A nurse is providing teaching for a client who has a new prescription for alprazolam to treat insomnia. Which of the following instructions should the nurse include?

"Avoid activities that require alertness, such as driving."

"Monitor for peripheral edema."

"Take this medication with a high-fat meal."

"Take this medication every night before sleep."

Answer and Explanation

The Correct Answer is A

Alprazolam is a benzodiazepine medication commonly used to treat anxiety and insomnia. Here's the rationale for each option:

A. "Avoid activities that require alertness, such as driving.": Alprazolam can cause drowsiness and impair cognitive function, so it's essential for clients to avoid activities that require alertness, such as driving or operating heavy machinery, while taking this medication. Providing this instruction promotes safety and prevents accidents.

B. "Monitor for peripheral edema.": Peripheral edema is not a common side effect of alprazolam. This instruction is not relevant to the use of this medication.

C. "Take this medication with a high-fat meal.": Alprazolam can be taken with or without food, but taking it with a high-fat meal may delay its absorption. Therefore, it is not necessary to instruct the client to take it with a high-fat meal, especially since this may affect the medication's effectiveness.

D. "Take this medication every night before sleep.": While alprazolam may be used to treat insomnia, it is not typically recommended for nightly use due to the risk of dependence and tolerance. Using it nightly can lead to addiction and withdrawal symptoms if abruptly stopped. Therefore, this instruction is not appropriate.

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Correct Answer is ["A","D","E"]

Explanation

Tardive dyskinesia (TD) is a potential adverse effect associated with long-term use of antipsychotic medications like haloperidol. It manifests as involuntary, repetitive movements, primarily involving the face, mouth, and tongue. The nurse should suspect tardive dyskinesia when observing the following manifestations:

A. Involuntary pelvic rocking and hip thrusting movements: These movements are characteristic of tardive dyskinesia and indicate abnormal involuntary motor activity.

B. Urinary retention and constipation: These are not typical manifestations of tardive dyskinesia. Urinary retention and constipation can be side effects of anticholinergic medications but are not associated with tardive dyskinesia.

C. Fine hand tremors and pill rolling: These manifestations are more characteristic of parkinsonism, which can be a side effect of antipsychotic medications but is distinct from tardive dyskinesia.

D. Tongue thrusting and lip smacking: These are classic manifestations of tardive dyskinesia and indicate abnormal involuntary movements of the tongue and lips.

E. Facial grimacing and eye blinking: These are also common manifestations of tardive dyskinesia, involving involuntary movements of the face, including grimacing and blinking of the eyes.

A. Dystonia B. Tardive dyskinesia C. Parkinsonism D. Akathisia

Correct Answer is B

Explanation

A. Dystonia - Dystonia presents as sustained or intermittent muscle contractions causing abnormal, often repetitive, movements or postures. It is an acute extrapyramidal side effect of antipsychotic medications like chlorpromazine but typically manifests as sudden-onset muscle spasms rather than involuntary movements of the tongue and face.

B. Tardive dyskinesia - Tardive dyskinesia is a late-appearing movement disorder characterized by involuntary, repetitive movements of the face, tongue, and limbs. It is associated with long-term use of antipsychotic medications like chlorpromazine and typically develops after months to years of treatment.

C. Parkinsonism - Parkinsonism resembles Parkinson's disease and is characterized by symptoms such as tremor, rigidity, bradykinesia, and postural instability. While antipsychotic medications can cause Parkinsonism as an adverse effect, it usually presents with symptoms different from those described in the scenario.

D. Akathisia - Akathisia is characterized by an inner feeling of restlessness and the urge to move, often accompanied by pacing and inability to sit still. It is an acute extrapyramidal side effect of antipsychotic medications but does not manifest as involuntary movements of the tongue and face as described in the scenario.

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A nurse is providing teaching for a client who has a new prescription for alprazolam to treat insomnia. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?

Correct Answer is B

Explanation

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