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 D

Explanation

A. Encourage the client to use relaxation techniques. While relaxation techniques can help manage symptoms in somatic symptom disorder, they should not be the first response to a new symptom like chest pain. The nurse must first rule out a medical cause before assuming the pain is psychological.
B. Reassure the client that pain is an expected part of their disorder. Assuming that the pain is purely psychosomatic without assessing for a potential medical emergency could lead to a delay in necessary treatment. Each new symptom should be evaluated independently.
C. Explain to the client that the pain is not real. The pain experienced by clients with somatic symptom disorder is real to them, even if a physical cause is not found. Dismissing their symptoms can damage trust and discourage them from reporting future concerns.
D. Assess the client's vital signs. Any new report of chest pain should be taken seriously, regardless of the client’s psychiatric history. Assessing vital signs ensures that a potential cardiac event or other medical issue is not overlooked before considering psychological factors.

A. Dissociative amnesia B. Depersonalization/derealization disorder C. Functional neurological symptom disorder D. Factitious disorder

Correct Answer is C

Explanation

A. Dissociative amnesia. This condition involves memory loss of personal information or past events due to psychological stress or trauma. It does not cause physical symptoms like numbness or an inability to grip the steering wheel.
B. Depersonalization/derealization disorder. This disorder causes feelings of detachment from oneself (depersonalization) or the environment (derealization). While distressing, it does not typically result in sensory or motor deficits such as hand numbness.
C. Functional neurological symptom disorder. Formerly known as conversion disorder, this condition involves neurological symptoms, such as numbness or paralysis, that cannot be explained by a medical condition. The symptoms are often triggered by psychological stress, such as anxiety related to driving.
D. Factitious disorder. Factitious disorder involves deliberately fabricating or inducing symptoms to assume the sick role. In this case, the client is describing involuntary symptoms that appear to have a psychological basis rather than being intentionally produced.

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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

A nurse on an inpatient unit is caring for a client who has somatic symptom disorder. The client comes to the nurse's station and reports chest pain. The nurse knows this is a new symptom for the client. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is caring for a client who states, "When I get in the car to drive to work in the morning, my hands go numb. It is to the point where I can't grip the steering wheel." Which of the following conditions is the client likely experiencing?

Correct Answer is C

Explanation

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