A client with psychosis who is receiving an antipsychotic medication is continuously rubbing the back of the neck. Which nursing intervention is best for the nurse to implement?

Obtain an extra pillow for the client to use at night.

Provide the client with a heating pad to place around the neck.

Give PRN prescription for benztropine.

Obtain a prescription for physical therapy services.

Answer and Explanation

The Correct Answer is C

Continuous rubbing of the back of the neck can be a side eﬀect of antipsychotic medication, known as acute dystonia. Benztropine is an anticholinergic medication that can eﬀectively treat acute dystonia. Therefore, the nurse should give a PRN prescription for benztropine to relieve the client's discomfort. Options a, b, and d do not address the underlying issue of acute dystonia and are not the best interventions for this particular situation.

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Correct Answer is D

Explanation

Sucralfate is a medication used to treat and prevent the return of duodenal ulcers. It is important to take sucralfate on an empty stomach, either 1 hour before meals or 2 hours after meals. This allows the medication to work eﬀectively by sticking to damaged ulcer tissue and protecting against acid and enzymes so healing can occur.

A. Teach the client self-injection skills for daily subcutaneous administration. B. Demonstrate how to select dose based on before meal blood sugar readings. C. Explain to the family how to inject this medication for severe hypoglycemia. D. Provide information on increasing medication dosage if ketoacidosis occurs.

Correct Answer is A

Explanation

Insulin glargine is a long-acting insulin that is given once daily at the same time every day via subcutaneous injection. Therefore, it is essential to teach the client self-injection skills for daily subcutaneous administration to ensure proper administration of insulin.

Option b is incorrect because insulin glargine is typically given at the same dose every day, not based on before meal blood sugar readings.

Option c is incorrect because insulin glargine is not used for the treatment of severe hypoglycemia, and it should not be administered by someone who is not trained to do so.

Option d is incorrect because ketoacidosis is a serious complication of diabetes mellitus that requires urgent medical atention, and increasing medication dosage is not appropriate for this condition.

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A client with psychosis who is receiving an antipsychotic medication is continuously rubbing the back of the neck. Which nursing intervention is best for the nurse to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning to administer the antiulcer GI agent sucralfate to a client with a peptic ulcer disease. Which action should the nurse include in this client’s plan of care?

Correct Answer is D

Explanation

The nurse is planning to discharge teaching for a client with diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse include in the discharge teaching?

Correct Answer is A

Explanation

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