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A nurse in a mental health clinic is caring for a client who has bipolar disorder and a prescription for an antipsychotic medication. The provider and nursing staff suspect the client is not adhering to his medication therapy. Which of the following interventions should the staff use to encourage the client's adherence? (Select all that apply.)

Rotate staff that administer the medications.

Engage the client in conversation following medication administration.

Use sustained-release forms.

Provide for once-daily dosing.

Perform mouth checks following the administration of the medication.

Answer and Explanation

Correct Answer : C,D,E

Answer:C, D, E

Rationale:

A) Rotate staff that administer the medications: Rotating staff can lead to inconsistency in communication and rapport with the client. A consistent nursing team is more likely to build trust and encourage adherence to medication therapy. Therefore, this intervention may not effectively promote adherence.

B) Engage the client in conversation following medication administration: While engaging the client in conversation can help build rapport and create a supportive environment, it may not be the most effective intervention for encouraging medication adherence. The priority should be focused on ensuring the client takes the medication as prescribed, rather than focusing on conversation after administration.

C) Use sustained-release forms: Sustained-release formulations can help with adherence by providing a more consistent therapeutic effect and reducing the number of doses a client needs to take throughout the day. This can simplify the medication regimen, making it easier for the client to adhere.

D) Provide for once-daily dosing: Once-daily dosing is beneficial for improving adherence because it reduces the complexity of the medication regimen. Clients are more likely to remember to take their medication if they only need to do so once a day.

E) Perform mouth checks following the administration of the medication: Performing mouth checks can help ensure that the client has actually taken the medication, especially if there is suspicion of non-adherence. This intervention can confirm that the medication is ingested and can serve as a prompt for adherence in future doses.

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Correct Answer is B

Explanation

A. Dystonia - Dystonia presents as sustained or intermittent muscle contractions causing abnormal, often repetitive, movements or postures. It is an acute extrapyramidal side effect of antipsychotic medications like chlorpromazine but typically manifests as sudden-onset muscle spasms rather than involuntary movements of the tongue and face.

B. Tardive dyskinesia - Tardive dyskinesia is a late-appearing movement disorder characterized by involuntary, repetitive movements of the face, tongue, and limbs. It is associated with long-term use of antipsychotic medications like chlorpromazine and typically develops after months to years of treatment.

C. Parkinsonism - Parkinsonism resembles Parkinson's disease and is characterized by symptoms such as tremor, rigidity, bradykinesia, and postural instability. While antipsychotic medications can cause Parkinsonism as an adverse effect, it usually presents with symptoms different from those described in the scenario.

D. Akathisia - Akathisia is characterized by an inner feeling of restlessness and the urge to move, often accompanied by pacing and inability to sit still. It is an acute extrapyramidal side effect of antipsychotic medications but does not manifest as involuntary movements of the tongue and face as described in the scenario.

A. The client demonstrated an allergic response to the medication. B. The client consumed alcohol while taking the medication. C. The client took an overdose of the medication. D. The client experienced a common side effect to the medication.

Correct Answer is B

Explanation

A. The client demonstrated an allergic response to the medication: While allergic reactions to disulfiram can occur, severe nausea and vomiting after taking the medication are more likely due to its interaction with alcohol rather than an allergic response.

B. The client consumed alcohol while taking the medication: Disulfiram is used to deter alcohol consumption by causing unpleasant reactions when alcohol is ingested. Severe nausea and vomiting are common adverse effects of consuming alcohol while on disulfiram.

C. The client took an overdose of the medication: An overdose of disulfiram could potentially lead to severe adverse effects, but nausea and vomiting alone are not typically indicative of an overdose.

D. The client experienced a common side effect of the medication: While nausea and vomiting are common side effects of disulfiram, they are typically experienced in response to alcohol consumption rather than as direct effects of the medication itself.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?

Correct Answer is B

Explanation

Correct Answer is B

Explanation

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