A nursing instructor is teaching a class on the pharmacodynamics of psychiatric medications. The instructor determines that additional teaching is needed when the students identify which of the following as a site of action?

Correct Answer: C

Rationale: The correct answer is C: Neurotransmitters. In pharmacodynamics, the site of action refers to where a drug exerts its effects in the body. Neurotransmitters are not a site of action; they are the chemical messengers that transmit signals between neurons. Drugs act on receptors, ion channels, and enzymes to produce their pharmacological effects. Receptors are proteins on cell surfaces or within cells that bind to specific drugs and initiate a response. Ion channels are proteins that regulate the flow of ions across cell membranes, affecting cell function. Enzymes are proteins that catalyze biochemical reactions. Therefore, neurotransmitters do not serve as the primary site of action for psychiatric medications.

Correct Answer: B

Rationale: The correct answer is B: Dramatic response to frustration. This is indicative of a Cluster B personality disorder, which includes traits such as emotional instability and impulsivity. People with Cluster B personality disorders often display intense and exaggerated emotional responses to situations like frustration. Choices A, C, and D do not specifically align with the characteristics of Cluster B personality disorders, making them incorrect. A reflects symptoms of an eating disorder, C is related to compulsive behavior, and D describes traits more commonly associated with mood disorders.

Correct Answer: B

Rationale: The correct answer is B: "Have you ever felt sorry after acting as you did on the spur of the moment?" This question directly assesses the client's level of impulsivity by probing into their past impulsive actions and their subsequent feelings of regret. Impulsivity is characterized by acting without thinking of the consequences, often leading to regret afterwards. Choices A, C, and D do not directly address impulsivity but instead focus on the client's emotions, views on others, and dissociative experiences respectively, which are not specifically related to impulsivity.

Correct Answer: C

Rationale: The correct answer is C: Fever. This is the highest priority for the client to report because fever can indicate a serious side effect called agranulocytosis, a potentially life-threatening condition associated with clozapine therapy. Agranulocytosis can lead to severe infections due to low white blood cell count. It is crucial to monitor for fever as an early sign of this condition to prevent complications. A: Constipation - While constipation can be a side effect of clozapine, it is not as urgent as fever in this context. B: Blurred vision - Blurred vision is a common side effect of clozapine but is not typically considered a medical emergency. D: Dry mouth - Dry mouth is a common side effect of many medications, including clozapine, and is not as concerning as fever in this scenario.

Correct Answer: B

Rationale: The correct initial nursing action for a client wanting to leave against medical advice from an inpatient locked psychiatric unit is to check the client's admission status and discuss the reasons for wanting to leave (Choice B). This approach allows the nurse to assess the client's mental status, risk factors, and reasons for wanting to leave, which are essential for providing appropriate care and interventions. By understanding the client's perspective and concerns, the nurse can work collaboratively with the client to address underlying issues and potentially prevent harm. Choices A, C, and D are incorrect because they do not prioritize understanding the client's reasons for wanting to leave or assessing the client's mental status and risk factors. Choice A dismisses the client's request without exploring the underlying issues. Choice C focuses on punitive measures rather than therapeutic communication. Choice D, placing the client on one-on-one observation, does not address the client's concerns or reasons for wanting to leave.