A client diagnosed with schizophrenia, who has been taking antipsychotic medication for the last 5 months, presents in an emergency department (ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect the physician to recognize which condition and implement which treatment?
Neuroleptic malignant syndrome, treated by discontinuing antipsychotic medications
Agranulocytosis treated by administration of clozapine (Clozaril)
Tardive dyskinesia treated by discontinuing antipsychotic medication
Headache treated by administration of Hydrochlorothiazide
The Correct Answer is C
A. Neuroleptic malignant syndrome, treated by discontinuing antipsychotic medications: The symptoms described (uncontrollable tongue movements, stiff neck, difficulty swallowing) are more indicative of tardive dyskinesia than neuroleptic malignant syndrome. Neuroleptic malignant syndrome is characterized by hyperthermia, autonomic dysregulation, altered mental status, and generalized muscle rigidity. Treatment involves discontinuing antipsychotic medications and supportive care.
B. Agranulocytosis treated by administration of clozapine (Clozaril): Agranulocytosis is a rare but serious side effect of clozapine, not a treatment for the symptoms described. The symptoms presented are more consistent with tardive dyskinesia.
C. Tardive dyskinesia treated by discontinuing antipsychotic medication: This is the correct answer. Tardive dyskinesia is a movement disorder characterized by involuntary and abnormal movements, including tongue protrusion and facial grimacing. It can result from long-term use of antipsychotic medications, and discontinuing or reducing the dose of the antipsychotic is a primary intervention.
D. Headache treated by administration of Hydrochlorothiazide: Hydrochlorothiazide is a diuretic used to treat conditions like high blood pressure and edema, not headache or the symptoms described, which are more indicative of tardive dyskinesia.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
While all the outcomes are important in the overall care of a client with bipolar disorder, the safety of the client takes precedence, especially during the acute phase of the disorder. Bipolar disorder is characterized by mood swings that can include episodes of mania, which may involve risky behaviors or even thoughts of self-harm.
A. The client will remain safe throughout hospitalization: This is the priority outcome. Ensuring the safety of the client during hospitalization involves monitoring for any signs of self-harm or harm to others, managing any acute manic or depressive symptoms, and providing a secure environment.
B. The client will accomplish activities of daily living independently by discharge: While independence in activities of daily living is a valuable outcome, it may not be the immediate priority during the acute phase of bipolar disorder. Addressing safety and stabilization come first.
C. The client will use problem-solving to cope adequately after discharge: Coping skills are important for long-term management, but ensuring safety and stabilization during the hospitalization phase takes precedence. Coping skills can be addressed as part of the overall treatment plan.
D. The client will verbalize feelings during group sessions by discharge: Expression of feelings is an important aspect of mental health treatment, but safety and stabilization remain the priority, especially during the acute phase of bipolar disorder.
Correct Answer is A
Explanation
A. "I'm the world's most perceptive attorney.": This statement reflects grandiosity, a common feature of grandiose delusions. The client is expressing an exaggerated belief in their own importance and abilities, indicating a distorted perception of reality.
B. "The FBI is out to get me": This statement suggests paranoid delusions, where the client believes they are being persecuted or conspired against. It does not specifically indicate grandiose delusions.
C. "I can't stop my sexual urges. They have led me to numerous affairs": This statement reflects impulsivity and hypersexuality, which are common features in manic episodes but do not specifically indicate grandiose delusions.
D. "My wife is distraught about my overspending": This statement reflects a consequence of manic behavior (overspending) but does not directly indicate grandiose delusions.
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