A nurse is educating a client starting on risperidone. Which of the following statements best explains the unique pharmacological action of second-generation antipsychotics compared to first-generation antipsychotics?
They enhance dopamine transmission to improve cognitive function in schizophrenia.
They block dopamine and serotonin receptors, reducing extrapyramidal side effects.
They primarily block dopamine D2 receptors, leading to high rates of extrapyramidal symptoms.
They selectively block only serotonin receptors, improving mood without affecting dopamine.
The Correct Answer is B
Choice A reason: Enhancing dopamine transmission is not the mechanism of antipsychotics; excessive dopamine is implicated in schizophrenia’s positive symptoms, so reducing—not enhancing—dopamine activity is key.
Choice B reason: Blocking both dopamine and serotonin receptors is characteristic of second-generation (atypical) antipsychotics. This dual action reduces extrapyramidal side effects while still targeting positive and negative symptoms.
Choice C reason: First-generation antipsychotics primarily block dopamine D2 receptors, which increases the risk for extrapyramidal side effects such as dystonia and parkinsonism.
Choice D reason: Selective serotonin receptor blockade is not the defining mechanism of second-generation antipsychotics. These medications act on both dopamine and serotonin systems.
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Related Questions
Correct Answer is ["C","E"]
Explanation
Choice A reason: Propranolol is a beta-blocker primarily used for performance-related anxiety and physical symptoms like tremors or palpitations. It is not considered first-line or standard treatment for panic disorder.
Choice B reason: Clonidine is an alpha-2 adrenergic agonist used more often for hypertension, withdrawal syndromes, and sometimes ADHD. It is not a recommended pharmacologic option for panic disorder.
Choice C reason: Alprazolam, a benzodiazepine, is effective for acute management of panic attacks by rapidly reducing anxiety. However, it is generally used short-term due to risks of tolerance, dependence, and withdrawal.
Choice D reason: Buspirone is an anxiolytic used mainly for generalized anxiety disorder. It lacks efficacy in panic disorder and is not typically prescribed for it.
Choice E reason: Clonazepam, another benzodiazepine, is often used to manage panic disorder due to its longer half-life compared to alprazolam, making it effective in reducing frequency and severity of panic attacks.
Correct Answer is D
Explanation
Choice A reason: While weight gain is a common side effect of olanzapine, simply stating this without providing management strategies does not support the client’s health.
Choice B reason: Stopping the medication abruptly without medical guidance risks relapse of psychotic symptoms and is unsafe.
Choice C reason: First-generation antipsychotics have their own significant risks, including extrapyramidal side effects, and are not automatically safer. Medication changes should only be considered if lifestyle modifications fail and under provider supervision.
Choice D reason: Encouraging healthy lifestyle changes like diet modification and exercise helps manage weight gain while maintaining medication adherence, making this the most appropriate intervention.
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