NURS 4010 LATEST 2026 PRACTICE EXAM QUESTIONS
AND SOLUTIONS GUARANTEE A+
✔✔positive symptoms of schizzophrenia - ✔✔-adding something not normally there
-reflect an alteration or distortion of normal mental functions
-hallucinations
-delusions
-thought disturbances
-bizarre behavior
✔✔negative symptoms of schizophrenia - ✔✔-loss of something, normal functions
-apathy
-avolition- lack of motivation
-apathy
-blunted affect
-loss of emotional warmth
-anhedonia (absence of pleasure)
-impaired social skills
-anergia- without energy
-difficult to treat and respond less well to antipsychotics than positive symptoms
✔✔treatment of shizophrenia - ✔✔-no single treatment
-multidisciplinary effort
-pharmacology
-psychosocial care: living skills, social skills training, family therapy
-real strain on families
-lot of social skills training
✔✔typical antipsychotics - ✔✔-older generation (first way to treat schizophrenia)
-block dopamine
-treat positive symptoms
-more parkinsonian like symptoms bc treat dopamine more strongly
✔✔atypical antipsychotics - ✔✔-weaker dopamine receptor antagonists
-increase serotonin, decrease dopamine
-treat positive and negative symptoms
-more recent, second generation
-not quite as strong as typical with positive symptoms
✔✔side effects (mostly typicals, atypicals can cause these SE) - ✔✔*anticholinergic
effects*
-dry mouth
-constipation
-blurred vision
-urinary retention
,*antihistamine side effects*
-sedation
-weight gain
*anti-alpha-adrenergic side effects*
-orthostatic hypotension
-dizziness
-cardiac abnormalities
-sexual dysfunction
*dermatologic*
-photosensitivity
*seizures*
-lowered seizure threshold
*EPS- extrapyramidal symptoms*
✔✔EPS- extrapyramidal symtoms - ✔✔-TYPICAL, can be atypical
-dystonia- involuntary muscular movements (spasms) of face, arms, legs, neck
-akathisia- restlessness (looks like anxiety but dont feel that way
-pseudoparkinsonism- tremor, shuffling gait, drooling, rigidity
-tardive dyskinesia- bizarre facial and tongue movements, stiff neck, difficulty
swallowing (IRREVERSIBLE)- stop drug at first sign, AIMS (abnormal involuntary
movement scale- tests for tardive dyskinesia)
✔✔treating EPS - ✔✔treat EPS with ABC except for TD!!!
A= *Artane* (anticholinergic)
B= *Benadryl* (antihistamine)
C= *Cogentin* (anticholinergic)
S= *Symmetrel* (dopamine agonist)
*anticholinergics best treatment*
-why benadryl instead of cogentin? (sedating, calm them down)
✔✔treating tardive dyskinesia - ✔✔-discontinue the medication
-switch to an atypical
-vitamin E (neutralizes free radicals)
✔✔neuroleptic malignant syndrome (NMS) - ✔✔-*rare, but potentially FATAL*
-emergency
-more common with typicals
-often first time you take antipsychotic
-assess pt right when starts!!!
*CHARMR*
-*C*PK elevated
-*H*yperpyrexia
-*A*utonomic instability
-*R*igidity
-*M*ental status changes
-*R*habdomyolysis
, -VS all over the place
-lot of rigidity
-rigidity will cause rhabdo, which will elevate CPK
-fever and altered mental status will clue you in
✔✔treating NMS - ✔✔-discontinue the medication
-supportive care (hydration, cooling)
-monitor VS
-monitor I&O
-monitor rigidity
-provider may order bromocriptine or dantrolene (muscle relaxers)
-need fluids to flush pt out and lower CPK
✔✔atypicals - ✔✔*"Imagine A Fat Ghost Really Can See Lazy Zebras Sleeping"*
Invega (palperidone)
Abilify (Aripiprazole)
Fanapt (Iloperidone)
Geodon (Ziprasidone)
Risperdal (Risperidone)
Clozaril (Clozapine)
Seroquel (Quetiapine)
Latuda (Lurasidone)
Zyprexa (Olanzapine)
Saphris (Asenapine)
✔✔considerations with atypical - ✔✔-black box warning: inc mortality in elderly pts with
dementia related psychosis
*hyperglycemia and diabetes- metabolic syndrome*
-baseline weight and BMI
-blood pressure
-baseline blood glucose levels
-fasting lipid profiles
*geodon*- can cause QT elevation (need baseline EKG)
*risperdal*- increase prolactin levels, gynecomastia
*abilify*- weight neutral
✔✔Clozaril (Clozapine) - ✔✔-atypical with special considerations and precautions
-indications for use: failed adequate course of standard antipsychotic therapy, reduce
risk of recurrent suicidal behavior
-last line bc of SE but excellent choice
-SE: weight gain, drooling, seizures, myocarditis, *agranulocytosis* (test for WBC count,
absolute neutrophil count)
-clozaril registry (not good for homeless pt, pharmacy has to keep copy of labs
*strict monitoring guidelines*
-baseline ANC and WBC
-weekly ANC and WBC (first 6 months)
AND SOLUTIONS GUARANTEE A+
✔✔positive symptoms of schizzophrenia - ✔✔-adding something not normally there
-reflect an alteration or distortion of normal mental functions
-hallucinations
-delusions
-thought disturbances
-bizarre behavior
✔✔negative symptoms of schizophrenia - ✔✔-loss of something, normal functions
-apathy
-avolition- lack of motivation
-apathy
-blunted affect
-loss of emotional warmth
-anhedonia (absence of pleasure)
-impaired social skills
-anergia- without energy
-difficult to treat and respond less well to antipsychotics than positive symptoms
✔✔treatment of shizophrenia - ✔✔-no single treatment
-multidisciplinary effort
-pharmacology
-psychosocial care: living skills, social skills training, family therapy
-real strain on families
-lot of social skills training
✔✔typical antipsychotics - ✔✔-older generation (first way to treat schizophrenia)
-block dopamine
-treat positive symptoms
-more parkinsonian like symptoms bc treat dopamine more strongly
✔✔atypical antipsychotics - ✔✔-weaker dopamine receptor antagonists
-increase serotonin, decrease dopamine
-treat positive and negative symptoms
-more recent, second generation
-not quite as strong as typical with positive symptoms
✔✔side effects (mostly typicals, atypicals can cause these SE) - ✔✔*anticholinergic
effects*
-dry mouth
-constipation
-blurred vision
-urinary retention
,*antihistamine side effects*
-sedation
-weight gain
*anti-alpha-adrenergic side effects*
-orthostatic hypotension
-dizziness
-cardiac abnormalities
-sexual dysfunction
*dermatologic*
-photosensitivity
*seizures*
-lowered seizure threshold
*EPS- extrapyramidal symptoms*
✔✔EPS- extrapyramidal symtoms - ✔✔-TYPICAL, can be atypical
-dystonia- involuntary muscular movements (spasms) of face, arms, legs, neck
-akathisia- restlessness (looks like anxiety but dont feel that way
-pseudoparkinsonism- tremor, shuffling gait, drooling, rigidity
-tardive dyskinesia- bizarre facial and tongue movements, stiff neck, difficulty
swallowing (IRREVERSIBLE)- stop drug at first sign, AIMS (abnormal involuntary
movement scale- tests for tardive dyskinesia)
✔✔treating EPS - ✔✔treat EPS with ABC except for TD!!!
A= *Artane* (anticholinergic)
B= *Benadryl* (antihistamine)
C= *Cogentin* (anticholinergic)
S= *Symmetrel* (dopamine agonist)
*anticholinergics best treatment*
-why benadryl instead of cogentin? (sedating, calm them down)
✔✔treating tardive dyskinesia - ✔✔-discontinue the medication
-switch to an atypical
-vitamin E (neutralizes free radicals)
✔✔neuroleptic malignant syndrome (NMS) - ✔✔-*rare, but potentially FATAL*
-emergency
-more common with typicals
-often first time you take antipsychotic
-assess pt right when starts!!!
*CHARMR*
-*C*PK elevated
-*H*yperpyrexia
-*A*utonomic instability
-*R*igidity
-*M*ental status changes
-*R*habdomyolysis
, -VS all over the place
-lot of rigidity
-rigidity will cause rhabdo, which will elevate CPK
-fever and altered mental status will clue you in
✔✔treating NMS - ✔✔-discontinue the medication
-supportive care (hydration, cooling)
-monitor VS
-monitor I&O
-monitor rigidity
-provider may order bromocriptine or dantrolene (muscle relaxers)
-need fluids to flush pt out and lower CPK
✔✔atypicals - ✔✔*"Imagine A Fat Ghost Really Can See Lazy Zebras Sleeping"*
Invega (palperidone)
Abilify (Aripiprazole)
Fanapt (Iloperidone)
Geodon (Ziprasidone)
Risperdal (Risperidone)
Clozaril (Clozapine)
Seroquel (Quetiapine)
Latuda (Lurasidone)
Zyprexa (Olanzapine)
Saphris (Asenapine)
✔✔considerations with atypical - ✔✔-black box warning: inc mortality in elderly pts with
dementia related psychosis
*hyperglycemia and diabetes- metabolic syndrome*
-baseline weight and BMI
-blood pressure
-baseline blood glucose levels
-fasting lipid profiles
*geodon*- can cause QT elevation (need baseline EKG)
*risperdal*- increase prolactin levels, gynecomastia
*abilify*- weight neutral
✔✔Clozaril (Clozapine) - ✔✔-atypical with special considerations and precautions
-indications for use: failed adequate course of standard antipsychotic therapy, reduce
risk of recurrent suicidal behavior
-last line bc of SE but excellent choice
-SE: weight gain, drooling, seizures, myocarditis, *agranulocytosis* (test for WBC count,
absolute neutrophil count)
-clozaril registry (not good for homeless pt, pharmacy has to keep copy of labs
*strict monitoring guidelines*
-baseline ANC and WBC
-weekly ANC and WBC (first 6 months)
