A nurse is collecting data from a client who is taking chlorpromazine. Which of the following findings should the nurse identify as extrapyramidal symptoms (EPS)? (Select all that apply.)

Impaired gait

Fidgeting behavior

Muscle contractions of the neck

Fluctuating vital signs

Sexual dysfunction

Answer and Explanation

Correct Answer : A,C

A.   Impaired gait is a classic extrapyramidal symptom, which includes issues like dystonia or bradykinesia.
B.   Fidgeting behavior is more related to anxiety or restlessness rather than EPS.
C.   Muscle contractions of the neck, known as torticollis, are common signs of EPS caused by antipsychotic medications such as chlorpromazine.
D.   Fluctuating vital signs are not directly linked to EPS but may indicate another underlying issue.
E.   Sexual dysfunction is a side effect of chlorpromazine but not classified as an EPS.

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Correct Answer is A

Explanation

A. Checking the patient's baseline blood pressure helps to determine if the current reading of 98/66 mm Hg is normal for them or if it represents a significant change.
B. This may not be necessary if the blood pressure is normal for the patient. Hypotension is relative, and what is considered low for one person might be normal for another.
C. While this is a good practice, it should be done after determining if there is a significant change from the baseline. The irregular pulse could be due to various factors, including medications, but the first step is to understand the patient's normal range.
D. The patient's pulse is 76 beats/min, which is not bradycardic (bradycardia is defined as a heart rate less than 60 beats/min). Therefore, notifying the doctor of bradycardia is not appropriate in this case.

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 is taking chlorpromazine. Which of the following findings should the nurse identify as extrapyramidal symptoms (EPS)? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A 45-year-old patient who is alert and oriented has a blood pressure of 98/66 mm Hg, radial pulse of 76 beats/min (irregular), and respirations of 18 breaths/min (regular). The best nursing intervention is to:

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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