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A client is diagnosed with schizophrenia. A physician orders haloperidol (Haldol), 50 mg
bid: benztropine (Cogentin), 1 mg prn: and zolpidem (Ambien). 10 mg HS. Which client
behavior would warrant the nurse to administer benztropine?
A. Tactile hallucinations 8%
B. Reports of hearing disturbing voices 0%
C. Hypotension 16%
D. Restlessness and muticle rigidity 75% Most selected
Answer and Explanation
Choice A:
Tactile hallucinations: Benztropine is not typically indicated for the treatment of tactile
hallucinations. It is primarily used to manage extrapyramidal symptoms (EPS)
associated with antipsychotic medications.
Choice B:
Reports of hearing disturbing voices: Benztropine is not the first-line treatment for
auditory hallucinations in schizophrenia. Antipsychotic medications, such as haloperidol,
are more commonly used for this purpose.
Choice C:
Hypotension: Benztropine is not used to treat hypotension. It is used to manage
extrapyramidal symptoms, such as rigidity and restlessness, that may result from
antipsychotic medication use.
Choice D:
Restlessness and muticle rigidity: This is the correct answer. Benztropine is an
anticholinergic medication that can help alleviate extrapyramidal symptoms (EPS)
caused by antipsychotic drugs like haloperidol. Restlessness and muticle rigidity are
symptoms of EPS, and benztropine can be used to counteract these side effects.
NS 228 BSN FINAL EXAM 2022 A nurse on an in-patient unit received the report at 15:00 hours. Which client should the
nurse see first?
A. A Client diagnosed with hypomania who is speaking loudly on the unit 0%
B. A client diagnosed with mania who expressed active suicidal ideations 100%
Most selected
C. A client with a history of mania who is pacing in the hallway 0%
D. A client diagnosed with hypomania who is complaining of pain 0%
Answer and Explanation
Choice A:
Client diagnosed with hypomania who is speaking loudly on the unit: While hypomanic
individuals may exhibit increased energy and talkativeness, the urgency is lower
compared to a client expressing active suicidal ideations. This client does not pose an
immediate threat to themselves or others.
Choice B:
Client diagnosed with mania who expressed active suicidal ideations: This is the correct
answer. A client with active suicidal ideations is at an elevated risk and requires
immediate attention. Suicidal thoughts in the context of mania can be impulsive, and
prompt intervention is crucial to ensure the client's safety.
Choice C:
Client with a history of mania who is pacing in the hallway: Pacing may be a symptom of
mania, but without additional information about the client's current state and any
potential immediate risks, the client expressing active suicidal ideations takes
precedence. Choice D:
Client diagnosed with hypomania who is complaining of pain: Pain complaints, in the
absence of other urgent factors, do not take precedence over active suicidal ideations.
The risk of harm to oneself or others is a higher priority.
What is being assessed when a nurse asks a client to identify name date, residential
address, and situation?
A. Orientation 100% Most selected
B. Affect 0%
C. Perception 0%
D. Mood 0%
Answer and Explanation
Choice A:
Orientation: When a nurse asks a client to identify their name, date, residential address,
and situation, they are assessing the client's orientation. Orientation refers to an
individual's awareness of time, place, person, and situation.
Choice B:
Affect: Affect refers to the observable expression of emotions. It involves the client's
emotional tone, such as being happy, sad, angry, or flat. It is not directly assessed by
asking about personal information.
Choice C:
Perception: Perception involves the way individuals interpret and make sense of sensory
information. Asking about personal information is more related to orientation than
perception.
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