When a client on an acute psychiatric unit develops Neuroleptic Malignant Syndrome, which of the following interventions should the nurse prioritize in the management of this condition?

Provide fluids and monitor electrolytes to prevent dehydration

Increase the dose of haloperidol to manage agitation

Withhold the haloperidol and initiate cooling measures

Administer a dose of acetaminophen to reduce the fever

Answer and Explanation

The Correct Answer is C

A. Provide fluids and monitor electrolytes to prevent dehydration: Hydration and electrolyte balance are important supportive measures in Neuroleptic Malignant Syndrome (NMS), but they are not the immediate priority. The underlying cause, dopamine blockade from antipsychotics, must first be addressed by stopping the offending drug.

B. Increase the dose of haloperidol to manage agitation: Increasing the antipsychotic dose would worsen NMS, as haloperidol and other dopamine antagonists are the main cause. This intervention would intensify muscle rigidity, hyperthermia, and autonomic instability.

C. Withhold the haloperidol and initiate cooling measures: This is the priority action. Immediate discontinuation of the antipsychotic removes the trigger, while cooling helps reduce hyperthermia. These steps prevent progression of the life-threatening syndrome and stabilize the client.

D. Administer a dose of acetaminophen to reduce the fever: Acetaminophen may lower temperature in infections, but in NMS the hyperthermia results from severe muscle rigidity and altered hypothalamic regulation. Cooling measures and stopping the medication are more effective interventions than antipyretics alone.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

A. Depressive characteristics of schizophrenia: While some atypical antipsychotics may have mood-stabilizing effects, paliperidone is not primarily indicated for treating depressive symptoms. Antidepressants are more effective for depressive features rather than antipsychotic agents.

B. Negative symptoms of schizophrenia only: Paliperidone helps address negative symptoms such as social withdrawal and blunted affect, but it is not limited to these alone. Its mechanism of action also targets positive symptoms, making this option incomplete.

C. Both positive and negative symptoms of schizophrenia: Paliperidone, an atypical antipsychotic, blocks dopamine D2 receptors and serotonin 5-HT2A receptors. This dual action makes it effective for reducing hallucinations and delusions (positive symptoms) as well as improving motivation and affect (negative symptoms).

D. Low serotonin levels: Paliperidone does act on serotonin receptors, but it does not treat “low serotonin levels” as a standalone condition. Instead, the benefit is its balanced effect on both dopamine and serotonin pathways, reducing positive and negative symptoms in schizophrenia.

A. Borderline B. Schizoid C. Narcissistic D. Histrionic

Correct Answer is C

Explanation

A. Borderline: Borderline personality disorder is associated with unstable mood, intense fear of abandonment, impulsivity, and self-destructive behaviors. While these clients may struggle with relationships, they do not exhibit grandiosity or an excessive need for admiration.

B. Schizoid: Schizoid personality disorder involves emotional detachment, preference for solitary activities, and limited expression of emotions. Clients with this disorder avoid social interactions but do not display traits of grandiosity or admiration-seeking.

C. Narcissistic: Narcissistic personality disorder is characterized by an inflated sense of self-importance, constant need for admiration, and lack of empathy toward others. These clients often exploit relationships for personal gain and require recognition to maintain self-esteem.

D. Histrionic: Histrionic personality disorder is marked by excessive emotionality, attention-seeking behavior, and dramatic expression. While they crave approval, they do not exhibit the pervasive grandiosity and lack of empathy that define narcissistic personality disorder.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

When a client on an acute psychiatric unit develops Neuroleptic Malignant Syndrome, which of the following interventions should the nurse prioritize in the management of this condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A major advantage of giving the antipsychotic drug Invega/paliperidone is that it is effective against what symptoms?

Correct Answer is C

Explanation

Which personality disorder is characterized by a pervasive pattern of grandiosity, need for admiration, and a lack of empathy?

Correct Answer is C

Explanation

The nurse is preparing a plan of care for a client with dependent personality disorder and assigns an outcome to increase problem-solving skills. Which client behavior would indicate progress toward meeting that outcome?

The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which requires immediate intervention?

Which of the following assessment findings would be expected in a client with chronic hypoxemia due to chronic obstructive pulmonary disease (COPD)?

A patient taking a first generation anti-psychotic medication is noted to grimace and smack both lips. The patient's neck and shoulders twisting in a snakelike motion. What problem would the nurse suspect?

The nurse working with a client with antisocial personality disorder would expect which behaviors? Select all that apply.

A client with chronic obstructive pulmonary disease (COPD) is experiencing dyspnea and has a low PaO2 level. The nurse plans to administer oxygen as prescribed. Which statement is true concerning oxygen administration to a client with COPD?