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?

Dystonia

Tardive dyskinesia

Parkinsonism

Akathisia

Answer and Explanation

The Correct Answer is B

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.

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Correct Answer is B

Explanation

A. Give the medication: Administering expired medication poses potential risks to the client's safety and efficacy of treatment. Therefore, giving the medication is not appropriate.

B. Discard the medication: Expired medications may have decreased potency or even become harmful due to chemical changes over time. It is essential to discard expired medications to ensure client safety and maintain the effectiveness of treatment.

C. Notify the provider: While it's important to communicate issues related to medication administration to the healthcare provider, in this case, the expired medication should not be used regardless of provider notification.

D. Return the medication to the pharmacy: Returning expired medication to the pharmacy might be appropriate in some settings, but it is not the primary action to take in this situation. The priority is to ensure the client does not receive expired medication.

A. "Gradually decrease the dose once tolerance to the effect is reached." B. "Take most of the daily dose at bedtime." C. "Take the medication with meals." D. "Distribute the doses evenly throughout the day."

Correct Answer is B

Explanation

A. "Gradually decrease the dose once tolerance to the effect is reached." - Gradually decreasing the dose may help mitigate daytime sedation, but it's not the most appropriate initial response. Additionally, it should be done under the guidance of a healthcare provider.

B. "Take most of the daily dose at bedtime." - This response is appropriate because diphenhydramine commonly causes drowsiness, and taking most of the dose at bedtime can help minimize daytime sedation.

C. "Take the medication with meals." - Taking diphenhydramine with meals may reduce the risk of gastrointestinal upset but is unlikely to significantly decrease daytime sedation.

D. "Distribute the doses evenly throughout the day." - This approach may not effectively minimize daytime sedation because diphenhydramine's sedative effects are prolonged and may persist throughout the day if taken at regular intervals. Taking most of the dose at bedtime is a more practical strategy.

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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?

Nursing Test Bank

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