The nurse suspects that a patient who is experiencing facial grimacing, involuntary upward eye movement, and muscle spasms of the tongue and face may have which condition?

Correct Answer: C

Rationale: The correct answer is C: Tardive dyskinesia. This condition is characterized by involuntary movements of the tongue, face, and limbs, which align with the patient's symptoms. The other choices are incorrect because: A: Akathisia involves restlessness and the inability to sit still. B: Acute dystonia presents with muscle spasms and abnormal postures, but not specifically facial grimacing or upward eye movement. D: Pseudoparkinsonism includes symptoms similar to Parkinson's disease, such as tremors and rigidity, but not the facial grimacing and eye movements described in the patient.

Correct Answer: D

Rationale: The correct answer is D: Tremors. Fluphenazine can lead to symptoms of extrapyramidal syndrome (EPS), with tremors being a common manifestation. Extrapyramidal symptoms include muscle stiffness, tremors, restlessness, and abnormal body movements. Parkinsonism (choice A) is a specific type of EPS characterized by tremors, rigidity, and bradykinesia. Nausea and vomiting (choice B) are not typical symptoms of EPS. Hyperthermia and dysrhythmias (choice C) are unrelated to EPS. Therefore, choice D is the correct answer as it aligns with the expected symptoms of EPS associated with fluphenazine administration.

Correct Answer: A

Rationale: The correct answer is A: Clozapine. Clozapine is an atypical antipsychotic known for its efficacy in treating refractory psychosis. It is typically used when other antipsychotics have failed. Fluphenazine (B) and Haloperidol (C) are typical antipsychotics, not atypical. Olanzapine (D) is also an atypical antipsychotic but is not the best choice in this scenario as clozapine is more specifically associated with treating psychosis that has not responded to other medications.

Correct Answer: A

Rationale: The correct answer is A: It is used to treat anxiety. Lorazepam is a benzodiazepine that is commonly prescribed for anxiety disorders due to its anxiolytic properties. It acts by enhancing the effects of GABA in the brain, leading to a calming effect. Choice B, status epilepticus, is incorrect as lorazepam is also used for acute management of seizures, but not specifically for status epilepticus. Choice C, insomnia, is incorrect as lorazepam is not typically prescribed for insomnia. Choice D, sedation induction, is incorrect as lorazepam is more commonly used for anxiety and not specifically for sedation induction.

Correct Answer: B

Rationale: The correct answer is B: Remain with the patient until medication is swallowed. This intervention is important to ensure medication compliance and prevent cheeking or hoarding of the medication. By staying with the patient until the medication is swallowed, the nurse can confirm that the full dose is taken, reducing the risk of treatment failure. Choice A is incorrect because aripiprazole can be taken with or without food, so administering it before meals on an empty stomach is not necessary for absorption. Choice C is incorrect because while monitoring vital signs is important when administering aripiprazole, it is primarily to detect side effects such as tachycardia rather than orthostatic hypotension specifically. Choice D is incorrect because while assessing for neuroleptic malignant syndrome is important with antipsychotic medications, it is not a specific nursing intervention related to aripiprazole administration.