AD Quiz: Psychosis

AD Quiz: Psychosis A client with schizophrenia is given an antipsychotic drug. The nurse recalls all the extrapyramidal effects associated with this type of medication and anticipates that the drug will be discontinued if which occurs? 1 Akathisia Correct2 Tardive dyskinesia 3 Parkinsonian syndrome 4 Acute dystonic reaction Tardive dyskinesia is characterized by protrusion and vermicular movements of the tongue, chewing and puckering movements of the mouth, and a puffing of the cheeks. These adverse effects may or may not be reversible when the antipsychotic medication is withdrawn. Motor restlessness (akathisia), parkinsonian symptoms, or an acute dystonic reaction can be treated with an antiparkinsonian or anticholinergic drug while the antipsychotic medication is continued. 67%of students nationwide answered this question correctly. 9 Confidence: Just a guess Stats Issue with this question? 2. The primary healthcare provider prescribes a neuroleptic drug to a client diagnosed with schizophrenia. On what basis would the primary healthcare provider choose the drug? 1 Symptoms Correct2 Side effects 3 Therapeutic effects 4 Underlying pathology First-generation antipsychotic drugs are also known as neuroleptics. The selection of these drugs is primarily based on side effects rather than therapeutic effects. Because all symptoms respond equally to antipsychotic drugs, the drug selection may not be based on symptoms. Because these drugs do not alter the underlying pathology, the selection may not be based on underlying pathology. 34%of students nationwide answered this question correctly. 1 Confidence: Just a guess Stats Issue with this question? 3. On the afternoon of admission to a psychiatric unit, an adolescent boy with the diagnosis of schizophrenia exposes his genitals to a female nurse. What should the nurse’s immediate therapeutic response be? 1 Ignoring the client at this time Correct2 Stating that this behavior is unacceptable 3 Moving him to his room for a short time-out 4 Telling the client to come to the office later to discuss the behavior When clients enter a new milieu, limits should be set on unacceptable behavior and acceptable behavior should be reinforced. Neither clients nor unacceptable behavior should ever be ignored. Moving the client to his room for a short time-out is punishment. Unacceptable attention-getting behavior must be addressed immediately; also, the focus should be on appropriate behavior. Test-Taking Tip: If the question asks for an immediate action or response, all of the answers may be correct, so base your selection on identified priorities for action. 82%of students nationwide answered this question correctly. 6 Confidence: Just a guess Stats Issue with this question? 4. Despite repeated nursing interventions to improve reality orientation, a client insists that he is the commander of an alien spaceship. What is the client experiencing? 1 Illusion Correct2 Delusion 3 Confabulation 4 Hallucination A delusion is a fixed false belief. An illusion is a false sense interpretation of an external stimulus. Confabulation is the client's attempt to fill gaps in memory with imaginary events. A hallucination is a false sensory perception with no external stimulus. Test-Taking Tip: Read every word of each question and option before responding to the item. Glossing over the questions just to get through the examination quickly can cause you to misread or misinterpret the real intent of the question. 83%of students nationwide answered this question correctly. 4 Confidence: Just a guess Stats Issue with this question? 5. A client with the diagnosis of schizophrenia who has been hospitalized on a mental health unit for 2 weeks is to be discharged home. The client is vacillating between being happy and sad about going home. What term best describes these conflicting emotions? 1 Double bind Correct2 Ambivalence 3 Loose association 4 Inappropriate affect The simultaneous existence of two conflicting emotions, impulses, or desires is known as ambivalence. A single communication containing two conflicting messages is known as a double-bind message. A lack of connections between thoughts is known as loose associations. Inappropriate affect is not two conflicting emotions but instead the inappropriate expression of emotions. 65%of students nationwide answered this question correctly. 8 Confidence: Just a guess Stats Issue with this question? 6. Which medication is the first choice drug for the treatment of attention deficit hyperactivity disorder (ADHD)? 1 Clonidine 2 Guanfacine 3 Atomoxetine Correct4 Methylphenidate Methylphenidate is the first choice drug for the treatment of attention deficit hyperactivity disorder (ADHD). Clonidine, guanfacine, and atomoxetine are nonstimulants used to treat ADHD; these medications are less effective than methylphenidate. 72%of students nationwide answered this question correctly. 5 Confidence: Just a guess Stats Issue with this question? 8. The night nurse reports that a young client with paranoid schizophrenia has been awake for several nights. The day nurse reviews the client’s record and finds that this client did not have an interrupted sleep pattern disorder before transfer from a private room to a four-bed room 3 days ago. What factor should the nurse identify as most likely related to the client’s sleeplessness? Correct1 Fear of the other clients 2 Concern about family at home 3 Watching for an opportunity to escape 4 Trying to work out emotional problems Because the client has paranoid feelings that other people are out to do harm, assignment to a four-bed room may be threatening. Concern about family at home seems unlikely, because the disruption appears to have started with the transfer to a four-bed room. Watching for an opportunity to escape is possible but unlikely; planning an escape is usually not part of a schizophrenic pattern of behavior. Trying to work out emotional problems is possible but not likely; clients with schizophrenia have difficulty solving problems. 92%of students nationwide answered this question correctly. 2 Confidence: Just a guess Stats Issue with this question? 9. Which condition is contraindicated for St. John’s wort herbal therapy? 1 Anxiety 2 Seizures Correct3 Dementia 4 Cardiac disease Dementia is contraindicated for St. John’s wort herbal therapy; this herbal therapy is used to treat anxiety. Seizures are contraindicated for bupropion therapy. Cardiac disease is contraindicated for valerian (Valeriana Officinalis). 31%of students nationwide answered this question correctly. 5 Confidence: Just a guess Stats Issue with this question? 10. A male client with a history of schizophrenia comes to the emergency department, accompanied by his wife. What is the emergency department nurse’s priority intervention? Correct1 Observing and evaluating his behavior 2 Writing a plan of care for the mental health team 3 Obtaining a copy of the client’s past medical records 4 Meeting separately with his wife and exploring why he came to the hospital The client and his needs are the priority, and assessment is the first step of the nursing process. Writing a plan of care for the mental health team is done after a thorough assessment is completed. The nurse must deal with the present, not the past. Although meeting separately with the wife should be done, it is not the priority. 72%of students nationwide answered this question correctly. 8 Confidence: Just a guess Stats Issue with this question? 11. 3 A healthcare provider prescribes aripiprazole 15 mg by mouth once a day for a client with the diagnosis of schizophrenia. The hospital pharmacy sends aripiprazole 5 mg/tablet. How many tablets will the nurse administer? Record your answer as a whole number. ____ tablet(s) Solve the problem using ratio and proportion. 2 Which medications are used to treat generalized anxiety disorder (GAD)? Select all that apply. Correct1 Duloxetine Correct2 Venlafaxine 3 Clonazepam Correct4 Escitalopram 5 Clomipramine Duloxetine, venlafaxine, and escitalopram are antidepressants approved for the treatment of generalized anxiety disorder (GAD). Clonazepam and clomipramine are used to treat panic disorders. 24%of students nationwide answered this question correctly. 8 Confidence: Just a guess Stats Issue with this question? 13. Which atypical antipsychotics are approved for long-term use to prevent the recurrence of mood episodes in clients with bipolar disease? Select all that apply. Correct1 Olanzapine 2 Quetiapine Correct3 Ziprasidone 4 Risperidone Correct5 Aripiprazole Olanzapine, ziprasidone, and aripiprazole are atypical antipsychotics approved for long-term use to prevent recurrence of mood episodes. Quetiapine and risperidone are atypical antipsychotics approved for use in bipolar disease but are not approved for long-term use to prevent the recurrence of mood episodes. 13%of students nationwide answered this question correctly. 2 Confidence: Just a guess Stats Issue with this question? 14. After assessing a client, the nurse suspects that the client has shift-work sleep disorder (SWSD). Which medication would be prescribed to the client? 1 Caffeine Correct2 Modafinil 3 Atomoxetine 4 Methylphenidate