A hospitalized client diagnosed with schizophrenia is receiving antipsychotic medications. While assessing the client, a nurse identifies signs and symptoms of a dystonic reaction. Which medication would the nurse expect to administer?

Aripiprazole (Abilify).

Risperidone (Risperdal).

Diphenhydramine (Benadryl).

Propranolol (Inderal).

Answer and Explanation

The Correct Answer is C

Choice A reason: Aripiprazole, an antipsychotic, may cause dystonic reactions via partial dopamine agonism. It is not used to treat dystonia, as it could worsen extrapyramidal symptoms by altering basal ganglia dopamine signaling, making it inappropriate for acute dystonic reaction management.

Choice B reason: Risperidone, an antipsychotic, can cause dystonic reactions due to dopamine D2 receptor blockade in the basal ganglia. Administering it would exacerbate extrapyramidal symptoms, not relieve them, making it unsuitable for treating acute dystonic reactions.

Choice C reason: Diphenhydramine, an antihistamine with anticholinergic properties, relieves dystonic reactions by counteracting dopamine blockade-induced basal ganglia dysfunction. It restores cholinergic-dopaminergic balance, reducing muscle spasms and rigidity, making it the standard treatment for antipsychotic-induced acute dystonic reactions.

Choice D reason: Propranolol, a beta-blocker, treats tremors or hypertension but not dystonic reactions, which stem from dopamine-cholinergic imbalance in the basal ganglia. It lacks anticholinergic effects needed to reverse dystonia, making it ineffective for this antipsychotic-related side effect.

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Correct Answer is A

Explanation

Choice A reason: A SAD PERSONS score over 8 indicates high suicide risk, driven by serotonin dysregulation and amygdala hyperactivity, necessitating hospitalization to prevent self-harm. Immediate intervention stabilizes neurochemical imbalances and ensures safety, addressing the acute risk effectively.

Choice B reason: A follow-up appointment is inadequate for a score of 10, indicating high suicide risk. Serotonin and dopamine dysregulation heighten impulsivity, and delaying hospitalization risks self-harm, as outpatient care cannot address acute amygdala-driven suicidal ideation effectively.

Choice C reason: Sending the patient home with a score of 10 is unsafe, as high suicide risk involves serotonin deficits and amygdala hyperactivity. This disregards the need for immediate intervention to stabilize neurochemical imbalances and ensure safety, making it inappropriate.

Choice D reason: Benzodiazepines address anxiety but not suicide risk directly. A score of 10 indicates severe serotonin dysregulation and amygdala-driven impulsivity, requiring hospitalization, not anxiolytics, which may mask symptoms without addressing the underlying neurochemical suicide risk.

A. Clomipramine (Anafranil). B. Risperidone (Risperdal). C. Clonidine (Catapres). D. Carbamazepine (Tegretol).

Correct Answer is D

Explanation

Choice A reason: Clomipramine, a tricyclic antidepressant, targets serotonin and norepinephrine reuptake for depression, not bipolar mood stabilization. It risks triggering mania by overstimulating monoamine pathways, making it unsuitable for rapid-cycling bipolar disorder, which requires mood-stabilizing anticonvulsants.

Choice B reason: Risperidone, an antipsychotic, blocks dopamine and serotonin receptors, managing acute mania but not rapid cycling. Anticonvulsants like carbamazepine stabilize mood by modulating sodium channels, making risperidone less effective for long-term control of bipolar mood fluctuations.

Choice C reason: Clonidine, an alpha-2 agonist, reduces norepinephrine release for hypertension or ADHD, not bipolar disorder. It lacks mood-stabilizing properties, unlike anticonvulsants, which modulate neuronal excitability, making it inappropriate for managing rapid-cycling bipolar mood changes.

Choice D reason: Carbamazepine, an anticonvulsant, stabilizes mood in rapid-cycling bipolar disorder by inhibiting voltage-gated sodium channels, reducing neuronal excitability in the limbic system. This prevents manic and depressive episodes, making it a first-line choice for stabilizing rapid mood cycles.

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A hospitalized client diagnosed with schizophrenia is receiving antipsychotic medications. While assessing the client, a nurse identifies signs and symptoms of a dystonic reaction. Which medication would the nurse expect to administer?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse states, "I evaluated a new patient using the modified SAD PERSONS scale and got a score of 10. Should I send the patient home?" Select the best reply.

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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