A nurse in an emergency department is assessing a client who has been taking haloperidol for 3 months. The client has a temperature of 39.5* C (103.4° F), blood pressure of 150/110 mm Hg, and muscle rigidity. Which of the following complications should the nurse suspect?

Akathisia

Neuroleptic malignant syndrome

Tardive dyskinesia

Agranulocytosis

Answer and Explanation

The Correct Answer is B

A. Akathisia: Akathisia is characterized by restlessness and an inability to sit still. While it can be a side effect of antipsychotic medications like haloperidol, it does not present with fever, hypertension, and muscle rigidity, as described in the scenario.

B. Neuroleptic malignant syndrome (NMS): NMS is a potentially life-threatening condition associated with antipsychotic medications like haloperidol. It is characterized by hyperthermia, autonomic dysfunction (e.g., hypertension), altered mental status, and severe muscle rigidity. The client's symptoms of fever, elevated blood pressure, and muscle rigidity are consistent with NMS.

C. Tardive dyskinesia: Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements of the face, tongue, and other body parts. It is a long-term side effect of antipsychotic medications and typically develops after prolonged use, unlike the acute onset seen in the scenario.

D. Agranulocytosis: Agranulocytosis is a rare but serious side effect of antipsychotic medications, characterized by a severe reduction in white blood cell count, leading to an increased risk of infection. The symptoms described in the scenario are not consistent with agranulocytosis.

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Correct Answer is A

Explanation

Alprazolam is a benzodiazepine medication commonly used to treat anxiety and insomnia. Here's the rationale for each option:

A. "Avoid activities that require alertness, such as driving.": Alprazolam can cause drowsiness and impair cognitive function, so it's essential for clients to avoid activities that require alertness, such as driving or operating heavy machinery, while taking this medication. Providing this instruction promotes safety and prevents accidents.

B. "Monitor for peripheral edema.": Peripheral edema is not a common side effect of alprazolam. This instruction is not relevant to the use of this medication.

C. "Take this medication with a high-fat meal.": Alprazolam can be taken with or without food, but taking it with a high-fat meal may delay its absorption. Therefore, it is not necessary to instruct the client to take it with a high-fat meal, especially since this may affect the medication's effectiveness.

D. "Take this medication every night before sleep.": While alprazolam may be used to treat insomnia, it is not typically recommended for nightly use due to the risk of dependence and tolerance. Using it nightly can lead to addiction and withdrawal symptoms if abruptly stopped. Therefore, this instruction is not appropriate.

A. Brain natriuretic peptide B. Erythrocyte sedimentation rate C. Thyroid hormone assay D. Liver function tests

Correct Answer is C

Explanation

A. Brain natriuretic peptide - Brain natriuretic peptide (BNP) is primarily used to diagnose heart failure and assess its severity. It is not routinely monitored in clients taking lithium.

B. Erythrocyte sedimentation rate - Erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation and is not specifically related to lithium therapy monitoring.

C. Thyroid hormone assay - Monitoring thyroid function is essential in clients taking lithium because lithium can affect thyroid function, leading to hypothyroidism or hyperthyroidism. Therefore, checking thyroid hormone levels (T3, T4, and TSH) is important before administering lithium.

D. Liver function tests - While lithium can affect liver function in some cases, routine monitoring of liver function tests is not typically required for clients taking lithium. However, periodic liver function tests may be ordered if clinically indicated or if the client has underlying liver disease.

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A nurse in an emergency department is assessing a client who has been taking haloperidol for 3 months. The client has a temperature of 39.5* C (103.4° F), blood pressure of 150/110 mm Hg, and muscle rigidity. Which of the following complications should the nurse suspect?

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