A patient with schizophrenia who has received chlorpromazine (Thorazine) 200 mg PO four times daily for 4 weeks has symptoms of a shuffling, propulsive gait, a masklike face, and drooling. Which nursing response would be most appropriate?(Select the one that does not apply.)

Correct Answer: A

Rationale: The correct answer is A: Advise the patient to be patient, since these side effects are only temporary. Rationale: 1. The side effects described (shuffling gait, masklike face, drooling) are indicative of extrapyramidal symptoms caused by chlorpromazine. 2. These side effects are common with typical antipsychotic medications like chlorpromazine. 3. Advising the patient to be patient is inappropriate as these symptoms may not resolve on their own. 4. Seeking a physician order for an antiparkinsonian medication (choice B) or administering trihexyphenidyl (choice D) would be appropriate interventions to manage the extrapyramidal symptoms. 5. Suggesting carrying a towel and initiating fall precautions (choice C) is important for managing the drooling and potential fall risk associated with the gait disturbances.

Correct Answer: A

Rationale: Step 1: Antipsychotics are used to treat psychotic disorders, distinct from the other classes mentioned. Step 2: Antipsychotics are commonly used to manage schizophrenia, bipolar disorder, and severe depression. Step 3: Antianxiety agents and anxiolytics are essentially the same, so D is not the correct answer. Step 4: Anticholinergics primarily affect the nervous system and are not typically used in psychotherapy. Step 5: Anticonvulsants are mainly used to treat epilepsy and mood disorders, not a core class in psychotherapeutic medications.

Correct Answer: C

Rationale: The correct answer is C: PET scans. PET scans use a radioactive form of glucose to detect brain activity based on glucose metabolism. Glucose is a primary energy source for brain cells, so increased glucose uptake indicates increased brain activity. CT scans (A) provide structural images, EEG (B) measures electrical activity, and MRI images (D) show detailed brain structure but do not directly measure brain activity based on glucose metabolism.

Correct Answer: D

Rationale: The correct answer is D: eszopiclone (Lunesta), a nonbenzodiazepine sleep aid. Eszopiclone is a preferred long-term treatment for insomnia due to its lower risk of dependence and tolerance compared to benzodiazepines and barbiturates. Eszopiclone acts on the GABA receptors to promote sleep without causing the same level of sedation or cognitive impairment as benzodiazepines or barbiturates. It is also less likely to cause rebound insomnia upon discontinuation. Incorrect Choices: A: secobarbital (Seconal), a barbiturate - Barbiturates have a high potential for tolerance, dependence, and overdose, making them unsuitable for long-term insomnia treatment. B: diazepam (Valium), a benzodiazepine - Benzodiazepines can lead to tolerance, dependence, and withdrawal symptoms, making them less ideal for long-term insomnia treatment.

Correct Answer: D

Rationale: The correct answer is D because removing the patch at bedtime and applying a new one in the morning helps to provide a nitrate-free period which prevents the development of tolerance to nitroglycerin. By allowing a nitrate-free interval, the body is less likely to become desensitized to the effects of nitroglycerin, thus maintaining its effectiveness. A: Omitting a dose once a week does not provide a consistent nitrate-free period and may not be effective in reducing tolerance. B: Leaving the patch on for 2 days at a time may lead to continuous exposure and potential tolerance development. C: Cutting the patch in half is not a recommended method as it alters the dose delivery and may lead to inconsistent effects.