A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social function. The patient is also overweight and hypertensive. Which drug should the nurse advocate?
Aripiprazole (Abilify)
Olanzapine (Zyprexa)
Clozapine (Clozaril)
Ziprasidone (Geodon)
The Correct Answer is A
A. Aripiprazole is an atypical antipsychotic with a lower risk of weight gain, metabolic syndrome, and hypertension compared with olanzapine or clozapine, making it suitable for a patient who is overweight and hypertensive. It effectively treats positive symptoms such as auditory hallucinations and may improve social functioning.
B. Olanzapine is effective for schizophrenia but is associated with significant weight gain, hyperlipidemia, and worsening hypertension, making it less appropriate for this patient.
C. Clozapine is reserved for treatment-resistant schizophrenia due to risks of agranulocytosis, myocarditis, and metabolic side effects; it is not first-line for this patient.
D. Ziprasidone has a lower risk of metabolic side effects than olanzapine or clozapine, but it carries a risk of QT prolongation, which may be concerning in hypertensive patients with potential cardiac risks.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This comment uses reflective communication to seek clarification and ensures the nurse accurately understands the patient’s concerns and feelings.
B. "Tell me everything from the beginning" may overwhelm the patient and does not specifically clarify understanding.
C. "Tell me again about your experiences" asks for repetition rather than clarification of understanding.
D. "What are the common elements here?" may be too abstract and analytical, making it difficult for the patient to respond effectively.
Correct Answer is A
Explanation
A. "My family will be better off without me" is an indirect or covert suicidal statement (passive ideation) that suggests the patient believes others would be better off if they were gone. Such remarks require immediate assessment of suicide risk (ask directly about thoughts, intent, plan, access to means) and appropriate safety interventions.
B. "Life is not worth living" is an explicit expression of hopelessness and indicates suicidal ideation, but it is more overt than covert. It still warrants urgent assessment, but the question asked specifically for the covert message.
C. "I wish I were dead" is a direct statement of suicidal desire (overt) rather than a covert hint.
D. "I have a plan that will fix everything" is the most concerning because it indicates a specific plan (high lethality risk), but it is overt rather than covert.
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