A client with schizophrenia is being treated with olanzapine (Zyprexa) 10 mg daily. The client asks the nurse how this medicine minimizes hallucinations. The nurse explains that the mechanism by which olanzapine controls the client's psychotic symptoms is believed to be what?

Increasing the amount of serotonin and norepinephrine in the brain.

Blocking dopamine receptors in the brain.

Decreasing the amount of an enzyme that breaks down neurotransmitters.

Normalizing the levels of serotonin, norepinephrine, and dopamine.

Answer and Explanation

The Correct Answer is B

Choice A reason: Olanzapine does not primarily increase serotonin or norepinephrine. It blocks dopamine D2 and serotonin 5-HT2 receptors, reducing hallucinations driven by mesolimbic dopamine excess in schizophrenia. Increasing monoamines would exacerbate psychosis, not alleviate it, making this mechanism incorrect.

Choice B reason: Olanzapine, an atypical antipsychotic, blocks dopamine D2 receptors in the mesolimbic pathway, reducing excessive dopamine signaling that causes hallucinations in schizophrenia. It also modulates serotonin 5-HT2 receptors, balancing limbic activity, making this the primary mechanism for controlling psychotic symptoms.

Choice C reason: Decreasing neurotransmitter breakdown enzymes is the mechanism of MAOIs, not olanzapine. Olanzapine’s dopamine and serotonin receptor blockade reduces psychotic symptoms, not enzyme activity, making this choice irrelevant to its antipsychotic action in schizophrenia.

Choice D reason: Olanzapine does not normalize serotonin, norepinephrine, and dopamine levels but blocks their receptors, particularly dopamine D2, to reduce hallucinations. Normalizing levels is not its mechanism, as schizophrenia involves dopamine hyperactivity, not deficiency, making this choice inaccurate.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: Touching a manic patient may escalate agitation due to hyperarousal from elevated dopamine and norepinephrine in the limbic system. Physical contact can overstimulate the amygdala, increasing irritability, making it an inappropriate intervention for mania management.

Choice B reason: Activities requiring concentration are unsuitable for mania, as elevated dopamine impairs prefrontal cortex focus, leading to distractibility. Structured, low-stimulation interventions are needed to calm limbic hyperactivity, not tasks that exacerbate cognitive overload in a manic state.

Choice C reason: Leading a meeting is inappropriate for a manic patient, as heightened dopamine and norepinephrine drive impulsivity and grandiosity, impairing leadership ability. This could worsen agitation via limbic overstimulation, making a structured environment a better choice.

Choice D reason: A safe, structured environment reduces stimuli, calming limbic hyperactivity driven by dopamine and norepinephrine excess in mania. This stabilizes the patient’s behavior, minimizes triggers, and supports prefrontal cortex regulation, promoting safety and effective management of manic symptoms.

A. Offer to taste each portion on the tray for the patient. B. Obtain a doctor's order for tube feedings or total parenteral nutrition. C. Allow the patient to telephone a local restaurant to deliver meals. D. Allow the patient to have supervised access to food vending machines.

Correct Answer is A

Explanation

Choice A reason: Delusions of persecution in schizophrenia involve hyperactive dopamine pathways in the mesolimbic system, leading to irrational fears like poisoning. Tasting food directly addresses the delusion by demonstrating safety, potentially reducing anxiety and engaging the patient’s trust, which can modulate amygdala hyperactivity and promote acceptance of nutrition without invasive measures.

Choice B reason: Tube feedings or parenteral nutrition are invasive and may reinforce the patient’s delusional fears of harm, as they bypass voluntary control. Schizophrenia’s dopamine dysregulation heightens suspicion, and forced interventions could exacerbate paranoia by stimulating the amygdala, increasing stress responses and potentially worsening the patient’s mental state and compliance.

Choice C reason: Allowing restaurant delivery does not directly address the poisoning delusion, as external food sources may still be perceived as unsafe due to hyperactive dopamine-driven paranoia in schizophrenia. This option fails to engage the patient’s trust or reduce amygdala-driven fear responses, making it unlikely to resolve the refusal to eat.

Choice D reason: Supervised vending machine access may not alleviate the patient’s delusional belief in poisoning, as the source remains external and unverified. Schizophrenia’s dopamine excess in the mesolimbic pathway sustains mistrust, and this intervention does not directly counter the delusion, potentially leaving amygdala-driven fear responses unaddressed, reducing its effectiveness.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client with schizophrenia is being treated with olanzapine (Zyprexa) 10 mg daily. The client asks the nurse how this medicine minimizes hallucinations. The nurse explains that the mechanism by which olanzapine controls the client's psychotic symptoms is believed to be what?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The plan of care for a patient in the manic state of bipolar disorder should include which intervention?

Correct Answer is D

Explanation

A patient presenting with delusions of persecution about being poisoned has refused all meals for 3 days. Which intervention will most likely be acceptable to the patient?

Correct Answer is A

Explanation

A client with bipolar disorder has advanced lithium toxicity with a lithium level of 1.7 mEq/L. Which symptom would the nurse expect to assess?

The most appropriate response by the nurse when a despondent patient says "Nothing matters anymore" would be:

A primary intervention strategy for coping with a maturational crisis includes:

A victim of intimate partner violence comes to the crisis center seeking help. The nurse uses crisis intervention strategies that focus on what?

A client asks a nurse about the need to alter any activities because of taking lithium. Which response would be most appropriate?

A nurse is preparing to administer methylprednisolone 10 mg IV bolus. The amount available from the pharmacy is 40 mg/mL. How many mL should the nurse administer? (Round to the nearest tenth.)

A client is brought to the emergency department after exhibiting vital sign instability, diaphoresis, shivering, incoordination, hyperreflexia, hyperpyrexia, and diarrhea. The client is taking paroxetine (Paxil) for depression. Which condition should the nurse most likely suspect?

Which scenario best demonstrates an example of eustress?