A patient received maintenance doses of fluphenazine decanoate (Prolixin Decanoate) 25 mg IM every 2 weeks for 2 years. The clinic nurse notes the patient is grimacing and seems to be constantly smacking her lips. On the next clinic visit, the patient's neck and shoulders twist in a slow, snakelike motion. The nurse should suspect the presence of ______ and should ______.

Correct Answer: B

Rationale: The correct answer is B: tardive dyskinesia"¦administer the Abnormal Involuntary Movement Scale. 1. Tardive dyskinesia is a side effect of long-term use of antipsychotic medications like fluphenazine. 2. The symptoms described - grimacing, lip smacking, twisting neck and shoulders - are characteristic of tardive dyskinesia. 3. Administering the Abnormal Involuntary Movement Scale is the appropriate assessment tool for diagnosing tardive dyskinesia. 4. Agranulocytosis (choice A) is a rare but serious side effect of some antipsychotic medications, not associated with the symptoms described. 5. Tourette's syndrome (choice C) typically presents with vocal and motor tics, not the specific symptoms mentioned. 6. Anticholinergic effects (choice D) can cause dry mouth, constipation, and blurred vision, but not the involuntary movements described.

Correct Answer: D

Rationale: The correct answer is D because it focuses on building a therapeutic relationship with the patient without placing pressure on them to speak. By planning time for staff members to sit with the patient, even if the patient does not talk, it allows for nonverbal communication and presence to convey support and care. This approach respects the patient's boundaries and allows them to engage at their own pace, fostering trust and a sense of safety. Choice A is incorrect as it may overwhelm the patient by placing them in a social situation they are not ready for. Choice B is incorrect as discussing superficial topics does not address the patient's underlying issues. Choice C is incorrect as it may make the patient feel judged or pressured to speak, further isolating them.

Correct Answer: C

Rationale: The correct response is C because it focuses on exploring the underlying reasons for the patient's belief, which can help uncover any triggers or stressors leading to the delusion. This approach shows empathy, builds rapport, and encourages the patient to share more about their experiences. Choice A is dismissive and may cause the patient to feel invalidated. Choice B only focuses on the belief itself without delving deeper into the context. Choice D jumps to assumptions about the patient's emotions without addressing the core issue of the delusion. Overall, choice C promotes therapeutic communication and understanding of the patient's perspective.

Correct Answer: B

Rationale: The correct answer is B: Biological. Theories based on the brain and its activities fall under the field of biological psychology, which focuses on how biological factors influence behavior and mental processes. This includes studying brain structures, neural pathways, neurotransmitters, and their impact on behavior. Social (A) theories focus on interactions between individuals, Psychological (C) theories relate to mental processes and behavior, and Psychobiological (D) is a term that could be used interchangeably with Biological but is less commonly used. Hence, the most specific and appropriate term for theories related to the brain is Biological.

Correct Answer: B

Rationale: The correct answer is B: Delusion. A delusion is a fixed false belief that is not based on reality, such as believing one is a famous figure like the President. In this scenario, the client's belief is firmly held despite evidence to the contrary, indicating a delusion. Mutism (A) is a lack of verbal communication, not applicable here. Neologism (C) is creating new words or phrases, not seen in this example. Flight of ideas (D) is a rapid, continuous flow of speech with abrupt topic changes, which is not demonstrated in the client's behavior described.