A nurse is caring for a client who has psychosis and is prescribed chlorpromazine. The client reports feelings of restlessness. The nurse should identify that the client should be monitored for which of the following adverse effects?

Shuffling walk

Suicidal ideation

Abnormal movements of the tongue and face

Oculogyric crisis

Answer and Explanation

The Correct Answer is D

A. Shuffling walk. A shuffling walk is typically associated with parkinsonism or other movement disorders, which may occur with antipsychotic medications, but the specific symptom of restlessness more directly relates to other conditions.
B. Suicidal ideation. While monitoring for suicidal ideation is important in any client with psychosis, it is not specifically associated with the restlessness that the client reports in relation to chlorpromazine use.
C. Abnormal movements of the tongue and face. Abnormal movements of the tongue and face are more characteristic of tardive dyskinesia, which develops over a longer period of treatment. The acute restlessness the client is experiencing is more closely aligned with akathisia, a side effect of antipsychotic medications.
D. Oculogyric crisis. This condition involves involuntary upward eye movement and can occur as an acute dystonic reaction to antipsychotic medications like chlorpromazine. Given the client's report of restlessness, the nurse should monitor for this adverse effect, as it is more likely to manifest in the context of acute medication side effects.

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Correct Answer is C

Explanation

A. "I don't eat because I do not like the taste of food." Clients with anorexia nervosa typically avoid food due to intense fears of weight gain and body image concerns rather than a dislike for taste. Their restrictive eating is driven by psychological distress rather than a simple aversion to flavor.
B. "I restrict myself to 2,000 calories per day." Individuals with anorexia nervosa usually consume significantly fewer calories than recommended daily amounts. A restriction of 2,000 calories per day is within normal dietary guidelines and does not reflect the extreme caloric limitation seen in this disorder.
C. "I have certain foods, like pizza, that cause me a lot of fear." Clients with anorexia nervosa often develop strong food-related anxieties, especially about high-calorie or "forbidden" foods. Fear of specific foods is a hallmark feature of the disorder, making this the expected statement.
D. "I don't bother to track the number of calories I eat in a week." Individuals with anorexia nervosa are typically obsessive about tracking their calorie intake, often meticulously counting every calorie consumed. This level of control is a defining characteristic of the disorder.

A. Extrapyramidal symptoms B. Impaired ability to regulate body temperature C. Neuroleptic malignant syndrome D. Tardive dyskinesia

Correct Answer is D

Explanation

A. Extrapyramidal symptoms. Extrapyramidal symptoms (EPS) include acute dystonia, akathisia, and parkinsonism, which are movement-related side effects caused by dopamine blockade. While EPS can involve muscle rigidity and tremors, tardive dyskinesia specifically refers to chronic, involuntary, repetitive movements such as facial twitching and tongue protrusion.
B. Impaired ability to regulate body temperature. Some antipsychotics can interfere with thermoregulation, leading to heat intolerance or hypothermia. However, this is not related to jerking or twitching movements seen in tardive dyskinesia.
C. Neuroleptic malignant syndrome. Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Unlike tardive dyskinesia, NMS does not cause chronic, involuntary facial movements but rather widespread muscle stiffness and severe autonomic dysfunction.
D. Tardive dyskinesia. Tardive dyskinesia (TD) is a late-onset, irreversible movement disorder caused by long-term use of first-generation antipsychotics. It is characterized by involuntary, repetitive movements, especially in the face, tongue, and extremities (e.g., lip smacking, tongue rolling, grimacing, jerking movements). These symptoms distinguish TD from acute extrapyramidal symptoms.

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A nurse is caring for a client who has psychosis and is prescribed chlorpromazine. The client reports feelings of restlessness. The nurse should identify that the client should be monitored for which of the following adverse effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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