The psychiatric-mental health nurse practitioner evaluates an 81-year-old man who was admitted to the hospital 3 days ago for community-acquired pneumonia and dehydration. Today, he has an altered level of consciousness and is only oriented to person. The nurses report he has become withdrawn and has refused to eat. He has no previous psychiatric history. Based on this scenario, what medication should the PMHNP prescribe for agitation as needed?
Benztropine (Cogentin)
Diphenhydramine (Benadryl)
Lorazepam (Ativan)
Haloperidol (Haldol)
The Correct Answer is D
Choice A reason: Benztropine is primarily used to treat extrapyramidal symptoms from antipsychotic medications and does not address agitation in delirium.
Choice B reason: Diphenhydramine may cause sedation but has anticholinergic properties that can worsen delirium in elderly patients, making it inappropriate.
Choice C reason: Lorazepam can exacerbate delirium in older adults and is generally avoided unless agitation is due to alcohol or benzodiazepine withdrawal.
Choice D reason: This choice is correct because haloperidol is the preferred first-line antipsychotic for acute agitation in elderly patients with delirium. It has minimal anticholinergic effects and can safely manage agitation while monitoring for extrapyramidal or cardiac side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This choice is correct because the facial nerve (CN VII) controls the muscles of facial expression, including eyebrow elevation, eye closure, smiling, frowning, and cheek puffing. Assessing these movements evaluates CN VII function.
Choice B reason: The trigeminal nerve (CN V) primarily mediates facial sensation and mastication muscles, not facial expressions.
Choice C reason: The oculomotor nerve (CN III) controls most extraocular eye movements and eyelid elevation, not the full range of facial expressions tested.
Choice D reason: The abducens nerve (CN VI) controls lateral eye movement only and is not involved in facial expressions.
Correct Answer is D
Explanation
Choice A reason: SWS is indeed a rare neurocutaneous disorder affecting the skin (port-wine stains) and central nervous system, making this a true clinical feature.
Choice B reason: Neurologic manifestations, including seizures, hemiparesis, and intellectual disability, are characteristic features of SWS.
Choice C reason: Management often involves anticonvulsants, glaucoma treatment, and sometimes low-dose aspirin to reduce vascular complications, confirming these are accurate features.
Choice D reason: The prognosis of SWS varies widely; many patients live well into adulthood, making the statement of an average lifespan of 30 years inaccurate.
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