AD Quiz: Psychosis
A client with schizophrenia is given an antipsychotic drug. The nurse recalls all the extrapyramidal effects
associated with this
... [Show More] 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be reversible when the antipsychotic medication is withdrawn.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.
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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 effects4
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.
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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.
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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.
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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?
1Double 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.
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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.
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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.
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9.
Which condition is contraindicated for St. John’s wort herbal therapy?
1
Anxiety2
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).
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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.
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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.
3042048782
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.
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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.
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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
3Atomoxetine
4
Methylphenidate
Modafinil is a unique nonamphetamine stimulant used to treat shift-work sleep disorder (SWSD). This
drug promotes wakefulness in clients suffering from excessive sleepiness associated with SWSD. Caffeine
is a central nervous stimulant used to promote wakefulness, but this drug is not as effective in the
treatment of SWSD. Atomoxetine is a nonstimulant used to treat attention deficit hyperactivity disorder
(ADHD). Methylphenidate is considered the first choice drug for the treatment of attention deficit
hyperactivity disorder (ADHD).
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15.
Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid?
1
Mydriasis
2
Bradycardia
3
Hypothermia
Correct4
Circulatory collapse
The clinical symptoms of monoamine oxidase inhibitors (MAOIs) generally appears after 12 hours of
ingestion. Circulatory collapse is associated with MAOI toxicity. Mydriasis, bradycardia, and hyperthermia
are not associated with an isocarboxazid overdose.
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16.
A client with paralysis of the legs is found to have somatoform disorder, conversion type. What must the
nurse consider when formulating a plan of care for this client?
Correct1
The illness is very real to the client and requires appropriate nursing care.
2
Although the client believes that there is an illness, there is no cause for concern.
3
There is no physiological basis for the illness; therefore only emotional care is needed.
4
Nursing intervention is needed even though the nurse understands that the client is not ill.
Individuals who have somatoform disorders are really ill; they need care in a nonthreatening
environment. The client requires physiological and emotional care for treatment of motor or sensory
functional deficits.
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17.
Which adverse effect is least likely to occur in a client who is prescribed clozapine?
1
Seizures
2
Sedation
3
Akathisia
Correct4
MyocarditisClozapine is a second-generation antipsychotic drug. Myocarditis is a very rare side effect caused by
clozapine. Seizures, sedation, and akathisia are common side effects of clozapine.
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18.
A client tells the nurse, "I’m a terrible, evil person. The voices are telling me that God needs to punish
me." What is the most therapeutic initial response by the nurse?
1
"God is loving and won’t punish you."
2
"Those voices you’re hearing are a fantasy."
Correct3
"Tell me what you’re thinking about yourself."
4
"You aren’t wicked—both God and I love you."
Encouraging the client to focus on the self will facilitate communication and foster self-perception.
Stating that God will not punish the client denies the client’s feelings and provides false reassurance.
Stating that the voices are fantasy denies the client’s experience. Stating that the client is not wicked
denies the client’s feelings and provides false reassurance.
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19.
A client who has been admitted with a diagnosis of schizophrenia says to the nurse, "Yes, it's March.
March is Little Women. That's literal, you know." What do these statements illustrate?
1Echolalia
2
Neologisms
3
Flight of ideas
Correct4
Loosening of associations
Loose associations are thoughts that are presented without the logical connections that are usually
necessary for the listener to interpret the message. Echolalia is the purposeless repetition of words
spoken by others or repetition of overheard sounds. Neologisms are new meaningless words coined by
the client or new, unique meanings given to old words. Flight of ideas is the rapid skipping from one
thought to another; these thoughts usually have only superficial or chance relationships. [Show Less]