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Chapter 17: Drugs Used for Psychoses
Test Bank
MULTIPLE CHOICE
1. The nurse is assessing a patient who is complaining of hearing voices. What is this patient
experiencing?
a. Delusions
b. Flight of ideas
c. Disorganized thinking
d. Hallucinations
ANS: D
Hallucinations are false sensory perceptions that are experienced without an external
stimulus but seem real to the patient. Auditory hallucinations are prominent in a
schizophrenic patient. Additional sensory hallucinations include those of touch, sight, smell,
and body sensation. Delusions are false beliefs that persist despite evidence to the contrary.
Flight of ideas is characterized by rapid changes in thought from one topic to another.
Disorganized thinking is commonly associated with psychoses and consists of a flight of ideas
during which the individual jumps from one idea or topic to another one.
DIF: Cognitive Level: Knowledge REF: p. 274 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity
2. A patient with schizophrenia has been nonadherent with his home medication regimen. He
requires frequent admissions to the intensive psychiatric unit for treatment of acute
psychotic episodes. Which medication regimen would be appropriate for this patient?
a. Daily home nursing visits to administer the prescribed oral medication
b. Continuous inpatient hospitalization for medication therapy
c. Administration of depot antipsychotic medication
d. Subcutaneous medication administration
ANS: C
Depot antipsychotic medications are long acting injections that may be used with
noncompliant patients and may assist in avoiding repeated hospital admissions. Daily home
nursing visits are not an efficient way to ensure medication compliance. Continuous inpatient
hospitalization is not an efficient way to ensure medication compliance. Subcutaneous
medication administration is not an option for this patient.
DIF: Cognitive Level: Application REF: pp. 274-276 OBJ: 2 | 3
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Psychosocial Integrity
3. What is the most common cause of nonadherence to antipsychotic pharmacologic
treatment? a. Expense
b. Increased symptoms of chemical dependency
-05:00
, c. Extrapyramidal effects
d. Inability of the patient to understand the need to take medications
ANS: C
Extrapyramidal effects are the most common reason for nonadherence to antipsychotic
therapy. The four categories of extrapyramidal effects are dystonic reactions,
pseudoparkinsonism, akathisia, and tardive dyskinesia. Although expense may be a concern,
it is not the most common reason for noncompliance. Chemical dependency is not a feature
of therapy with antipsychotic drugs. Although knowledge deficit is a concern, it is not the
most common reason for noncompliance.
DIF: Cognitive Level: ComprehensionREF: p. 279 OBJ: 3
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
4. Which type of adverse effects is present when a patient displays prolonged tonic
contractions of the tongue, oculogyric crisis, and torticollis?
a. Dystonic reactions
b. Pseudoparkinsonism
c. Akathisia
d. Tardive dyskinesia
ANS: A
Dystonic reactions are the first extrapyramidal symptoms to occur when a patient is taking
antipsychotic agents. Dystonias are spasmodic movements of muscle groups such as tongue
protrusion, rolling back of the eyes (oculogyric crisis), jaw spasms (trismus), or neck torsion
(torticollis). Pseudoparkinsonism is characterized by tremor and rigidity. Akathisia is
characterized by subjective feelings of anxiety and restlessness, accompanied by pacing and
the inability to remain in one place for extended periods. Tardive dyskinesia is characterized
by persistent involuntary hyperkinetic movements.
DIF: Cognitive Level: ComprehensionREF: p. 279 OBJ: 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
5. The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests
for the first 6 months of treatment to monitor for which potential complication?
a. Agranulocytosis
b. Vitamin deficiencies
c. Clotting abnormalities
d. Polycythemia
ANS: A
The use of clozapine requires a baseline and weekly white blood cell (WBC) counts because
of the high incidence of agranulocytosis. Clozapine does not cause vitamin deficiencies.
Clozapine does not interfere with clotting abilities. Clozapine does not affect red blood cell
volume.
DIF: Cognitive Level: Knowledge REF: p. 278 | p. 281
OBJ: 4 TOP: Nursing Process Step: Assessment MSC: NCLEX Client
Needs Category: Physiological Integrity
Chapter 17: Drugs Used for Psychoses
Test Bank
MULTIPLE CHOICE
1. The nurse is assessing a patient who is complaining of hearing voices. What is this patient
experiencing?
a. Delusions
b. Flight of ideas
c. Disorganized thinking
d. Hallucinations
ANS: D
Hallucinations are false sensory perceptions that are experienced without an external
stimulus but seem real to the patient. Auditory hallucinations are prominent in a
schizophrenic patient. Additional sensory hallucinations include those of touch, sight, smell,
and body sensation. Delusions are false beliefs that persist despite evidence to the contrary.
Flight of ideas is characterized by rapid changes in thought from one topic to another.
Disorganized thinking is commonly associated with psychoses and consists of a flight of ideas
during which the individual jumps from one idea or topic to another one.
DIF: Cognitive Level: Knowledge REF: p. 274 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity
2. A patient with schizophrenia has been nonadherent with his home medication regimen. He
requires frequent admissions to the intensive psychiatric unit for treatment of acute
psychotic episodes. Which medication regimen would be appropriate for this patient?
a. Daily home nursing visits to administer the prescribed oral medication
b. Continuous inpatient hospitalization for medication therapy
c. Administration of depot antipsychotic medication
d. Subcutaneous medication administration
ANS: C
Depot antipsychotic medications are long acting injections that may be used with
noncompliant patients and may assist in avoiding repeated hospital admissions. Daily home
nursing visits are not an efficient way to ensure medication compliance. Continuous inpatient
hospitalization is not an efficient way to ensure medication compliance. Subcutaneous
medication administration is not an option for this patient.
DIF: Cognitive Level: Application REF: pp. 274-276 OBJ: 2 | 3
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Psychosocial Integrity
3. What is the most common cause of nonadherence to antipsychotic pharmacologic
treatment? a. Expense
b. Increased symptoms of chemical dependency
-05:00
, c. Extrapyramidal effects
d. Inability of the patient to understand the need to take medications
ANS: C
Extrapyramidal effects are the most common reason for nonadherence to antipsychotic
therapy. The four categories of extrapyramidal effects are dystonic reactions,
pseudoparkinsonism, akathisia, and tardive dyskinesia. Although expense may be a concern,
it is not the most common reason for noncompliance. Chemical dependency is not a feature
of therapy with antipsychotic drugs. Although knowledge deficit is a concern, it is not the
most common reason for noncompliance.
DIF: Cognitive Level: ComprehensionREF: p. 279 OBJ: 3
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
4. Which type of adverse effects is present when a patient displays prolonged tonic
contractions of the tongue, oculogyric crisis, and torticollis?
a. Dystonic reactions
b. Pseudoparkinsonism
c. Akathisia
d. Tardive dyskinesia
ANS: A
Dystonic reactions are the first extrapyramidal symptoms to occur when a patient is taking
antipsychotic agents. Dystonias are spasmodic movements of muscle groups such as tongue
protrusion, rolling back of the eyes (oculogyric crisis), jaw spasms (trismus), or neck torsion
(torticollis). Pseudoparkinsonism is characterized by tremor and rigidity. Akathisia is
characterized by subjective feelings of anxiety and restlessness, accompanied by pacing and
the inability to remain in one place for extended periods. Tardive dyskinesia is characterized
by persistent involuntary hyperkinetic movements.
DIF: Cognitive Level: ComprehensionREF: p. 279 OBJ: 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
5. The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests
for the first 6 months of treatment to monitor for which potential complication?
a. Agranulocytosis
b. Vitamin deficiencies
c. Clotting abnormalities
d. Polycythemia
ANS: A
The use of clozapine requires a baseline and weekly white blood cell (WBC) counts because
of the high incidence of agranulocytosis. Clozapine does not cause vitamin deficiencies.
Clozapine does not interfere with clotting abilities. Clozapine does not affect red blood cell
volume.
DIF: Cognitive Level: Knowledge REF: p. 278 | p. 281
OBJ: 4 TOP: Nursing Process Step: Assessment MSC: NCLEX Client
Needs Category: Physiological Integrity
