Chapter 18: Drugs Used for Psychoses

Chapter 18: Drugs Used for Psychoses

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing?

ANS:  D

Hallucinations are false sensory perceptions that are experienced without an external stimulus but seem real to the patient. Auditory hallucinations are prominent in a schizophrenic patient. Additional sensory hallucinations include those of touch, sight, smell, and body sensation. Delusions are false beliefs that persist despite evidence to the contrary. Flight of ideas is characterized by rapid changes in thought from one topic to another. Disorganized thinking is commonly associated with psychoses and consists of a flight of ideas during which the individual jumps from one idea or topic to another one.

DIF:    Cognitive Level: Knowledge            REF:   p. 274             OBJ:   1

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Psychosocial Integrity

2. A patient with schizophrenia has been nonadherent with his home medication regimen. He requires frequent admissions to the intensive psychiatric unit for treatment of acute psychotic episodes. Which medication regimen would be appropriate for this patient?

ANS:  C

Depot antipsychotic medications are long acting injections that may be used with noncompliant patients and may assist in avoiding repeated hospital admissions. Daily home nursing visits are not an efficient way to ensure medication compliance. Continuous inpatient hospitalization is not an efficient way to ensure medication compliance. Subcutaneous medication administration is not an option for this patient.

DIF:    Cognitive Level: Application           REF:   pp. 274-276    OBJ:   2 | 3

TOP:   Nursing Process Step: Evaluation

MSC:  NCLEX Client Needs Category: Psychosocial Integrity

3. What is the most common cause of nonadherence to antipsychotic pharmacologic treatment?

ANS:  C

Extrapyramidal effects are the most common reason for nonadherence to antipsychotic therapy. The four categories of extrapyramidal effects are dystonic reactions, pseudoparkinsonism, akathisia, and tardive dyskinesia. Although expense may be a concern, it is not the most common reason for noncompliance. Chemical dependency is not a feature of therapy with antipsychotic drugs. Although knowledge deficit is a concern, it is not the most common reason for noncompliance.

DIF:    Cognitive Level: Comprehension     REF:   p. 279             OBJ:   3

TOP:   Nursing Process Step: Evaluation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

4. Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis?

ANS:  A

Dystonic reactions are the first extrapyramidal symptoms to occur when a patient is taking antipsychotic agents. Dystonias are spasmodic movements of muscle groups such as tongue protrusion, rolling back of the eyes (oculogyric crisis), jaw spasms (trismus), or neck torsion (torticollis). Pseudoparkinsonism is characterized by tremor and rigidity. Akathisia is characterized by subjective feelings of anxiety and restlessness, accompanied by pacing and the inability to remain in one place for extended periods. Tardive dyskinesia is characterized by persistent involuntary hyperkinetic movements.

DIF:    Cognitive Level: Comprehension     REF:   p. 279             OBJ:   4

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

5. The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication?

ANS:  A

The use of clozapine requires a baseline and weekly white blood cell (WBC) counts because of the high incidence of agranulocytosis. Clozapine does not cause vitamin deficiencies. Clozapine does not interfere with clotting abilities. Clozapine does not affect red blood cell volume.

DIF:    Cognitive Level: Knowledge            REF:   p. 278 | p. 281

OBJ:   4                    TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity