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NURS 222 MENTAL HEALTH EXAM|| ALL
QUESTIONS AND CORRECT ANSWERS|| LATEST
AND COMPLETE VERSION 2024-2025 WITH
VERIFIED SOLUTIONS|| ASSURED PASS!!!
A client with schizophrenia who receives fluphenazine (Prolixin) develops
pseudoparkinsonism and akinesia. What drug would the nurse administer to
minimize extrapyramidal symptoms?
A) benztropine (Cogentin)
B) dantrolene (Dantrium)
C) clonazepam (Klonopin)
D) diazepam (Valium)
Benztropine is an anticholinergic drug administered to reduce extrapyramidal
adverse effects in the client taking antipsychotic drugs. It works by restoring the
equilibrium between the neurotransmitters acetylcholine and dopamine in the
central nervous system (CNS). Dantrolene, a hydantoin drug that reduces the
catabolic processes, is administered to alleviate the symptoms of neuroleptic
malignant syndrome, a potentially fatal adverse effect of antipsychotic drugs.
Clonazepam, a benzodiazepine drug that depresses the CNS, is administered to
control seizure activity. Diazepam, a benzodiazepine drug, is administered to
reduce anxiety.
A client with a diagnosis of paranoid schizophrenia comments to the nurse, "How
do I know what is really in those pills?" Which of the following is the best
response?
A) Say, "You know it's your medicine."
B) Allow him to open the individual wrappers of the medication.
C) Say, "Don't worry about what is in the pills. It's what is ordered."
D) Ignore the comment because it's probably a joke.
Option B is correct because allowing a paranoid client to open his medication can
help reduce suspiciousness. Option A is incorrect because the client doesn't know
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that it's his medication and he's obviously suspicious. Telling the client not to
worry or ignoring the comment isn't supportive and doesn't offer reassurance.
A client tells the nurse that people from Mars are going to invade the earth. Which
response by the nurse would be most therapeutic?
A) "That must be frightening to you. Can you tell me how you feel about it?"
B) "There are no people living on Mars."
C) "What do you mean when you say they're going to invade the earth?"
D) "I know you believe the earth is going to be invaded, but I don't believe that."
This response addresses the client's underlying fears without feeding the delusion.
Refuting the client's delusion, as in option B, would increase anxiety and reinforce
the delusion. Asking the client to elaborate on the delusion, as in option C, would
also reinforce it. Voicing disbelief about the delusion, as in option D, wouldn't help
the client deal with underlying fears.
A client with schizophrenia tells the nurse he hears the voices of his dead parents.
To help the client ignore the voices, the nurse should recommend that he:
A) sit in a quiet, dark room and concentrate on the voices.
B) listen to a personal stereo through headphones and sing along with the music.
C) call a friend and discuss the voices and his feelings about them.
D) engage in strenuous exercise.
Increasing the amount of auditory stimulation, such as by listening to music
through headphones, may make it easier for the client to focus on external sounds
and ignore internal sounds from auditory hallucinations. Option A would make it
harder for the client to ignore the hallucinations. Talking about the voices, as in
option C, would encourage the client to focus on them. Option D is incorrect
because exercise alone wouldn't provide enough auditory stimulation to drown out
the voices.
A client with schizophrenia is receiving antipsychotic medication. Which nursing
diagnosis may be appropriate for this client?
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A) Ineffective protection related to blood dyscrasias
B)Urinary frequency related to adverse effects of antipsychotic medication
C) Risk for injury related to a severely decreased level of consciousness
D) Risk for injury related to electrolyte disturbances
Antipsychotic medications may cause neutropenia and granulocytopenia, life-
threatening blood dyscrasias, that warrant a nursing diagnosis of Ineffective
protection related to blood dyscrasias. These medications also have anticholinergic
effects, such as urine retention, dry mouth, and constipation. Urinary frequency
isn't an approved nursing diagnosis. Although antipsychotic medications may
cause sedation, they don't severely decrease the level of consciousness, eliminating
option C. These drugs don't cause electrolyte disturbances, eliminating option D.
A client with persistent, severe schizophrenia has been treated with phenothiazines
for the past 17 years. Now the client's speech is garbled as a result of drug-induced
rhythmic tongue protrusion. What is another name for this extrapyramidal
symptom?
A) Dystonia
B) Akathisia
C) Pseudoparkinsonism
D) Tardive dyskinesia
An adverse reaction to phenothiazines, tardive dyskinesia refers to choreiform
tongue movements that commonly are irreversible and may interfere with speech.
Dystonia refers to involuntary contraction of a muscle group. Akathisia is
restlessness or inability to sit still. Pseudoparkinsonism describes a group of
symptoms that mimic those of Parkinson's disease.
An adverse reaction to phenothiazines, tardive dyskinesia refers to choreiform
tongue movements that commonly are irreversible and may interfere with speech.
Dystonia refers to involuntary contraction of a muscle group. Akathisia is
restlessness or inability to sit still. Pseudoparkinsonism describes a group of
symptoms that mimic those of Parkinson's disease.
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A) Meeting all of the client's physical needs
B) Giving the client an opportunity to express concerns
C) Administering lithium carbonate (Lithonate) as prescribed
D) Providing a quiet environment where the client can be alone
Because a client with catatonic schizophrenia can't meet physical needs
independently, the nurse must provide for all of these needs, including adequate
food and fluid intake, exercise, and elimination. This client is incapable of
expressing concerns; however, the nurse should try to verbalize the message
conveyed by the client's nonverbal behavior. Lithium is used to treat mania, not
catatonic schizophrenia. Despite the client's mute, unresponsive state, the nurse
should provide nonthreatening stimulation and should spend time with the client,
not leave the client alone all the time. Although aware of the environment, the
client doesn't interact with it actively; the nurse's support and presence can be
reassuring.
A client with a history of medication noncompliance is receiving outpatient
treatment for chronic undifferentiated schizophrenia. The physician is most likely
to prescribe which medication for this client?
A) chlorpromazine (Thorazine)
B) imipramine (Tofranil)
C) lithium carbonate (Lithane)
D) fluphenazine decanoate (Prolixin Decanoate)
Fluphenazine decanoate is a long-acting antipsychotic agent given by injection.
Because it has a 4-week duration of action, it's commonly prescribed for
outpatients with a history of medication noncompliance. Chlorpromazine, also an
antipsychotic agent, must be administered daily to maintain adequate plasma
levels, which necessitates compliance with the dosage schedule. Imipramine, a
tricyclic antidepressant, and lithium carbonate, a mood stabilizer, are rarely used to
treat clients with chronic schizophrenia.
Propranolol (Inderal) is used in the mental health setting to manage which of the
following conditions?
A) Antipsychotic-induced akathisia and anxiety
