A nurse is collecting data from a client who has schizophrenia and has been taking chlorpromazine for 8 years. The nurse notes choreiform or jerking uncontrolled movements, lip smacking, and spastic facial distortions. Which of the following conditions should the nurse document in her finding?

Tardive dyskinesia

Lock Jaw (unable to close mouth)

Pseudoparkinsonism

Akathisia

Answer and Explanation

The Correct Answer is A

A.   Tardive dyskinesia is a movement disorder often caused by long-term use of antipsychotic medications like chlorpromazine. Symptoms include involuntary movements such as jerking or lip smacking.
B.   Lock Jaw is not a characteristic of tardive dyskinesia; it refers to trismus, often seen with other conditions.
C.   Pseudoparkinsonism is characterized by tremors, rigidity, and bradykinesia, typically occurring early in antipsychotic treatment.
D.   Akathisia involves restlessness and an inability to stay still, not the involuntary movements associated with tardive dyskinesia.

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Correct Answer is B

Explanation

A. While the voices may be part of the illness, it is important to acknowledge the client’s experience
without dismissing it.
B. Acknowledging the client's experience ("I know you hear the voices, but I do not") is important in establishing rapport and validating their reality.
C. Asking how often the voices are heard can be useful, but acknowledging the client’s perception
should be the first priority.
D. Asking what the voices are telling the client may come later, after the client’s experience has been
acknowledged.

A. Bipolar type B. Bipolar type I C. Bipolar mixed D. Anxiety

Correct Answer is B

Explanation

A. Bipolar type is not a specific classification; the nurse needs to differentiate between bipolar I and II.
B. Bipolar type I involves manic episodes that last for at least a week or require hospitalization, with possible depressive episodes. The presence of a depressive episode confirms bipolar type I.
C. Bipolar mixed refers to simultaneous symptoms of both mania and depression, which is not described here.
D. Anxiety is unrelated to the symptoms described.

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A nurse is collecting data from a client who has schizophrenia and has been taking chlorpromazine for 8 years. The nurse notes choreiform or jerking uncontrolled movements, lip smacking, and spastic facial distortions. Which of the following conditions should the nurse document in her finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is experiencing auditory hallucinations. Which of the following responses should the nurse make first?

Correct Answer is B

Explanation

A nurse is collecting data on a client and finds that Ari is always manic but has had one depressive episode in the last year. Which of the following diagnosis should the nurse suspect?

Correct Answer is B

Explanation

A nurse is collecting data from a client who has schizophrenia and has been taking chlorpromazine for 8 years. The nurse notes choreiform or jerking uncontrolled movements, lip smacking, and spastic facial distortions. Which of the following conditions should the nurse document in her finding?

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