A client is having trouble remembering to take his antipsychotic medication, risperidone 3 mg PO, BID. The treatment team at the clinic he attends is considering starting him on risperidone 10 mg IM every 2 weeks. The rationale for this is:

This will help with medication compliance.

It will help him remember to take his medication.

This has a faster onset of action.

This new medication is stronger and will clear his symptoms faster.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

This will help with medication compliance.

This is the correct response. Long-acting injectable (LAI) antipsychotics like risperidone IM are often used to improve medication compliance in patients who have difficulty remembering to take their oral medications regularly. By administering the medication every two weeks, the treatment team can ensure that the client receives a consistent dose, reducing the risk of relapse due to missed doses. This approach is particularly beneficial for clients with schizophrenia, as consistent medication adherence is crucial for managing symptoms and preventing hospitalizations.

Choice B Reason:

It will help him remember to take his medication.

While this statement is related to medication compliance, it is not entirely accurate. The purpose of switching to an injectable form is to eliminate the need for the client to remember to take daily doses. Instead, the healthcare provider administers the medication at regular intervals, ensuring adherence without relying on the client’s memory.

Choice C Reason:

This has a faster onset of action.

This statement is incorrect. The onset of action for long-acting injectable risperidone is not necessarily faster than the oral form. In fact, LAIs are designed to release the medication slowly over time to maintain stable blood levels. The primary advantage of LAIs is improved adherence, not a faster onset of action.

Choice D Reason:

This new medication is stronger and will clear his symptoms faster.

This statement is also incorrect. The strength of the medication and the speed at which it clears symptoms are not the primary reasons for switching to an injectable form. The goal is to ensure consistent medication levels and improve adherence, not to increase the potency or speed of symptom relief.

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Correct Answer is A

Explanation

Choice A Reason:

Confirming boundaries by setting limits on behavior.

This response is correct because it directly addresses the need to set clear boundaries with the client. In a psychiatric setting, it is crucial to establish and maintain professional boundaries to ensure a therapeutic environment. By limiting the client’s approach to the nurse’s station, the nurse is setting a clear boundary that helps manage the client’s behavior and ensures that the nurse can attend to other patients as well. This intervention helps in maintaining structure and predictability, which can be very beneficial for clients with psychiatric conditions.

Choice B Reason:

Providing reality orientation.

Providing reality orientation involves helping clients understand their surroundings and current situation, often used for clients with cognitive impairments or disorientation. While important, this intervention does not specifically address the behavior of frequently approaching the nurse’s station. Reality orientation would be more relevant in cases where the client is confused about time, place, or person.

Choice C Reason:

Providing client education in a direct manner.

Providing client education is essential, but it does not directly relate to setting behavioral limits. Education might involve explaining the reasons behind certain rules or treatments, but it does not address the immediate need to manage the client’s frequent requests. The intervention described in the question is more about behavior management than education.

Choice D Reason:

Ensuring physical need fulfillment.

Ensuring physical need fulfillment involves addressing the client’s basic needs such as food, hydration, and comfort. While this is a fundamental aspect of nursing care, it does not relate to setting behavioral limits or managing the frequency of the client’s requests. The intervention in the question is focused on managing behavior rather than fulfilling physical needs.

A. “It is okay to eat dessert with my dinner every night.” B. “I have less to worry about because I am a female.” C. “I can speak with my healthcare provider about genetic testing.” D. “I need to make sure to take my blood pressure medication daily.” E. “I do not have time in my schedule to add a daily walk.”

Correct Answer is ["A","B","E"]

Explanation

Choice A Reason:

The statement “It is okay to eat dessert with my dinner every night” indicates a need for re-teaching. Diet plays a significant role in the risk of developing Alzheimer’s disease. Consuming high amounts of sugar and unhealthy fats can increase the risk of developing conditions like diabetes and cardiovascular disease, which are linked to a higher risk of Alzheimer’s. A balanced diet, such as the Mediterranean or MIND diet, which emphasizes fruits, vegetables, whole grains, and healthy fats, is recommended to reduce the risk.

Choice B Reason:

The statement “I have less to worry about because I am a female” is incorrect and indicates a need for re-teaching. In fact, women are at a higher risk of developing Alzheimer’s disease compared to men. This increased risk is partly due to women living longer than men, but even after accounting for longevity, women still have a higher incidence of Alzheimer’s. Therefore, it is crucial for females to be aware of their risk and take preventive measures.

Choice C Reason:

The statement “I can speak with my healthcare provider about genetic testing” does not indicate a need for re-teaching. Genetic testing can provide valuable information about one’s risk for Alzheimer’s disease, especially if there is a family history of the condition. While routine genetic testing is not generally recommended for everyone, discussing it with a healthcare provider can help individuals understand their risk and make informed decisions about their health.

Choice D Reason:

The statement “I need to make sure to take my blood pressure medication daily” is correct and does not indicate a need for re-teaching. Controlling blood pressure is crucial in reducing the risk of Alzheimer’s disease. High blood pressure, particularly in midlife, is a significant risk factor for cognitive decline and Alzheimer’s. Therefore, taking blood pressure medication as prescribed is an important preventive measure.

Choice E Reason:

The statement “I do not have time in my schedule to add a daily walk” indicates a need for re-teaching. Regular physical activity is one of the most effective ways to reduce the risk of Alzheimer’s disease. Exercise improves blood flow to the brain, reduces inflammation, and promotes the growth of new brain cells. Incorporating physical activity, such as a daily walk, into one’s routine is essential for maintaining cognitive health and reducing the risk of Alzheimer’s.

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A client is having trouble remembering to take his antipsychotic medication, risperidone 3 mg PO, BID. The treatment team at the clinic he attends is considering starting him on risperidone 10 mg IM every 2 weeks. The rationale for this is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client on an acute psychiatric inpatient unit approaches the nurse’s station every 10-15 minutes with various requests. The nurse intervenes by stating, “You may approach the nurse’s station only once an hour.” Which nursing intervention has been employed?

Correct Answer is A

Explanation

A client was recently diagnosed with mild Alzheimer’s disease. Which of the statements shared by the client’s child about their risk for Alzheimer’s disease indicates the need for re-teaching? (Select all that apply.)

Correct Answer is ["A","B","E"]

Explanation

Which of the following nursing strategies would be most appropriate when caring for an individual who is delusional?

An IV infusion of 125 mL of a GI prokinetic agent is ordered to be given over 1 hour. The nurse will use a microdrip infusion set (60 gtts/mL). How many drops per minute will the drug infuse at the proper rate? Use a preceding zero if necessary. Do not use trailing zeros.

A client with schizophrenia has had 2 hospitalizations within the past 9 months due to non-adherence to medications and their counseling plan. What measures should the nurse and the mental health treatment team recommend for tertiary prevention? (Select All That Apply)

A client on the inpatient psychiatric unit is scheduled for discharge tomorrow. Which of the following statements would indicate that the client is ready for discharge?

A client is diagnosed with schizophrenia. The nurse would interpret which behavior as apathy? The client is:

A nurse is caring for a client who has schizophrenia. The client is in the dayroom and shouting at other clients, stating, “Do not eat the food here. The staff is poisoning the food!” The nurse should document that the client is experiencing which type of delusion?

A client with schizophrenia approaches the nurse with a look of distress and anguish on his face. He says, “Can’t you hear him? It’s the devil. He’s telling me I’m going to hell.” Which is the most appropriate response by the nurse?

A nurse notices that a client with paranoid schizophrenia stops in mid-sentence when talking and tilts his head to the side as if to listen. The most appropriate intervention by the nurse would be to: