The Psychiatrist calls Jake’s father to obtain collateral information, pending Jake’s discharge home. Jake’s father reports Jake’s mother died when he was 14 years old. Jake is unable to tell the nurse or Psychiatrist how old he was or the year she died. Which defense mechanism is being depicted?

Regression

Projection

Repression

Suppression

Answer and Explanation

The Correct Answer is C

Choice A reason:
Regression involves reverting to an earlier stage of development in response to stress. This defense mechanism is not indicated by Jake’s inability to recall specific details about his mother’s death.
Choice B reason:
Projection involves attributing one’s own unacceptable thoughts, feelings, or flaws to others. This defense mechanism does not explain Jake’s inability to remember details about his mother’s death.
Choice C reason:
Repression is a defense mechanism where distressing memories, thoughts, or feelings are unconsciously pushed out of conscious awareness. Jake’s inability to recall how old he was or the year his mother died suggests that he may be repressing these painful memories.
Choice D reason:
Suppression is a conscious effort to push distressing thoughts or feelings out of awareness. Since Jake is unable to recall specific details, it is more likely that repression, an unconscious process, is at play.

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Correct Answer is B

Explanation

Choice A reason:
Neuroleptic malignant syndrome (NMS) is a rare but serious side effect of antipsychotic medications. It is characterized by symptoms such as high fever, muscle rigidity, altered mental status, and autonomic dysfunction. The client’s description of needing to move around does not align with the symptoms of NMS.
Choice B reason:
Akathisia is a common side effect of first-generation antipsychotic medications. It is characterized by a feeling of inner restlessness and an urgent need to move. The client’s behavior of pacing and the statement “I just need to move around” are indicative of akathisia.
Choice C reason:
Tardive dyskinesia is a long-term side effect of antipsychotic medications, characterized by involuntary, repetitive movements, particularly of the face and tongue. The client’s symptoms of needing to move around do not match the typical presentation of tardive dyskinesia.
Choice D reason:
Impaired ability to regulate body temperature can occur with antipsychotic medications, but it is not characterized by the need to move around. The client’s symptoms are more consistent with akathisia rather than issues with thermoregulation.

A. Dystonia B. Parkinsonism C. Akathisia D. Tardive dyskinesia

Correct Answer is D

Explanation

Choice A reason:
Dystonia involves muscle contractions causing twisting and repetitive movements or abnormal postures. It typically occurs early in treatment and affects the neck, face, and back muscles. The involuntary movements described in the scenario are more characteristic of tardive dyskinesia rather than dystonia.

Choice B reason:
Parkinsonism is characterized by symptoms similar to Parkinson’s disease, such as tremors, bradykinesia, and rigidity. While it can occur with long-term use of antipsychotics, the specific involuntary movements of the tongue and face described are more indicative of tardive dyskinesia.

Choice C reason:
Akathisia involves a feeling of inner restlessness and an urgent need to move. It does not typically present with the involuntary movements of the tongue and face described in the scenario. Akathisia is more about the inability to stay still rather than specific muscle movements.

Choice D reason:
Tardive dyskinesia is a well-known adverse effect of long-term antipsychotic use, characterized by repetitive, involuntary movements, especially of the face, tongue, and limbs. The description of involuntary movements of the tongue and face fits the profile of tardive dyskinesia, making it the most likely diagnosis.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?

Correct Answer is D

Explanation

While working with an older client, a nurse begins to think of the client as a grandparent and responds to the client as a grandchild. The nurse is developing what type of emotional reaction?

A nurse is reviewing the medical record of a client who has a new prescription for chlorpromazine for the treatment of schizophrenia. Which of the following findings indicates a contraindication to chlorpromazine?

After experiencing increasing conflict in the home, a social worker calls and schedules a therapy meeting. A 24-year-old, his sister, his mother, and the mother’s live-in boyfriend are asked to attend the therapy meeting. Who is the “client” who will be treated during this session?

After being scolded by his supervisor at work, a man comes home and punches several holes in his walls and yells at his significant other. Which of the following defense mechanisms does this scenario depict?

A nurse is explaining advance care directives, or “living wills,” to a client and the client’s spouse. Which detail would the nurse include in the description of an advance care directive?

A nurse is preparing to assist with electroconvulsive therapy (ECT). Which of the following pieces of equipment should the nurse set up in the room prior to the treatment? (Select all that apply)

A nurse is caring for a client who is experiencing a crisis related to anxiety. Which of the following actions should the nurse take? (Select all that apply).