What should the nurse prioritize when evaluating whether a client is using effective coping mechanisms for stress related to taking typical antipsychotics?
Reduction of hallucinations and delusions
Adherence to medication regimen
Client's ability to manage adverse drug effects
Improved family communication
The Correct Answer is C
Choice A reason: The reduction of hallucinations and delusions is a primary therapeutic goal of antipsychotic therapy, indicating pharmacological efficacy. However, it does not measure the client's internal coping mechanisms for the specific stressors or physical discomforts caused by the medications themselves, such as extrapyramidal symptoms or anticholinergic effects.
Choice B reason: Medication adherence is a behavioral outcome that suggests the client is following the prescribed treatment plan. While adherence is necessary for stability, it can occur without the client having effective coping strategies for the secondary stress or physiological burden that typical antipsychotics often impose on the body.
Choice C reason: Typical antipsychotics are associated with a high incidence of distressing side effects, including dystonia, akathisia, and dry mouth. Evaluating the client's ability to identify, report, and manage these adverse effects demonstrates functional coping and self-efficacy, which are critical for long-term psychological resilience and treatment success.
Choice D reason: Improved family communication is a positive outcome of psychosocial rehabilitation and family therapy. While it provides a support system that can mitigate stress, it is a broad social metric rather than a specific evaluation of how the individual client copes with the pharmacological challenges of their medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Increasing the dose of risperidone would likely exacerbate pseudoparkinsonism. These symptoms are caused by the blockade of dopamine D2 receptors in the nigrostriatal pathway; adding more of the offending agent would worsen the imbalance between dopamine and acetylcholine, leading to increased rigidity and tremors.
Choice B reason: While education is important for long-term management, it is not the priority action when a client is suffering from acute, distressing extrapyramidal symptoms. The immediate goal is to alleviate the physical discomfort and functional impairment caused by the drug-induced parkinsonian symptoms through pharmacological intervention.
Choice C reason: Monitoring symptoms over time is insufficient because pseudoparkinsonism typically does not resolve without intervention as long as the antipsychotic remains at the same dose. Delaying treatment can lead to decreased medication adherence and prolonged physical distress, which may negatively impact the client's overall psychiatric prognosis.
Choice D reason: Pseudoparkinsonism results from a relative deficiency of dopamine and an excess of cholinergic activity. Administering an anticholinergic medication, such as benztropine or trihexyphenidyl, restores the chemical balance in the basal ganglia, rapidly relieving the muscle stiffness, shuffling gait, and tremors associated with the antipsychotic medication.
Correct Answer is A
Explanation
Choice A reason: Risperidone is an atypical antipsychotic that functions as a dopamine D2 and serotonin 5-HT2A receptor antagonist. By modulating these neurotransmitter pathways, it effectively diminishes positive symptoms of schizophrenia, such as auditory hallucinations and delusional paranoia, which are the primary therapeutic targets for achieving clinical stabilization and safety.
Choice B reason: Significant weight loss is not a desired therapeutic outcome of risperidone; in fact, the medication is frequently associated with metabolic side effects, including significant weight gain, hyperlipidemia, and increased risk of type 2 diabetes. Monitoring metabolic parameters is a standard nursing intervention during treatment with atypical antipsychotics.
Choice C reason: While risperidone may have some sedative properties that could incidentally help with sleep, the absence of a need for sleep medication is not the specific clinical indicator used to determine if the antipsychotic is successfully treating the underlying primary symptoms of the client's schizophrenic disorder.
Choice D reason: Increased energy and hyperactivity are not desired outcomes and could actually indicate a worsening of symptoms or the development of adverse effects like akathisia. The goal of risperidone is to achieve behavioral stability and symptom reduction rather than inducing a state of heightened psychomotor activity or agitation.
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