fighting ability. "t is (ery important, therefore, that the patient ha(e regular blood wor* done while on this medication. >ruising is not a side effect of clozapine $Clozaril%. #eight gain, not weight loss, is a serious side effect of clozapine $Clozaril%. &ightmares are not a side effect of clozapine $Clozaril%. #ationa$e 4' Agranulocytosis can be a life6threatening side effect of clozapine $Clozaril%, which may also suppress bone marrow, and lower infection6fighting ability. "t is (ery important, therefore, that the patient ha(e regular blood wor* done while on this medication. >ruising is not a side effect of clozapine $Clozaril%. #eight
gain, not weight loss, is a serious side effect of clozapine $Clozaril%. &ightmares are not a side effect of clozapine $Clozaril%. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' 1(aluation )earnin' ,ut!ome: ,565 Question / Type: MC)A The patient is recei(ing clozapine $Clozaril%. #hat is a priority outcome for this patient 1. The patient reports any narrowing of the field of (ision. 2. The patient reports any ?oint pain or swelling. 3. The patient reports any signs of a sore throat or an infection. 4. The patient reports any yellowish halos around lights. Corre!t Ans"er: < #ationa$e 1' )igns of a sore throat or an infection could indicate agranulocytosis, which is a life6threatening side effect of clozapine $Clozaril%. @ellowish halos around lights are not a side effect of clozapine $Clozaril%. Aoint pain or swelling is not a side effect of clozapine $Clozaril%. &arrowing of the field of (ision is not a side effect of clozapine $Clozaril%. #ationa$e 2' )igns of a sore throat or an infection could indicate agranulocytosis, which is a life6threatening side effect of clozapine $Clozaril%. @ellowish halos around lights are not a side effect of clozapine $Clozaril%. Aoint pain or swelling is not a side effect of clozapine $Clozaril%. &arrowing of the field of (ision is not a side effect of clozapine $Clozaril%. #ationa$e 3' )igns of a sore throat or an infection could indicate agranulocytosis, which is a life6threatening side effect of clozapine $Clozaril%. @ellowish halos around lights are not a side effect of clozapine $Clozaril%. Aoint pain or swelling is not a side effect of clozapine $Clozaril%. &arrowing of the field of (ision is not a side effect of clozapine $Clozaril%. #ationa$e 4' )igns of a sore throat or an infection could indicate agranulocytosis, which is a life6threatening side effect of clozapine $Clozaril%. @ellowish halos around lights are not a side effect of clozapine $Clozaril%. Aoint pain or swelling is not a side effect of clozapine $Clozaril%. &arrowing of the field of (ision is not a side effect of clozapine $Clozaril%. %$o&a$ #ationa$e:
Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' 4lanning )earnin' ,ut!ome: ,565 Question 10 Type: MC)A :or any patient recei(ing clozapine $Clozaril%, which laboratory result should be reported to the physician 1. +ed blood cell $+>C% of <.B million cells0mC 2. +ed blood cell $+>C% of ..3 million cells0mC 3. #hite blood cell $#>C% of <,B33 cells0mcl 4. #hite blood cell $#>C% of ,2,333 cells0mcl Corre!t Ans"er: < #ationa$e 1' The normal white blood cell $#>C% count is -,.33D,3,.33 cells0mcl. A lower count indicates agranulocytosis, which is a life6threatening side effect of clozapine $Clozaril%. A red blood cell $+>C% of ..3 million cells0mC is a normal red blood cell $+>C% count. A white blood cell $#>C% of ,2,333 cells0mcl is an ele(ated white blood cell $#>C% count and could indicate an infection, but it is not a side effect of clozapine $Clozaril%. A red blood cell $+>C% of <.B million cells0mC is a low range of red blood cells $+>Cs% and could indicate anemia, but it is not a side effect of clozapine $Clozaril%. #ationa$e 2' The normal white blood cell $#>C% count is -,.33D,3,.33 cells0mcl. A lower count indicates agranulocytosis, which is a life6threatening side effect of clozapine $Clozaril%. A red blood cell $+>C% of ..3 million cells0mC is a normal red blood cell $+>C% count. A white blood cell $#>C% of ,2,333 cells0mcl is an ele(ated white blood cell $#>C% count and could indicate an infection, but it is not a side effect of clozapine $Clozaril%. A red blood cell $+>C% of <.B million cells0mC is a low range of red blood cells $+>Cs% and could indicate anemia, but it is not a side effect of clozapine $Clozaril%. #ationa$e 3' The normal white blood cell $#>C% count is -,.33D,3,.33 cells0mcl. A lower count indicates agranulocytosis, which is a life6threatening side effect of clozapine $Clozaril%. A red blood cell $+>C% of ..3 million cells0mC is a normal red blood cell $+>C% count. A white blood cell $#>C% of ,2,333 cells0mcl is an ele(ated white blood cell $#>C% count and could indicate an infection, but it is not a side effect of clozapine $Clozaril%. A red blood cell $+>C% of <.B million cells0mC is a low range of red blood cells $+>Cs% and could indicate anemia, but it is not a side effect of clozapine $Clozaril%. #ationa$e 4' The normal white blood cell $#>C% count is -,.33D,3,.33 cells0mcl. A lower count indicates agranulocytosis, which is a life6threatening side effect of clozapine $Clozaril%. A red blood cell $+>C% of ..3 million cells0mC is a normal red blood cell $+>C% count. A white blood cell $#>C% of ,2,333 cells0mcl is an ele(ated white blood cell $#>C% count and could indicate an infection, but it is not a side effect of clozapine $Clozaril%. A red blood cell $+>C% of <.B million cells0mC is a low range of red blood cells $+>Cs% and could indicate anemia, but it is not a side effect of clozapine $Clozaril%.
%$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' 1(aluation )earnin' ,ut!ome: ,565 Question 11 Type: MC)A The nurse has completed diet education for a group of patients who are recei(ing antipsychotic medications. "f the medication education has been effecti(e, patients will eliminate what choice from their menu selection 1. Meats with a high6fat content 2. >e(erages with caffeine 3. +efined breads and desserts 4. )hellfish and peanuts Corre!t Ans"er: 2 #ationa$e 1' The use of caffeine6containing substances will decrease the effect of antipsychotic medications. Although unhealthy, high6fat meats do not affect the action of antipsychotic medications. Although unhealthy, refined breads and desserts do not affect the action of antipsychotic medications. Many indi(iduals are allergic to shellfish and peanuts, but they do not affect the action of antipsychotic medications. #ationa$e 2' The use of caffeine6containing substances will decrease the effect of antipsychotic medications. Although unhealthy, high6fat meats do not affect the action of antipsychotic medications. Although unhealthy, refined breads and desserts do not affect the action of antipsychotic medications. Many indi(iduals are allergic to shellfish and peanuts, but they do not affect the action of antipsychotic medications. #ationa$e 3' The use of caffeine6containing substances will decrease the effect of antipsychotic medications. Although unhealthy, high6fat meats do not affect the action of antipsychotic medications. Although unhealthy, refined breads and desserts do not affect the action of antipsychotic medications. Many indi(iduals are allergic to shellfish and peanuts, but they do not affect the action of antipsychotic medications. #ationa$e 4' The use of caffeine6containing substances will decrease the effect of antipsychotic medications. Although unhealthy, high6fat meats do not affect the action of antipsychotic medications. Although unhealthy, refined breads and desserts do not affect the action of antipsychotic medications. Many indi(iduals are allergic to shellfish and peanuts, but they do not affect the action of antipsychotic medications. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying
C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' 1(aluation )earnin' ,ut!ome: ,56B Question 12 Type: MC)A The patient is recei(ing antipsychotic medications and tells the nurse he has not had a bowel mo(ement for 2 days. #hat is the best initial action of the nurse 1. Hold the medication until the patient has a bowel mo(ement. 2. Ha(e the patient drin* prune ?uice and additional fluids. 3. Contact the physician for an order for a :leet 1nema. 4. Contact the physician for an order for a stool softener. Corre!t Ans"er: 2 #ationa$e 1' Constipation is a common side effect of antipsychotic medications. The best approach is to ha(e the patient increase dietary fiber and fluids, and to e/ercise to pre(ent constipation. Contacting the physician for an order for a :leet 1nema is premature; the patient should initially increase dietary fiber, fluids, and e/ercise to pre(ent constipation. Contacting the physician for an order for a stool softener is premature; the patient should initially increase dietary fiber, fluids, and e/ercise to pre(ent constipation. Antipsychotic medications should not be held because of constipation. #ationa$e 2' Constipation is a common side effect of antipsychotic medications. The best approach is to ha(e the patient increase dietary fiber and fluids, and to e/ercise to pre(ent constipation. Contacting the physician for an order for a :leet 1nema is premature; the patient should initially increase dietary fiber, fluids, and e/ercise to pre(ent constipation. Contacting the physician for an order for a stool softener is premature; the patient should initially increase dietary fiber, fluids, and e/ercise to pre(ent constipation. Antipsychotic medications should not be held because of constipation. #ationa$e 3' Constipation is a common side effect of antipsychotic medications. The best approach is to ha(e the patient increase dietary fiber and fluids, and to e/ercise to pre(ent constipation. Contacting the physician for an order for a :leet 1nema is premature; the patient should initially increase dietary fiber, fluids, and e/ercise to pre(ent constipation. Contacting the physician for an order for a stool softener is premature; the patient should initially increase dietary fiber, fluids, and e/ercise to pre(ent constipation. Antipsychotic medications should not be held because of constipation. #ationa$e 4' Constipation is a common side effect of antipsychotic medications. The best approach is to ha(e the patient increase dietary fiber and fluids, and to e/ercise to pre(ent constipation. Contacting the physician for an order for a :leet 1nema is premature; the patient should initially increase dietary fiber, fluids, and e/ercise to pre(ent constipation. Contacting the physician for an order for a stool softener is premature; the patient should initially increase dietary fiber, fluids, and e/ercise to pre(ent constipation. Antipsychotic medications should not be held because of constipation.
%$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' "mplementation )earnin' ,ut!ome: ,56= Question 13 Type: MC)A The patient who is recei(ing antipsychotic medication complains of ha(ing a dry mouth. The patient refused the morning dose of the medication. #hat is the best response by the nurse 1. "#hy are you refusing the medicine " 2. "" can gi(e you benztropine $Cogentin% for your dry mouth." 3. "" will let your doctor *now about your dry mouth." 4. "A dry mouth is common, but drin*ing more water will help." Corre!t Ans"er: #ationa$e 1' The symptom of dry mouth is (ery common with antipsychotic medications. The best approach is to ha(e the patient suc* on sugarless candy, chew gum, or ha(e fre7uent drin*s of water. >enztropine $Cogentin% is indicated for e/trapyramidal side effects, not for a dry mouth. As*ing the patient why he is refusing his medication is an inappropriate 7uestion, as the nurse *nows the patient has been complaining of a dry mouth. !ry mouth is a common side effect treated by nursing inter(entions, not physician's orders. #ationa$e 2' The symptom of dry mouth is (ery common with antipsychotic medications. The best approach is to ha(e the patient suc* on sugarless candy, chew gum, or ha(e fre7uent drin*s of water. >enztropine $Cogentin% is indicated for e/trapyramidal side effects, not for a dry mouth. As*ing the patient why he is refusing his medication is an inappropriate 7uestion, as the nurse *nows the patient has been complaining of a dry mouth. !ry mouth is a common side effect treated by nursing inter(entions, not physician's orders. #ationa$e 3' The symptom of dry mouth is (ery common with antipsychotic medications. The best approach is to ha(e the patient suc* on sugarless candy, chew gum, or ha(e fre7uent drin*s of water. >enztropine $Cogentin% is indicated for e/trapyramidal side effects, not for a dry mouth. As*ing the patient why he is refusing his medication is an inappropriate 7uestion, as the nurse *nows the patient has been complaining of a dry mouth. !ry mouth is a common side effect treated by nursing inter(entions, not physician's orders. #ationa$e 4' The symptom of dry mouth is (ery common with antipsychotic medications. The best approach is to ha(e the patient suc* on sugarless candy, chew gum, or ha(e fre7uent drin*s of water. >enztropine $Cogentin% is indicated for e/trapyramidal side effects, not for a dry mouth. As*ing the patient why he is refusing his medication is an inappropriate 7uestion, as the nurse *nows the patient has been complaining of a dry mouth. !ry mouth is a common side effect treated by nursing inter(entions, not physician's orders.
%$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' "mplementation )earnin' ,ut!ome: ,565 Question 14 Type: MC)A The patient recei(es 7uetiapine $)ero7uel% and as*s the nurse how the medication wor*s. #hat is the best response by the nurse 1. "Euetiapine $)ero7uel% decreases norepinephrine in your brain and that decreases your auditory hallucinations." 2. "Euetiapine $)ero7uel% increases norepinephrine in your brain and that decreases your feelings of depression." 3. "Euetiapine $)ero7uel% decreases dopamine in your brain and that decreases your symptoms." 4. "Euetiapine $)ero7uel% increases dopamine in your brain and that helps you to thin* more clearly." Corre!t Ans"er: < #ationa$e 1' Euetiapine $)ero7uel% acts by interfering with the binding of dopamine to its receptors in the brain. Euetiapine $)ero7uel% does not increase dopamine in the brain. Euetiapine $)ero7uel% does not decrease norepinephrine in the brain. Euetiapine $)ero7uel% does not increase norepinephrine in the brain. #ationa$e 2' Euetiapine $)ero7uel% acts by interfering with the binding of dopamine to its receptors in the brain. Euetiapine $)ero7uel% does not increase dopamine in the brain. Euetiapine $)ero7uel% does not decrease norepinephrine in the brain. Euetiapine $)ero7uel% does not increase norepinephrine in the brain. #ationa$e 3' Euetiapine $)ero7uel% acts by interfering with the binding of dopamine to its receptors in the brain. Euetiapine $)ero7uel% does not increase dopamine in the brain. Euetiapine $)ero7uel% does not decrease norepinephrine in the brain. Euetiapine $)ero7uel% does not increase norepinephrine in the brain. #ationa$e 4' Euetiapine $)ero7uel% acts by interfering with the binding of dopamine to its receptors in the brain. Euetiapine $)ero7uel% does not increase dopamine in the brain. Euetiapine $)ero7uel% does not decrease norepinephrine in the brain. Euetiapine $)ero7uel% does not increase norepinephrine in the brain. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' "mplementation )earnin' ,ut!ome: ,56B
Question 1 Type: MC)A )ymptoms of schizophrenia are thought to be associated with which receptor sites 1. !opamine type 2 2. Adrenergic 3. >eta 2 4. Cholinergic Corre!t Ans"er: , #ationa$e 1' Although other receptor sites can be in(ol(ed, it appears that dopamine type 2 receptors are the most responsible. #ationa$e 2' Although other receptor sites can be in(ol(ed, it appears that dopamine type 2 receptors are the most responsible. #ationa$e 3' Although other receptor sites can be in(ol(ed, it appears that dopamine type 2 receptors are the most responsible. #ationa$e 4' Although other receptor sites can be in(ol(ed, it appears that dopamine type 2 receptors are the most responsible. %$o&a$ #ationa$e: Co'niti(e )e(e$: +emembering C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,56, Question 1Type: MC)A A patient with a psychiatric history is communicating using made6up words, and indicates he doesnFt care about anything. This patient would most li*ely be 1. demonstrating symptoms of depression. 2. demonstrating positi(e symptoms of schizophrenia. 3. demonstrating negati(e symptoms of schizophrenia.
4. demonstrating symptoms of bipolar disorder. Corre!t Ans"er: 2 #ationa$e 1' The use of made6up words and detachment from life most li*ely indicate he is demonstrating the positi(e symptoms of schizophrenia. #ationa$e 2' The use of made6up words and detachment from life most li*ely indicate he is demonstrating the positi(e symptoms of schizophrenia. #ationa$e 3' The use of made6up words and detachment from life most li*ely indicate he is demonstrating the positi(e symptoms of schizophrenia. #ationa$e 4' The use of made6up words and detachment from life most li*ely indicate he is demonstrating the positi(e symptoms of schizophrenia. %$o&a$ #ationa$e: Co'niti(e )e(e$: 8nderstanding C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' !iagnosis )earnin' ,ut!ome: ,562 Question 17 Type: MC)A #hich of the following drugs would be indicated for a schizophrenic who needs management of both positi(e and negati(e symptoms 1. Thioridazine HCC $Mellaril% 2. Haloperidol $Haldol% 3. Clozapine $Clozaril% 4. Chlorpromazine $Thorazine% Corre!t Ans"er: < #ationa$e 1' Clozaril is an atypical antipsychotic indicated for positi(e and negati(e symptoms of schizophrenia. Con(entional antipsychotic agents $phenothiazines and phenothiazine6li*e drugs% are indicated for positi(e symptoms. #ationa$e 2' Clozaril is an atypical antipsychotic indicated for positi(e and negati(e symptoms of schizophrenia. Con(entional antipsychotic agents $phenothiazines and phenothiazine6li*e drugs% are indicated for positi(e symptoms.
#ationa$e 3' Clozaril is an atypical antipsychotic indicated for positi(e and negati(e symptoms of schizophrenia. Con(entional antipsychotic agents $phenothiazines and phenothiazine6li*e drugs% are indicated for positi(e symptoms. #ationa$e 4' Clozaril is an atypical antipsychotic indicated for positi(e and negati(e symptoms of schizophrenia. Con(entional antipsychotic agents $phenothiazines and phenothiazine6li*e drugs% are indicated for positi(e symptoms. %$o&a$ #ationa$e: Co'niti(e )e(e$: 8nderstanding C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' 4lanning )earnin' ,ut!ome: ,56< Question 1. Type: MC)A The relapse rate for psychotic patients who are not compliant and discontinue their medications is 1. 93DB3G. 2. .3D53G. 3. <3D-3G. 4. 23D.3G. Corre!t Ans"er: , #ationa$e 1' The relapse rate for psychotic patients who are not compliant and discontinue their medications is 93 to B3G. #ationa$e 2' The relapse rate for psychotic patients who are not compliant and discontinue their medications is 93 to B3G. #ationa$e 3' The relapse rate for psychotic patients who are not compliant and discontinue their medications is 93 to B3G. #ationa$e 4' The relapse rate for psychotic patients who are not compliant and discontinue their medications is 93 to B3G. %$o&a$ #ationa$e: Co'niti(e )e(e$: +emembering C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&:
*ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,56Question 1/ Type: MC)A An elderly female psychotic patient has been ta*ing haloperidol $Haldol% for , wee*. The patient has been ma*ing wormli*e mo(ements with her tongue. The nurse identifies this to most li*ely be 1. an ad(erse effect li*ely caused by the medication, *nown as tardi(e dys*inesia. 2. a normal reaction to the medication that will li*ely go away in a wee* or two. 3. a sign that the patient has not been ta*ing the medication. 4. a sign of the patient's underlying psychosis, indicating that the medication is not effecti(e. Corre!t Ans"er: , #ationa$e 1' 1lderly female patients on Haldol ha(e a higher incidence of tardi(e dys*inesia $an ad(erse effect%. Tardi(e dys*inesia is characterized by wormli*e mo(ements of the tongue. #ationa$e 2' 1lderly female patients on Haldol ha(e a higher incidence of tardi(e dys*inesia $an ad(erse effect%. Tardi(e dys*inesia is characterized by wormli*e mo(ements of the tongue. #ationa$e 3' 1lderly female patients on Haldol ha(e a higher incidence of tardi(e dys*inesia $an ad(erse effect%. Tardi(e dys*inesia is characterized by wormli*e mo(ements of the tongue. #ationa$e 4' 1lderly female patients on Haldol ha(e a higher incidence of tardi(e dys*inesia $an ad(erse effect%. Tardi(e dys*inesia is characterized by wormli*e mo(ements of the tongue. %$o&a$ #ationa$e: Co'niti(e )e(e$: 8nderstanding C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,56. and ,569 Question 20 Type: MC)A A patient e/periencing an e/trapyramidal ad(erse effect is not able to rela/. This is *nown as 1. dystonia. 2. tardi(e dys*inesia.
3. a*athisia. 4. 4ar*insonism. Corre!t Ans"er: < #ationa$e 1' The inability to rela/ is a*athisia. #ationa$e 2' The inability to rela/ is a*athisia. #ationa$e 3' The inability to rela/ is a*athisia. #ationa$e 4' The inability to rela/ is a*athisia. %$o&a$ #ationa$e: Co'niti(e )e(e$: +emembering C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' !iagnosis )earnin' ,ut!ome: ,569 Question 21 Type: MC)A #hich of the following would be the most appropriate action while treating a patient who o(erdosed on risperidone $+isperdal% 23 minutes ago 1. Administer a C&) depressant. 2. Administer an anticholinergic. 3. Administer acti(ated charcoal. 4. )ymptom management is the only indicated treatment. Corre!t Ans"er: < #ationa$e 1' Acti(ated charcoal will bind the +isperdal that has not been absorbed and pre(ent absorption into the bloodstream. )ymptom management might be warranted, but gi(en that the o(erdose occurred only 23 minutes ago, charcoal li*ely will be effecti(e, and should be used. Anticholinergic agents and C&) depressants li*ely will worsen symptoms. #ationa$e 2' Acti(ated charcoal will bind the +isperdal that has not been absorbed and pre(ent absorption into the bloodstream. )ymptom management might be warranted, but gi(en that the o(erdose occurred only 23 minutes ago, charcoal li*ely will be effecti(e, and should be used. Anticholinergic agents and C&) depressants li*ely will worsen symptoms.
#ationa$e 3' Acti(ated charcoal will bind the +isperdal that has not been absorbed and pre(ent absorption into the bloodstream. )ymptom management might be warranted, but gi(en that the o(erdose occurred only 23 minutes ago, charcoal li*ely will be effecti(e, and should be used. Anticholinergic agents and C&) depressants li*ely will worsen symptoms. #ationa$e 4' Acti(ated charcoal will bind the +isperdal that has not been absorbed and pre(ent absorption into the bloodstream. )ymptom management might be warranted, but gi(en that the o(erdose occurred only 23 minutes ago, charcoal li*ely will be effecti(e, and should be used. Anticholinergic agents and C&) depressants li*ely will worsen symptoms. %$o&a$ #ationa$e: Co'niti(e )e(e$: 8nderstanding C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' "mplementation )earnin' ,ut!ome: ,565 Question 22 Type: MC)A A patient who has been treated with antipsychotic agents for schizophrenia has an ele(ated blood pressure, dyspnea, and an e/tremely high temperature. This condition is *nown as 1. a*athisia. 2. e/trapyramidal side effects. 3. acute dystonias. 4. neuroleptic malignant syndrome. Corre!t Ans"er: #ationa$e 1' The condition that causes an ele(ated blood pressure, dyspnea, and high temperature is neuroleptic malignant syndrome. #ationa$e 2' The condition that causes an ele(ated blood pressure, dyspnea, and high temperature is neuroleptic malignant syndrome. #ationa$e 3' The condition that causes an ele(ated blood pressure, dyspnea, and high temperature is neuroleptic malignant syndrome. #ationa$e 4' The condition that causes an ele(ated blood pressure, dyspnea, and high temperature is neuroleptic malignant syndrome. %$o&a$ #ationa$e:
Co'niti(e )e(e$: +emembering C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,56= Question 23 Type: MCMA The nurse suspects a patient is demonstrating negati(e symptoms of schizophrenia and will be a challenge to treat because of which barriers Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: )elect all that apply. 1. The patient feels that the symptoms are normal. 2. :amily members feel the patient is going through a period of depression. 3. The patient is suspicious of the moti(es of the health care pro(ider. 4. :amily members ha(e labeled the patient as lazy. . The patient is indifferent to obtaining help. Corre!t Ans"er: 2,-,. #ationa$e 1' 4atients with a psychosis rather than the negati(e symptoms of schizophrenia are often unaware that their bizarre beha(ior is not normal. #ationa$e 2' &egati(e symptoms of schizophrenia are often mista*en for depression. #ationa$e 3' )uspicion that someone is trying to do harm is characteristic of delusions. #ationa$e 4' &egati(e symptoms of schizophrenia are often mista*en for laziness. #ationa$e ' &egati(e symptoms are characteristic of the indifferent personality typical of many patients with schizophrenia. %$o&a$ #ationa$e: Co'niti(e )e(e$: Analyzing C$ient *eed: 4sychosocial "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' 4lanning )earnin' ,ut!ome: ,562
Question 24 Type: MCMA The nurse is performing the initial assessment on a patient admitted to the psychiatric unit. The patient hears (oices saying to cut the patient's arms with razor blades until they bleed. The nurse should assess for Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: )elect all that apply. 1. family history of first6degree relati(e with schizophrenia. 2. use of illegal substances. 3. recent episodes of an/iety. 4. f:amily history of heart disease. . hHistory of a dysfunctional family. Corre!t Ans"er: ,,2,. #ationa$e 1' A person has a .H ,3 times greater ris* of getting schizophrenia if a first6degree relati(e has the disorder. #ationa$e 2' 8se of drugs such as cocaine can produce hallucinations or paranoia. #ationa$e 3' A history of an/iety has no connection to the de(elopment of schizophrenia. #ationa$e 4' A family history of heart disease has no connection to the de(elopment of schizophrenia. #ationa$e ' :amily dynamics can affect coping s*ills, which can influence the onset of schizophrenia. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4sychosocial "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,56< Question 2 Type: MCMA
A patient with a history of suicidal beha(ior with schizophrenia stopped ta*ing clozapine $Clozaril% after - wee*s of therapy. The patient is currently e/periencing a return of hallucinations. #hat might the nurse assess when determining the reason the patient stopped ta*ing the medication Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: )elect all that apply. 1. :eeling sedated all the time 2. )ignificant weight gain 3. Agitation 4. :atigue and headache . Cac* of desire to consume alcohol Corre!t Ans"er: ,,2,<,#ationa$e 1' 4atients do not li*e the side effect of being sedated all the time. #ationa$e 2' )ubstantial weight gain has been reported in some patients ta*ing this medication. This is a reason some stop ta*ing the medication. #ationa$e 3' Agitation may be an e/trapyramidal symptom of treatment with this medication and is an unwanted ad(erse effect. #ationa$e 4' :atigue and headache are possible side effects of this medication. #ationa$e ' The desire to drin* alcohol would be a reason for the patient to stop ta*ing this medication. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: 4harmacological and 4arenteral Therapies *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,56. Question 2Type: MCMA The nurse is assessing a female patient who has been ta*ing chlorpromazine for schizophrenia. #hat should the nurse include in this assessment Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: )elect all that apply. 1. 4erform an eye e/am and as* if there ha(e been changes in (ision. 2. !raw blood to chec* a lipid profile. 3. As* the patient 7uestions regarding amount of alcohol inta*e. 4. !etermine the date of her last menstrual period. . !raw blood to chec* thyroid function. Corre!t Ans"er: ,,<,#ationa$e 1' Chlorpromazine accumulates in the eye, and there is a ris* of phototo/icity, blurred (ision, dry eyes, and glaucoma. #ationa$e 2' Treatment with chlorpromazine would not be a reason to chec* the patient's lipid le(els, and there is no information gi(en to indicate the need to chec* a lipid profile. #ationa$e 3' "t is important to assess for alcohol use, as this could cause e/cessi(e drowsiness. #ationa$e 4' "t is important to assess for pregnancy as this drug is 4regnancy Category C. #ationa$e ' There is no indication that antipsychotics affect thyroid function, and nothing in the scenario indicates the need to chec* thyroid function. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: +eduction of +is* 4otential *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,56= Question 27 Type: MCMA A patient ta*ing aripiprazole $Abilify% for schizophrenia is e/periencing signs of hypotension with certain acti(ities since starting this medication. #hat should the nurse teach the patient Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: )elect all that apply. 1. A(oid being outside in the heat of the day.
2. A(oid hot baths or hot showers. 3. A(oid caffeine6containing preparations. 4. Change positions slowly, especially from lying or sitting to standing. . Ta*e fre7uent naps during the day. Corre!t Ans"er: ,,2,#ationa$e 1' The patient should a(oid any situation that might cause o(erheating, especially in hot weather, to reduce the ris* of hypotension. #ationa$e 2' Hot baths and hot showers should be a(oided to decrease the chance of hypotension. #ationa$e 3' Caffeine products are more li*ely to produce an/iety or palpitations. #ationa$e 4' Changing positions slowly will help reduce orthostatic hypotension. #ationa$e ' :re7uent naps will not affect the symptoms of hypotension. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4hysiological "ntegrity C$ient *eed Su&: +eduction of +is* 4otential *ursin'/+nte'rated Con!epts: &ursing 4rocess' "mplementation )earnin' ,ut!ome: ,56,, Question 2. Type: MCMA !uring an assessment, the nurse determines a patient is demonstrating symptoms of a psychosis. #hat did the nurse assess in this patient Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: )elect all that apply. 1. The patient says, "The ser(ants need to be disciplined." 2. The patient says, "The (oice told me to cut myself." 3. The patient laughs when as*ed about the health of a family member hospitalized for cancer treatment. 4. The patient as*s to close the room door so "that man can't get to me."
. The patient says, "" ha(e not been able to get any sleep for months." Corre!t Ans"er: ,,2,<,#ationa$e 1' This statement is an e/ample of a grandiose delusion. #ationa$e 2' This statement is an e/ample of an auditory hallucination. #ationa$e 3' !uring a psychotic episode, the patient's mood and affect may (ary widely and be inappropriate, such as laughing at sad e(ents. #ationa$e 4' This statement is an e/ample of a delusion in which someone is trying to harm the patient. #ationa$e ' The lac* of sleep is not a symptom of psychosis. %$o&a$ #ationa$e: Co'niti(e )e(e$: Analyzing C$ient *eed: 4sychosocial "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,56, Question 2/ Type: MCMA #hile conducting a health history, the nurse notes that the patient is demonstrating positi(e signs of schizophrenia. #hat did the nurse assess in this patient Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: )elect all that apply. 1. !isorganized sentence structure 2. Iic*ing the nurse 3. &ot responding to 7uestions 4. !ifficulty following instructions . )tating that Jod wants the patient to go home Corre!t Ans"er: ,,2,. #ationa$e 1' !isorganized speech is a positi(e symptom of schizophrenia.
#ationa$e 2' Combati(eness is a positi(e symptom of schizophrenia. #ationa$e 3' Cac* of responsi(eness is a negati(e symptom of schizophrenia. #ationa$e 4' !ifficulty following instructions is not a positi(e symptom of schizophrenia. #ationa$e ' A delusion is a positi(e symptom of schizophrenia. %$o&a$ #ationa$e: Co'niti(e )e(e$: Applying C$ient *eed: 4sychosocial "ntegrity C$ient *eed Su&: *ursin'/+nte'rated Con!epts: &ursing 4rocess' Assessment )earnin' ,ut!ome: ,562

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Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 17

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