This schizophrenic patient has been taking Prolixin for 6 months. She now is experiencing extrapyramidal symptoms (EPS). Which medication is most likely to be added?

Correct Answer: C

Rationale: In the context of treating a schizophrenic patient experiencing extrapyramidal symptoms (EPS) due to Prolixin (fluphenazine) use, the most appropriate medication to add is Benztropine (Cogentin) (Option C). Benztropine is an anticholinergic medication commonly used to manage EPS associated with antipsychotic drugs like Prolixin. It helps alleviate symptoms such as dystonia, akathisia, and parkinsonism by blocking excess acetylcholine in the brain. Option A, Acetaminophen (Tylenol), is a pain reliever and would not address EPS symptoms. Option B, Alprazolam (Xanax), is a benzodiazepine used for anxiety and would not target EPS. Option D, Amitriptyline (Elavil), is a tricyclic antidepressant and is not indicated for EPS. Educationally, understanding the mechanism of action of different medications in managing side effects of psychotropic drugs is crucial for healthcare professionals. It is essential to tailor treatment to the specific symptoms and side effects a patient is experiencing to optimize their care and quality of life. In this case, choosing Benztropine aligns with evidence-based practice for managing EPS in patients on antipsychotic medications like Prolixin.

Correct Answer: A

Rationale: In the context of psychobiological disorders, understanding the term codependency is crucial for identifying and addressing dysfunctional relationship dynamics. Codependency refers to a psychological condition where individuals become excessively reliant on others for their sense of self-worth and identity, often enabling destructive behaviors in their loved ones. Option A) Enabling is the correct answer because codependency often involves enabling the behavior of the person they are dependent on, such as covering up for their alcoholism or substance abuse. Option B) Dual diagnosis refers to a situation where an individual has both a substance abuse disorder and a mental health disorder. While this can co-occur with codependency, it is not another term for codependency. Option C) Rationalization is a defense mechanism where individuals justify their behaviors or feelings, which is not synonymous with codependency. Option D) Identification with the alcoholic is a concept related to the psychological phenomenon where a person adopts the traits or behaviors of another individual, which is not specifically indicative of codependency. Educationally, understanding the term codependency is important for mental health professionals, caregivers, and individuals themselves to recognize and address unhealthy relationship patterns. By grasping the nuances of codependency, individuals can work towards establishing healthier boundaries, fostering self-reliance, and promoting overall well-being in themselves and their relationships.

Correct Answer: C

Rationale: In the context of psychobiological disorders, understanding schizophrenia and its characteristic symptoms is crucial for accurate diagnosis and treatment. In this case, the correct answer is C) Intense relationships with friends. The hallmark symptoms of schizophrenia typically include hallucinations, delusions, and suspiciousness. Patients with schizophrenia often experience hallucinations, such as hearing voices or seeing things that are not there. Delusions are also common, where individuals hold false beliefs despite evidence to the contrary. Suspiciousness, or paranoia, is another prevalent symptom in schizophrenia, leading individuals to mistrust others and feel persecuted. The incorrect answer choices are A) Suspiciousness, B) Hallucinations, and D) Delusions, as these are actually common characteristics seen in individuals with schizophrenia. It is important to note that the absence of intense relationships with friends is characteristic of schizophrenia, as individuals with this disorder often struggle with social interactions and maintaining close relationships due to the nature of their symptoms. Educationally, this question serves to reinforce the distinguishing features of schizophrenia and highlight the importance of recognizing the specific symptoms associated with this disorder. By understanding these key characteristics, healthcare professionals can provide more effective care and support for patients with schizophrenia.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Delusion. A delusion is a fixed, false belief that is resistant to reason or confrontation with actual fact. In Max's case, he believes that a man on television is the cause of his illness, despite this not being true. This belief is not based on reality and is characteristic of a delusion. Option A) Hallucination is incorrect because a hallucination is a sensory experience without a stimulus, like seeing, hearing, or feeling something that is not present. Max is not experiencing a sensory perception, but rather holding a false belief. Option C) Illusion is incorrect as it refers to a misinterpretation of a real external stimulus, like seeing a shadow and thinking it's a person. Max is not misinterpreting anything real in his environment. Option D) Autistic thought is not a recognized term in psychology related to this context. It does not accurately describe Max's situation of having a fixed false belief. Educationally, understanding the distinction between hallucinations, delusions, illusions, and other cognitive distortions is crucial in diagnosing and treating psychobiological disorders. Recognizing and correctly interpreting these symptoms can help healthcare providers provide appropriate care and support to individuals experiencing these symptoms.

Correct Answer: B

Rationale: In this scenario, the correct first nursing action for Sally would be to implement suicide precautions to keep her safe (Option B). This is crucial because Sally is experiencing an exacerbation of symptoms of her schizophrenia, including commanding auditory hallucinations instructing her to harm herself. Suicide risk assessment and precautions are essential in ensuring the safety of individuals experiencing such symptoms. Diverting Sally into a group activity (Option A) would not address the immediate risk of harm she is facing. Explaining to Sally that there is nobody telling her to walk in front of a big truck (Option C) may invalidate her experience and could further escalate her distress. Notifying her family and asking if she has said this before (Option D) may delay the necessary intervention to ensure Sally's safety. From an educational standpoint, it is important to highlight the significance of recognizing and responding to acute psychiatric symptoms promptly and effectively. Implementing suicide precautions is a standard protocol in managing individuals at risk of self-harm or suicide, and this case emphasizes the critical role of nurses in ensuring the safety and well-being of patients experiencing psychobiological disorders.