ATI LPN
Psychiatric Nursing: Contemporary Practice 6th Edition
Chapter 22 : Schizophrenia and Related Disorders: Nursing Care of Persons with Thought Disorders Questions
Question 1 of 5
The nurse is caring for a hospitalized client who has schizophrenia. The client has been taking antipsychotic medications for 1 week when the nurse observes that the client?s eyes are fixed on the ceiling. The nurse interprets this finding as which of the following?
Correct Answer: B
Rationale: Oculogyric crisis (
B) is an acute dystonic reaction characterized by fixed upward gaze, often caused by antipsychotics within days of starting treatment. Akathisia (
A) involves restlessness, retrocollis (
C) is neck muscle dystonia, and tardive dyskinesia (
D) involves late-onset involuntary movements, none of which match the symptom.
Question 2 of 5
A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer?
Correct Answer: A
Rationale: Diphenhydramine (
A), an antihistamine with anticholinergic properties, is commonly used to treat acute dystonic reactions caused by antipsychotics, relieving muscle spasms. Propranolol (
B) treats akathisia, while risperidone (
C) and aripiprazole (
D) are antipsychotics that could worsen dystonia.
Question 3 of 5
The nurse is caring for a client who has been receiving treatment for schizophrenia with chlorpromazine for the past year. It would be essential for the nurse to monitor the client for which of the following?
Correct Answer: D
Rationale: Tardive dyskinesia (
D), a potentially irreversible side effect of long-term use of typical antipsychotics like chlorpromazine, involves involuntary movements and requires ongoing monitoring. Weight loss (
A) is unlikely (weight gain is more common), torticollis (
B) is an acute dystonia, and hypoglycemia (
C) is not a typical side effect.
Question 4 of 5
A client hospitalized for treatment of schizophrenia has been receiving olanzapine (Zyprexa) for the past 2 months. The nurse would be especially alert for which of the following?
Correct Answer: D
Rationale: Olanzapine (
D) is associated with metabolic side effects, including an increased risk of diabetes due to weight gain and insulin resistance. Weight loss (
A) is unlikely, hypertension (
B) is less common, and diarrhea (
C) is not a primary concern with olanzapine.
Question 5 of 5
The nurse is caring for a client who has been taking clozapine (Clozaril) for 2 weeks. The client tells the nurse, My throat is sore, and I feel weak. The nurse assesses the client?s vital signs and finds that the client has a fever. The nurse notifies the physician, expecting an order to obtain which laboratory test?
Correct Answer: A
Rationale: Clozapine (
A) carries a risk of agranulocytosis, a potentially life-threatening drop in white blood cells, presenting with symptoms like sore throat, weakness, and fever. Monitoring white blood cell counts is critical. Liver function (
B), potassium (
C), and sodium (
D) levels are less relevant to these symptoms.