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

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. Transport victim to hospital: While transport to the hospital is necessary, it is not the immediate priority when the victim is still on fire.

B. Stop, drop, and roll: The first action for someone whose clothing is on fire is to stop, drop, and roll to extinguish the flames and prevent further burns.

C. Cover victim with clean cloth or sheet: Covering with a clean cloth is important after the flames have been extinguished but not the first step when the victim is still burning.

D. Remove all nonadherent clothing and jewelry: Removing clothing and jewelry should be done after the flames are extinguished and initial care has been administered.

A. Delirium B. Psychotic break C. Possible stroke D. Anxiety disorder

Correct Answer is A

Explanation

A. Delirium: Delirium is characterized by acute confusion, disorientation, and altered mental status often due to severe infection or high fever.

B. Psychotic break: While hallucinations are a symptom, a psychotic break is generally a chronic mental health condition rather than an acute response to infection.

C. Possible stroke: Stroke symptoms usually involve sudden onset of neurological deficits rather than fever and hallucinations.

D. Anxiety disorder: Anxiety disorders do not typically cause such high fevers or acute hallucinations.

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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?

Nursing Test Bank

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