A client receiving risperidone reports severe muscle stiffness at 1030. By 1200, the client has difficulty swallowing food and is drooling. The client is diaphoretic. By 1600, vital signs are as follows Temperature 102.8 F pulse 110 beats/minute, respirations 26 breaths/minute, and blood pressure 150/90 mmHg.

What is the nurse's best analysis and action?

Institute reverse isolation

Withhold the next dose of medication

Begin high protein, high cholesterol diet

Notify health care provider stat

Answer and Explanation

The Correct Answer is D

A) Incorrect. Reverse isolation is not indicated in this situation. The client's symptoms are likely due to a side effect of the medication, not an infectious process.

B) Incorrect. While it may be necessary to withhold the next dose of medication, the client's symptoms require more immediate attention.

C) Incorrect. The client's symptoms are indicative of a serious adverse reaction, and dietary changes would not address the issue.

D) Correct. The client's symptoms, including severe muscle stiffness, difficulty swallowing, drooling, diaphoresis, and elevated vital signs, are indicative of neuroleptic malignant syndrome (NMS), a potentially life-threatening side effect of antipsychotic medications like risperidone.
The nurse should notify the healthcare provider immediately for further guidance and intervention.

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Correct Answer is B

Explanation

A. Haloperidol is a first-generation antipsychotic and may not be as effective in addressing the negative symptoms (e.g., apathy, poverty of thought) as second-generation antipsychotics.
B. Olanzapine is a second-generation antipsychotic known to be effective in treating both positive and negative symptoms of schizophrenia.
C. Diphenhydramine is not typically used as a primary treatment for schizophrenia.
D. Chlorpromazine is a first-generation antipsychotic and may not be as effective in addressing the negative symptoms as second-generation antipsychotics.

A. The client has increasing aggression. B. The client has elevated blood pressure. C. The client has complaints of dizziness. D. The client has extrapyramidal symptoms (EPS).

Correct Answer is D

Explanation

A. Increasing aggression may be an indication for a PRN medication, but benztropine specifically targets extrapyramidal symptoms (EPS).
B. Elevated blood pressure is not a direct indication for benztropine; it is used to address EPS.

C. Complaints of dizziness may not be directly related to EPS, which is the target of benztropine.
D. Benztropine is an anticholinergic medication used to manage extrapyramidal symptoms (EPS) associated with antipsychotic medications like haloperidol.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Benztropine is ordered as needed (PRN) for a client taking haloperidol after being diagnosed with schizoaffective disorder. Which of the following assessments by the nurse would indicate a need for this medication?

Correct Answer is D

Explanation

The nurse is caring for a client who has become increasingly agitated. He is pacing in the hallway and shouting at other clients. What is the priority action of the nurse?

A newly admitted client diagnosed with paranoid schizophrenia is super vigilant and constantly scans the environment. The client states, "I saw doctors talking in the hall. They were plotting to kill me." Which of the following does the nurse correctly identify as this behavior?

The nurse is admitting a client with a dual diagnosis of major depressive disorder and alcohol abuse. What is the primary intervention?

A client has been prescribed lithium for long-term maintenance of bipolar disorder diagnosis. Which statement by the client shows an understanding of the medication?

A client diagnosed with major depressive disorder with psychotic features hears voices commanding self harm. The client refuses to commit to developing a plan for safety. What should be the nurse's priority intervention at this time?

When assessing a client immediately following electroconvulsive therapy (ECT), the nurse expects what side effect in a client?

Which of the following is the most therapeutic response by the nurse when a client states, "I no longer need my medication since I do not hear voices"?

A client is showing symptoms of alcohol intoxication. What question should the nurse ask first?