A nurse on a mental health unit observes a patient diagnosed with schizophrenia on antipsychotics exhibiting an impaired gait and uncontrollable tremors. The nurse should recognize that which of the following adverse effects may be occurring?

Acute dystonia

Pseudoparkinsonism

Neuroleptic malignant syndrome

Tardive dyskinesia

Answer and Explanation

The Correct Answer is B

Choice A reason:

Acute dystonia is a type of extrapyramidal side effect that can occur with antipsychotic medications. It typically presents as muscle spasms, stiffness, and oculogyric crisis. While it can affect gait and cause tremors, these symptoms are more commonly associated with pseudoparkinsonism when they appear as part of a medication side effect profile.

Choice B reason:

Pseudoparkinsonism is an adverse effect of antipsychotic medications that mimics the symptoms of Parkinson's disease, such as bradykinesia, rigidity, tremors, and postural instability. The impaired gait and uncontrollable tremors observed by the nurse are characteristic signs of pseudoparkinsonism.

Choice C reason:

Neuroleptic malignant syndrome (NMS) is a rare but serious condition associated with the use of antipsychotic medications. It presents with severe muscle rigidity, fever, autonomic instability, and altered mental status. While tremors can be a symptom, the defining features of NMS are high fever and muscle rigidity, which were not mentioned in the scenario.

Choice D reason:

Tardive dyskinesia is a late-onset side effect of antipsychotic medications characterized by repetitive, involuntary, and purposeless movements such as grimacing, tongue protrusion, lip smacking, and blinking. It does not typically present with an impaired gait or tremors, which are more indicative of pseudoparkinsonism.

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Correct Answer is D

Explanation

Choice A Reason:

An overdose of disulfiram can cause symptoms such as nausea and vomiting, but it is less likely to be the cause in this scenario. Overdoses typically present with more severe symptoms, including seizures and coma in rare cases¹. The client's symptoms are more consistent with a disulfiram-alcohol reaction.

Choice B Reason:

An allergic response to disulfiram can cause symptoms such as rash, itching, and swelling, but severe nausea and vomiting are not typical allergic reactions². Allergic reactions would also likely present with other symptoms such as difficulty breathing or hives, which are not mentioned in this case.

Choice C Reason:

While nausea and vomiting can be common side effects of disulfiram, the severity described by the client suggests a more significant reaction. Common side effects are usually milder and do not typically cause the client to stop the medication abruptly.

Choice D Reason:

The most likely cause of the client's severe nausea and vomiting is the consumption of alcohol while taking disulfiram. Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, leading to an accumulation of acetaldehyde when alcohol is consumed. This results in unpleasant effects such as severe nausea, vomiting, headache, and flushing. The client's symptoms align with this reaction, making it the most probable cause.

A. Sudden onset of high fever B. Twisting tongue movements C. Constant tapping of feet when sitting D. Shuffling gait

Correct Answer is B

Explanation

Choice A reason:

A sudden onset of high fever is not a symptom of tardive dyskinesia (TD). High fever may indicate an infection or other serious conditions such as neuroleptic malignant syndrome, which is a different and more severe reaction to antipsychotic medications

Choice B reason:

Twisting tongue movements are a classic sign of tardive dyskinesia. TD is characterized by repetitive, involuntary, and purposeless movements that often affect the face, including the tongue. These movements result from long-term use of certain antipsychotic medications, like fluphenazine, which block dopamine receptors in the brain.

Choice C reason:

Constant tapping of the feet when sitting could be a sign of restlessness or akathisia, which is another side effect of antipsychotic medications but is not specifically indicative of tardive dyskinesia. TD typically involves more complex movements of the limbs, not just simple tapping.

Choice D reason:

A shuffling gait is more commonly associated with parkinsonism or pseudoparkinsonism, which can also be a side effect of antipsychotic medications. It is not a typical manifestation of tardive dyskinesia, which usually presents with involuntary movements of the face, tongue, and upper body

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A nurse on a mental health unit observes a patient diagnosed with schizophrenia on antipsychotics exhibiting an impaired gait and uncontrollable tremors. The nurse should recognize that which of the following adverse effects may be occurring?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a substance abuse clinic is assessing a client who is prescribed disulfiram (Antabuse). The client states he stopped the medication after developing severe nausea and vomiting. Which of the following does the nurse realize is most likely the cause of the client's symptoms?

Correct Answer is D

Explanation

A nurse is assessing a client diagnosed with schizophrenia who has been treated with fluphenazine (Prolixin) for several years. Which of the following findings should the nurse document as manifestations of tardive dyskinesia (TD)?

Correct Answer is B

Explanation

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