A nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years.

Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?.

Twisting tongue movements.

Shuffling gait.

Sudden onset of high fever.

Constant tapping of feet when sitting.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Twisting tongue movements are a common symptom of tardive dyskinesia (TD), a side effect of long-term use of antipsychotic medications like fluphenazine.

Choice B rationale:

Shuffling gait is more commonly associated with Parkinson’s disease and certain antipsychotic medications can cause Parkinson-like symptoms, but it is not a characteristic of TD2.

Choice C rationale:

Sudden onset of high fever is not associated with TD. It could be a sign of a serious condition like neuroleptic malignant syndrome, which requires immediate medical attention.

Choice D rationale:

Constant tapping of feet when sitting could be a sign of restlessness or akathisia, another potential side effect of antipsychotic medications, but it is not a specific sign of TD2.

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Correct Answer is D

Explanation

Choice A rationale:
Stopping medication can be a sign of non-compliance or dissatisfaction with treatment, but it is not a direct warning sign of suicide.
Choice B rationale:
Requesting an appointment to discuss depression is a positive step towards seeking help and managing mental health.
Choice C rationale:
Sleeping 12 hours a day could indicate depression or other mental health issues, but it is not a specific warning sign of suicide.
Choice D rationale:
Giving away possessions can be a warning sign of suicide as it might indicate that the person is putting their affairs in order, which is a serious suicide warning sign.

A. Joining a group discussion about a local election. B. Watching a video with a group in the day room. C. Walking with the nurse in the courtyard. D. Participating in a basketball game in the gym.

Correct Answer is C

Explanation

Choice A rationale:

Group discussions about local elections can be stimulating and may exacerbate the client’s manic symptoms.

Choice B rationale:

Watching a video with a group in the day room may not provide enough engagement for a client in a manic phase.

Choice C rationale:

Walking with the nurse in the courtyard provides physical activity and one-on-one interaction, which can help manage energy levels and provide a calming influence.

Choice D rationale:

Participating in a basketball game in the gym could overstimulate the client and potentially lead to injury.

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A nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a group of clients at a mental health facility. The nurse should identify that which of the following clients is exhibiting a warning sign of suicide?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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A nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?.

A nurse is assessing a client who has schizophrenia which has been treated with fluphenazine for several years.

Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?.