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A nurse in a mental health clinic is caring for a client who has bipolar disorder and a prescription for an antipsychotic medication. The provider and nursing staff suspect the client is not adhering to his medication therapy. Which of the following interventions should the staff use to encourage the client's adherence? (Select all that apply.)

Rotate staff that administer the medications.

Engage the client in conversation following medication administration.

Use sustained-release forms.

Provide for once-daily dosing.

Perform mouth checks following the administration of the medication.

Answer and Explanation

Correct Answer : C,D,E

Answer:C, D, E

Rationale:

A) Rotate staff that administer the medications: Rotating staff can lead to inconsistency in communication and rapport with the client. A consistent nursing team is more likely to build trust and encourage adherence to medication therapy. Therefore, this intervention may not effectively promote adherence.

B) Engage the client in conversation following medication administration: While engaging the client in conversation can help build rapport and create a supportive environment, it may not be the most effective intervention for encouraging medication adherence. The priority should be focused on ensuring the client takes the medication as prescribed, rather than focusing on conversation after administration.

C) Use sustained-release forms: Sustained-release formulations can help with adherence by providing a more consistent therapeutic effect and reducing the number of doses a client needs to take throughout the day. This can simplify the medication regimen, making it easier for the client to adhere.

D) Provide for once-daily dosing: Once-daily dosing is beneficial for improving adherence because it reduces the complexity of the medication regimen. Clients are more likely to remember to take their medication if they only need to do so once a day.

E) Perform mouth checks following the administration of the medication: Performing mouth checks can help ensure that the client has actually taken the medication, especially if there is suspicion of non-adherence. This intervention can confirm that the medication is ingested and can serve as a prompt for adherence in future doses.

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Correct Answer is D

Explanation

A. Bleeding: While haloperidol can cause side effects such as orthostatic hypotension and sedation, it is not typically associated with bleeding as a common adverse effect.

B. Pancreatitis: Pancreatitis is not a common adverse effect of haloperidol. However, it can cause gastrointestinal side effects such as constipation, nausea, and vomiting.

C. Cataracts: Haloperidol is not known to cause cataracts. However, long-term use of antipsychotic medications, including haloperidol, may increase the risk of developing metabolic side effects such as weight gain, dyslipidemia, and hyperglycemia, which can contribute to conditions like diabetes and potentially increase the risk of cataracts.

D. Dysrhythmias: Haloperidol can prolong the QT interval on an electrocardiogram (ECG), leading to an increased risk of dysrhythmias, including torsades de pointes. This risk is particularly important in clients with preexisting cardiovascular conditions or those taking other medications that can prolong the QT interval. Therefore, nurses should monitor clients receiving haloperidol for signs of dysrhythmias, including palpitations, dizziness, and syncope, and promptly report any abnormalities to the healthcare provider.

A. Check the child's blood pressure. B. Shake the container vigorously. C. Be sure the child has not eaten within the hour. D. Perform mouth care.

Correct Answer is B

Explanation

B. Shake the container vigorously:

This is the correct action. Phenytoin suspension tends to settle over time, leading to non-uniform distribution of the medication in the suspension. Therefore, shaking the container vigorously before administering each dose ensures proper dispersion of the medication and helps maintain consistent drug concentration, thus promoting therapeutic efficacy.

A. Check the child's blood pressure:

Checking the child's blood pressure is not directly related to the administration of phenytoin suspension. Monitoring blood pressure may be indicated in certain clinical situations or with certain medications, but it is not specifically required before administering phenytoin suspension.

C. Be sure the child has not eaten within the hour:

While it's important to consider food-drug interactions with certain medications, such as those affected by food intake, there are no specific dietary restrictions associated with phenytoin suspension administration. Therefore, checking whether the child has eaten within the hour is not a necessary step before administering phenytoin suspension.

D. Perform mouth care:

Performing mouth care is not directly related to the administration of phenytoin suspension. However, oral hygiene is important for overall health, especially in children who may have difficulty performing adequate mouth care independently. While mouth care should be encouraged, it is not specifically required before administering phenytoin suspension.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has severe manifestations of schizophrenia and is medicated PRN for agitation with haloperidol. The nurse should assess the client for which of the following adverse effects?

Correct Answer is D

Explanation

A nurse is caring for a 2-year-old child who has seizures and is receiving phenytoin in suspension form. Which of the following actions should the nurse take before administering each dose?

Correct Answer is B

Explanation

A nurse is preparing to administer buspirone 7.5 mg PO every 12 hr to a client. The amount available is buspirone 15 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is preparing to administer midazolam 0.2 mg/kg via IV bolus now. The client weighs 220 lb. How many mg should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is preparing to administer a medication to a client who states. "That looks different from the pill I usually take." Which of the following responses should the nurse make?

A nurse is teaching a client who has a new prescription for diazepam. Which of the following information should the nurse include in the teaching?

A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Which of the following statements by the client indicates an understanding of the teaching?

A nurse in an acute care mental health facility is preparing to administer morning medication for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?

A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.)