A client with schizophrenia receives a prescription for fluphenazine. Which instruction is most important for the nurse to include when teaching the client about this drug?

Wear sunscreen when going outside to prevent effects of sun sensitivity.

Notify your healthcare provider immediately if involuntary movements develop.

Drink water frequently throughout the day as the medication increases thirst.

Check blood pressure daily and notify the healthcare provider if it increases

Answer and Explanation

The Correct Answer is B

A) Wearing sunscreen when going outside to prevent effects of sun sensitivity is important for clients taking certain antipsychotic medications, but it is not the most critical instruction. While fluphenazine can cause photosensitivity, the risk of developing involuntary movements (extrapyramidal symptoms) is a more immediate concern that could significantly affect the client’s quality of life.

B) Notifying the healthcare provider immediately if involuntary movements develop is crucial when taking fluphenazine. This medication can lead to extrapyramidal symptoms such as tardive dyskinesia or acute dystonia, which require prompt assessment and intervention to prevent long-term complications. Educating the client about these potential side effects empowers them to seek timely help.

C) Drinking water frequently throughout the day is generally good advice for overall hydration, but fluphenazine does not significantly increase thirst. While maintaining hydration is important, the focus should be on the potential for serious side effects like involuntary movements, making this instruction secondary in priority.

D) Checking blood pressure daily and notifying the healthcare provider if it increases is relevant for some medications, particularly antihypertensives or those that can cause orthostatic hypotension. However, with fluphenazine, the more critical instruction revolves around recognizing and responding to neurological side effects rather than routine blood pressure monitoring, making this less of a priority.

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Correct Answer is B

Explanation

A) Advising the client to reschedule until committing to recovery may come across as dismissive and could discourage the client from making positive changes. It’s important to support any intention to improve rather than setting conditions that might lead to feelings of failure or frustration.

B) Supporting the client to list small behavioral changes needed is the best response. This approach empowers the client by encouraging them to take manageable steps toward their goals. Focusing on small changes can enhance the client's confidence and motivation, making the process of leading a healthier lifestyle more achievable.

C) Explaining the specific skills needed to prevent relapse is important, but it may be overwhelming for the client at this stage. The focus should be on fostering a sense of hope and readiness for change rather than diving immediately into complex relapse prevention strategies.

D) Providing teaching on the symptoms of substance use dependence might be relevant, but it may not directly support the client's desire for change. The client is expressing a wish to move forward, so it’s more beneficial to focus on positive actions rather than reiterating the challenges of dependence. Supporting behavioral change aligns better with the client’s expressed intentions.

A. Praise her for the new behavior. B. Offer her a choice of activities. C. Involve her in group therapy. D. Observe her actions continuously.

Correct Answer is D

Explanation

A) Praising the client for her new behavior can be encouraging and may boost her self-esteem. However, it’s essential to approach this cautiously, as excessive praise might overwhelm her or be perceived as insincere. While positive reinforcement is valuable, it should not be the sole focus of the intervention.

B) Offering her a choice of activities can promote autonomy and encourage engagement, but given her recent shift from despondency to exhibiting energy, it’s crucial to assess her mood and mental state carefully first. Providing choices may be helpful, but it should be accompanied by vigilant monitoring to ensure her safety.

C) Involving her in group therapy could facilitate social interaction and support, but it may not be appropriate immediately. After several days of nonverbal behavior, she may still be vulnerable. Group settings could be overwhelming, and her readiness to participate should be carefully evaluated.

D) Observing her actions continuously is the most critical action at this stage. The change in her behavior—from being despondent and nonverbal to talking and exhibiting energy—can indicate a potential shift toward increased risk for impulsivity or self-harm. Continuous observation allows the nurse to assess her safety and intervene if her behavior escalates, ensuring she is supported during this transitional phase.

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A client with schizophrenia receives a prescription for fluphenazine. Which instruction is most important for the nurse to include when teaching the client about this drug?

Nursing Test Bank

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Correct Answer is D

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