The nurse knows that the patient in the scenario who has schizophrenia will need to have their medication dose adjusted if they develop which of the following?

Significant weight gain

Delusions that they are perceived as being controlled by radio waves

Loss of their sense of taste and smell

The sense that the medications do not work anymore

Answer and Explanation

The Correct Answer is D

Patients with schizophrenia may require medication dose adjustments if they report a perceived loss of efficacy, as this may indicate tolerance, subtherapeutic dosing, or nonadherence. Nurses play a critical role in assessing symptom recurrence, monitoring side effects, and collaborating with prescribers to optimize antipsychotic therapy while ensuring patient safety.

Rationale for correct answer:

D. The sense that the medications do not work anymore
This may indicate tolerance, suboptimal plasma levels, or nonadherence. It signals the need for reassessment of dosage, medication type, or adherence strategies to ensure continued symptom control.

Rationale for incorrect answer:

A. Significant weight gain
While weight gain is a common adverse effect of antipsychotics, it does not automatically require a dose adjustment. Management usually focuses on lifestyle interventions, dietary counseling, and monitoring metabolic parameters.

B. Delusions that they are perceived as being controlled by radio waves
This represents ongoing psychotic symptoms, but the presence of delusions alone does not necessarily indicate a need for a dose change unless symptoms are worsening or not controlled with the current regimen.

C. Loss of their sense of taste and smell
Changes in taste or smell are not typical indicators for adjusting antipsychotic dosing. These sensory alterations are usually unrelated to drug efficacy.

Take-home points:

Patient-reported loss of medication efficacy is a key indicator for reassessment.
Dose adjustments should be considered only after evaluating adherence, drug interactions, and therapeutic levels.
Ongoing monitoring and collaboration with the prescriber optimize treatment outcomes.

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Correct Answer is B

Explanation

Clozapine (Clozaril) is an atypical antipsychotic with a well-documented risk of agranulocytosis, a potentially life-threatening decrease in white blood cells (WBCs). Regular monitoring of WBC count is essential for early detection of this adverse effect and for ensuring patient safety during ongoing therapy. Nursing care includes educating the patient about infection signs and emphasizing the importance of adherence to scheduled lab testing.

Rationale for correct answer:

B. WBC count: Clozapine can cause agranulocytosis, which increases the patient’s risk for serious infections. Regular WBC monitoring is critical to detect decreases early and prevent complications. This includes baseline testing and weekly or biweekly checks during initial therapy, with gradual spacing as stability is achieved.

Rationale for incorrect answer:

A. Platelet count: While important for general hematologic monitoring, clozapine specifically affects WBCs, not platelets, so routine platelet checks are not the primary safety measure.

C. Liver function studies: Liver function may be monitored periodically, but hepatotoxicity is less common and not the primary concern with clozapine.

D. Renal function studies: Clozapine is not nephrotoxic, and routine renal monitoring is not a standard requirement for safety.

Take-home points:

Clozapine carries a high risk of agranulocytosis; WBC monitoring is essential.
Patients should report fever, sore throat, or signs of infection immediately.
Monitoring schedules typically start weekly and may become less frequent if counts remain stable.

A. Disorganized speech B. Bizarre behavior C. Impaired social interactions D. Hallucinations E. Decreased motivation

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

Explanation

Chlorpromazine (Thorazine) is a first-generation antipsychotic primarily effective for positive symptoms of schizophrenia, which are those that represent an excess or distortion of normal function. Positive symptoms include hallucinations, delusions, disorganized thinking, and bizarre behavior. Nurses should focus assessments on improvement in these areas to evaluate therapeutic effectiveness.

Rationale for correct answer:

A. Disorganized speech – First-generation antipsychotics help clarify thought processes and reduce incoherent or tangential speech, improving communication and cognitive clarity.

B. Bizarre behavior – Chlorpromazine targets agitation, inappropriate social behavior, and unusual motor activity, helping normalize behavioral patterns.

D. Hallucinations – Positive symptoms like auditory and visual hallucinations are significantly reduced, which improves client safety and insight into reality.

Rationale for incorrect answer:

C. Impaired social interactions – Social withdrawal is a negative symptom and often shows limited improvement with first-generation antipsychotics. These symptoms may require psychosocial interventions or second-generation antipsychotics for better response.

E. Decreased motivation – This is a negative symptom (avolition) that does not respond well to first-generation antipsychotics and often persists despite treatment.

Take-home points:

First-generation antipsychotics are most effective for positive symptoms of schizophrenia.
Negative symptoms such as social withdrawal and decreased motivation may persist despite therapy.
Nursing assessments should focus on reduction in hallucinations, disorganized speech, and bizarre behavior to gauge effectiveness.

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The nurse knows that the patient in the scenario who has schizophrenia will need to have their medication dose adjusted if they develop which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient who has been taking clozapine (Clozaril) for 2 months. Which laboratory test(s) should be performed regularly while the patient is taking this medication?

Correct Answer is B

Explanation

A nurse is preparing to perform a follow-up assessment on a client who takes chlorpromazine (Thorazine) for the treatment of schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? Select all that apply.

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

Explanation

Nursing implications of the administration of haloperidol (Haldol) to a client exhibiting psychotic behavior include which of the following? Select all that apply.

The nurse knows that the patient in the scenario who has schizophrenia will need to have their medication dose adjusted if they develop which of the following?

The nurse is discussing with the patient in the scenario being treated for psychoses with antipsychotic medications what to expect. Which statement by the nurse needs to be revised?

Which of the following second-generation antipsychotics is considered most effective for treatment-resistant schizophrenia and requires strict hematologic monitoring?

The nurse reviewing a patient’s medication list recognized which one as the antipsychotic?

An atypical antipsychotic is prescribed for a patient with psychosis. The nurse understands that this category of medications includes which drugs? Select all that apply.

A patient with a feeding tube will be receiving risperidone (Risperdal) 8 mg in two divided doses via the feeding tube. The medication is available in a 1 mg/mL solution. How many milliliters will the nurse administer for each dose?