Chapter 18 Drugs Used for Psychoses

$2.50

Pay And Download The Complete Chapter Questions And Answers

Chapter 18  Drugs Used for Psychoses

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

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
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: Comprehension REF: 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: Comprehension REF: 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

6. A male patient becomes verbally aggressive and insists the nurse is poisoning him as she attempts to administer haloperidol (Haldol). Which action will the nurse take?
a.
Support the patient’s decision to refuse the medication.
b.
Discreetly ask an assistant to put the medication in the patient’s food.
c.
Firmly redirect the patient to take the medication.
d.
Speak privately with the patient and reinforce medication action.

ANS: C
During episodes of acute psychosis, the patient is out of touch with reality and often does not understand the need for medication in stabilizing his or her condition. Target symptoms such as agitation, suspicion, and paranoia are common. Health care providers must be supportive yet firm in their expectations. An open and direct manner in handling patients who are highly suspicious is critical. Delusions should not be supported. The patient is not competent to determine his need for medication. It is dishonest to hide medication in a patient’s food and destroys a trusting relationship. Reasoning with the patient is unlikely to change his mind; he needs external structure for making decisions when he is aggressive and paranoid.

DIF: Cognitive Level: Analysis REF: p. 276 OBJ: 1
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Psychosocial Integrity

 

There are no reviews yet.

Add a review

Be the first to review “Chapter 18 Drugs Used for Psychoses”

Your email address will not be published. Required fields are marked *

Category: Tag:
Updating…
  • No products in the cart.