The nurse is caring for a patient who is being treated with antipsychotic medications. As part of the plan of care, the nurse monitors the patient for dyskinesia. What would the nurse assess with dyskinesia?
Involuntary movements of the mouth and tongue
Abnormal breathing
Migraine headache, hypertension
Severe flushing, headache, and tremors
The Correct Answer is A
A. Involuntary movements of the mouth and tongue: Dyskinesia, particularly tardive dyskinesia, involves involuntary movements, often of the mouth, tongue, and sometimes other parts of the body.
B. Abnormal breathing: This is not a typical manifestation of dyskinesia.
C. Migraine headache, hypertension: These symptoms are not associated with dyskinesia.
D. Severe flushing, headache, and tremors: These symptoms do not describe dyskinesia, although tremors can be seen in other movement disorders.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Skeletal x-ray: Skeletal x-rays can show bone loss but are not sensitive enough for early detection of osteoporosis.
B. Calcium blood level: Blood calcium levels do not directly indicate bone density.
C. Bone density scan: Bone density scans (DEXA scans) are the gold standard for diagnosing osteoporosis and assessing fracture risk.
D. CAT scan: CAT scans are not typically used for assessing bone density.
Correct Answer is A
Explanation
A. Use nightlights and remove extra furniture from the room: Nightlights provide gentle lighting that can reduce disorientation, and removing extra furniture minimizes fall risk.
B. Place the patient in a room with another recovering patient. This might increase agitation and disrupt both patients' sleep.
C. Instruct the patient to orient himself to his surroundings at bedtime. This may not be effective due to the patient's disorientation during detoxification.
D. Wake the patient up every 4 hours to eat a small snack. Frequent waking can disrupt sleep patterns and increase confusion.
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