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.

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Correct Answer is B

Explanation

A. Highly self-directed people reflect low intolerance of change: This description does not explain the development of personality disorders. Self-direction is generally considered a positive trait that supports adaptability, not a factor leading to pathology.

B. Failure to complete developmental tasks: According to Erikson and other developmental theories, unresolved developmental stages such as trust, identity, or intimacy can lead to maladaptive coping patterns that evolve into personality disorders.

C. Cooperative people become less helpless over time: This reflects a positive growth pattern, not a factor in personality disorder development. Increased cooperation typically strengthens relationships and resilience rather than causing pathology.

D. Self-transcendence contributes to unaware self-consciousness: Self-transcendence is usually considered a positive quality associated with spirituality or meaning-making, not a cause of disordered personality development.

A. Client fears criticism from others, including staff B. Client shows no remorse when accidentally breaking another clients television C. Client cries loudly whenever requests are denied D. Client talks about three failed marriages

Correct Answer is A

Explanation

A. Client fears criticism from others, including staff: This supports a diagnosis of avoidant personality disorder. Individuals with this disorder are highly sensitive to criticism or rejection, which leads them to avoid social situations despite often desiring close relationships.

B. Client shows no remorse when accidentally breaking another client’s television: This aligns more closely with antisocial personality disorder, which is characterized by disregard for others and lack of empathy or remorse.

C. Client cries loudly whenever requests are denied: This is more consistent with borderline personality disorder, where emotional regulation is poor, and reactions to perceived rejection or frustration are intense and disproportionate.

D. Client talks about three failed marriages: Multiple failed relationships are more suggestive of borderline personality disorder, which is marked by instability in interpersonal relationships, not the avoidance and fear of rejection typical of avoidant personality disorder.

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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

Which is a psychosocial explanation for the development of personality disorders?

Correct Answer is B

Explanation

Which observation by the nurse is supportive of a diagnosis of avoidant personality disorder?

Correct Answer is A

Explanation

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