A nurse is caring for a client who has psychosis and is prescribed chlorpromazine. The client reports feelings of restlessness. The nurse should identify that the client should be monitored for which of the following adverse effects?

Shuffling walk

Suicidal ideation

Abnormal movements of the tongue and face

Oculogyric crisis

Answer and Explanation

The Correct Answer is D

A. Shuffling walk. A shuffling walk is typically associated with parkinsonism or other movement disorders, which may occur with antipsychotic medications, but the specific symptom of restlessness more directly relates to other conditions.
B. Suicidal ideation. While monitoring for suicidal ideation is important in any client with psychosis, it is not specifically associated with the restlessness that the client reports in relation to chlorpromazine use.
C. Abnormal movements of the tongue and face. Abnormal movements of the tongue and face are more characteristic of tardive dyskinesia, which develops over a longer period of treatment. The acute restlessness the client is experiencing is more closely aligned with akathisia, a side effect of antipsychotic medications.
D. Oculogyric crisis. This condition involves involuntary upward eye movement and can occur as an acute dystonic reaction to antipsychotic medications like chlorpromazine. Given the client's report of restlessness, the nurse should monitor for this adverse effect, as it is more likely to manifest in the context of acute medication side effects.

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Correct Answer is B

Explanation

A. Functional neurological symptom disorder. This condition involves neurological symptoms, such as paralysis or seizures, that cannot be explained by medical findings. The symptoms are not related to fear of disease or body checking, making this option irrelevant in this scenario.
B. Illness anxiety disorder. This disorder is characterized by excessive worry about having or acquiring a serious illness, often accompanied by behaviors like repeated body checking. Clients misinterpret normal bodily sensations as signs of severe disease, which aligns with the client's described symptoms.
C. Somatic symptom disorder. This disorder involves experiencing physical symptoms that cause significant distress or impairment, but the focus is on the symptoms themselves rather than an excessive fear of disease. The behaviors described in the question are more indicative of illness anxiety disorder.
D. Factitious disorder. This involves intentionally producing or feigning symptoms for the purpose of assuming the sick role, rather than from a fear of disease. The client’s fear and checking behaviors do not fit this disorder's criteria.

A. The importance of avoiding foods that contain tyramine when taking an antipsychotic B. The importance of routine red blood cell count laboratory work when taking an antipsychotic C. The importance of limiting fluid intake when taking an antipsychotic D. The importance of medication adherence after the resolution of acute psychosis when taking an antipsychotic

Correct Answer is D

Explanation

A. The importance of avoiding foods that contain tyramine when taking an antipsychotic. Tyramine restrictions apply to monoamine oxidase inhibitors (MAOIs), not antipsychotics like clozapine. MAOIs require dietary modifications to prevent hypertensive crises, but clozapine does not interact with tyramine-containing foods.
B. The importance of routine red blood cell count laboratory work when taking an antipsychotic. Clozapine requires regular white blood cell (WBC) and absolute neutrophil count (ANC) monitoring, not red blood cell counts, due to the risk of agranulocytosis, a potentially fatal condition that can lead to severe infections.
C. The importance of limiting fluid intake when taking an antipsychotic. Fluid restriction is not a standard recommendation for clozapine use. However, some antipsychotics can cause polydipsia (excessive thirst), which may lead to water intoxication, but fluid restriction is not a routine precaution.
D. The importance of medication adherence after the resolution of acute psychosis when taking an antipsychotic. Antipsychotic medications, including clozapine, require long-term adherence to prevent symptom relapse. Clients may feel better and stop taking their medication, increasing the risk of relapse into psychosis, so adherence education is crucial.

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A nurse is caring for a client who has psychosis and is prescribed chlorpromazine. The client reports feelings of restlessness. The nurse should identify that the client should be monitored for which of the following adverse effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who describes extreme fear of having or acquiring a disease. The client is also exhibiting behaviors like repeated body checking. The nurse should identify that the client is exhibiting manifestations of which of the following disorders?

Correct Answer is B

Explanation

A nurse is caring for a client who has been prescribed clozapine. Which of the following topics should the nurse prepare to discuss with the client?

Correct Answer is D

Explanation

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