The nurse examines a client who is taking haloperidol for schizophrenia and notices that she habitually twists her tongue and arms. Which side effect should the nurse document in this client's record?
dystonia
akathisia
neuroleptic malignant syndrome
tardive dyskinesia
The Correct Answer is D
Rationale:
A. Dystonia is incorrect because dystonia involves sudden, sustained muscle contractions that cause twisting or abnormal postures, often occurring early in treatment. It is usually acute and painful, unlike the repetitive, involuntary movements described here.
B. Akathisia is incorrect because akathisia is characterized by an inner sense of restlessness and an inability to stay still, often leading to constant pacing or fidgeting. It does not involve the involuntary twisting of the tongue and arms.
C. Neuroleptic malignant syndrome is incorrect because this is a rare, life-threatening reaction to antipsychotics characterized by fever, muscle rigidity, autonomic instability, and altered mental status, not repetitive involuntary movements.
D. Tardive dyskinesia is correct because it is a late-onset side effect of long-term antipsychotic use, presenting as repetitive, involuntary movements of the face, tongue, lips, and sometimes extremities. The twisting movements of the tongue and arms in this client are classic manifestations of tardive dyskinesia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Cholera is caused by the bacterium Vibrio cholerae and is a classic example of a waterborne disease. Transmission occurs when individuals consume water or food contaminated with fecal matter containing the bacteria. Cholera primarily spreads in areas with poor sanitation, inadequate sewage systems, or contaminated drinking water. The disease can lead to profuse watery diarrhea, severe dehydration, and electrolyte imbalances, which can be fatal if untreated. Public health measures such as ensuring safe drinking water, proper sanitation, and hygiene education are essential to prevent outbreaks.
B. Malaria is a vector-borne disease, transmitted through the bite of an infected female Anopheles mosquito. The mosquito carries Plasmodium parasites, which enter the human bloodstream. Malaria is not spread through water consumption, although mosquito breeding often occurs in stagnant water. Preventive strategies focus on mosquito control, use of insecticide-treated nets, and prophylactic medications.
C. Influenza spreads via airborne droplets, generated when an infected person coughs, sneezes, or talks. It can also be spread by touching surfaces contaminated with the virus. Influenza is not transmitted through water, so preventive strategies include vaccination, hand hygiene, and respiratory etiquette.
D. Chickenpox (varicella) is another airborne disease, transmitted through respiratory droplets or direct contact with lesion fluid from an infected person. It does not spread through contaminated water. Prevention relies on varicella vaccination and isolation of infected individuals.
Correct Answer is ["A","C","D"]
Explanation
Rationale:
A. Tremors are one of the most common early signs of alcohol withdrawal, typically appearing 6–12 hours after the last alcohol intake. They often start as mild, fine hand shakes but can progress to severe, generalized tremors. Tremors result from hyperactivity of the central nervous system after the depressant effects of alcohol wear off, reflecting neuronal excitability.
B. Pinpoint pupils are not a symptom of alcohol withdrawal. They are usually associated with opioid intoxication or overdose. In alcohol withdrawal, pupil changes tend to reflect autonomic hyperactivity, not constriction.
C. Diaphoresis (excessive sweating) occurs due to sympathetic nervous system overactivation during alcohol withdrawal. It may be accompanied by tachycardia, elevated blood pressure, and hyperthermia, and is an important indicator of autonomic instability, which can progress to delirium tremens if untreated.
D. Dilated pupils can also be present due to sympathetic overdrive. While not as specific as tremors or diaphoresis, they reflect increased adrenergic activity associated with withdrawal. Other signs of autonomic hyperactivity may include increased heart rate, hypertension, and restlessness.
E. Warm, dry skin is not characteristic of alcohol withdrawal. Instead, patients usually exhibit cool, clammy, or moist skin due to sweating and fluid loss, reflecting heightened sympathetic tone.
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