A client diagnosed with schizophrenia disorder is prescribed clozapine. Which symptoms, related to the side effects of this medication, should prompt a nurse to intervene immediately?

Akathisia and hypersalivation

Dry mouth and urinary retention

Akinesia and insomnia

Sore throat, fever, and malaise

Answer and Explanation

The Correct Answer is D

a. Akathisia and hypersalivation. These side effects are uncomfortable but generally not immediately life-threatening.
b. Dry mouth and urinary retention. These side effects are concerning and should be monitored, but they do not typically require immediate intervention unless severe.
c. Akinesia and insomnia. While akinesia (lack of movement) and insomnia are significant, they are not immediately life-threatening symptoms.
d. Sore throat, fever, and malaise. This choice is correct because these symptoms could indicate agranulocytosis, a potentially life-threatening side effect of clozapine that requires immediate medical intervention.

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Correct Answer is D

Explanation

a. Focused conversations on various foods: While a healthy relationship with food is a treatment goal, focusing excessively on food during therapy sessions might indicate continued preoccupation, not necessarily a positive change.
b. Is able to binge eat without purging: This might seem positive on the surface, but it doesn't address the underlying problem of binge eating. The goal is to develop healthy eating habits and reduce both bingeing and purging behaviors.
c. Gained ten pounds in one week: Rapid weight gain is unlikely to be a healthy or sustainable outcome in bulimia nervosa treatment. It's important to focus on healthy weight management alongside addressing the core eating disorder behaviors.
d. Demonstrated healthy coping mechanisms that decreased anxiety (Correct): Bulimia nervosa involves recurrent episodes of binge eating followed by purging behaviors. Recovery involves developing healthy coping mechanisms to manage anxiety and reduce the urge to binge or purge. This is a key indicator of progress.

A. "I can see that you are upset. Let's talk about ways to resolve this." B. I'll fix this right away. You need to calm down." C. "Let's find a way to avoid this conflict in the future." D. "You should bring this up during group therapy later this week."

Correct Answer is A

Explanation

a. "I can see that you are upset. Let's talk about ways to resolve this." This is correct because it validates the client's feelings, encourages problem-solving, and maintains the therapeutic milieu's principles of respect and support.
b. "I'll fix this right away. You need to calm down." This response does not encourage the client’s participation in resolving the issue and does not foster the therapeutic milieu's goal of client empowerment.
c. "Let's find a way to avoid this conflict in the future." While this promotes future problem-solving, it does not address the immediate concern or validate the client's current feelings.
d. "You should bring this up during group therapy later this week." This delays addressing the client's immediate concerns and might make the client feel unheard.

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A client diagnosed with schizophrenia disorder is prescribed clozapine. Which symptoms, related to the side effects of this medication, should prompt a nurse to intervene immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with bulimia nervosa has been attending a mental health clinic for several months. Which factor should a nurse identify as an appropriate indicator of a positive client behavioral change? The client:

Correct Answer is D

Explanation

A client diagnosed with schizophrenia, on an inpatient unit, approaches a nurse, stating, "Someone took my dinner! People need to respect others, and you need to do something about this now!" Which response by the nurse is guided by the basic assumption of the therapeutic milieu?

Correct Answer is A

Explanation

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