A patient begins therapy with clozapine medication. What teaching should the nurse provide related to the drug’s strong dopaminergic effect?
Monitor for weight gain and metabolic changes
Watch for movement disorders like tardive dyskinesia
Report any signs of infection immediately
Expect improved mood within days
The Correct Answer is B
Choice A reason: Weight gain and metabolic changes are side effects of clozapine, primarily due to its antihistaminic and serotonergic effects, not its dopaminergic action. Dopamine blockade is more associated with movement disorders, making this choice incorrect for teaching related to dopaminergic effects.
Choice B reason: Clozapine’s strong dopaminergic effect, particularly D2 receptor blockade, can cause extrapyramidal symptoms like tardive dyskinesia, a movement disorder. Patient education must emphasize monitoring for abnormal movements, as these are significant risks in antipsychotic therapy, making this the correct choice.
Choice C reason: Infection risk, particularly agranulocytosis, is a serious clozapine side effect but is unrelated to its dopaminergic action. It stems from bone marrow suppression, requiring blood monitoring, not dopamine-related teaching, making this choice incorrect for the question’s focus.
Choice D reason: Improved mood is not a direct result of clozapine’s dopaminergic effect, which primarily addresses psychotic symptoms. Mood changes occur over weeks and involve multiple receptors, not just dopamine, making this choice incorrect for dopaminergic-focused teaching.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A neutral attitude in psychiatric nursing maintains professional boundaries and objectivity, preventing bias or emotional entanglement. This fosters a therapeutic environment, allowing patients to express feelings without judgment, aligning with principles of therapeutic communication and mental health care, making this the correct choice.
Choice B reason: Brief check-ins, while useful, may not provide the depth needed for therapeutic care in mental health settings. Consistent, meaningful engagement is more effective for building trust and addressing complex emotional needs, making this approach less optimal compared to maintaining neutrality.
Choice C reason: Discussing a patient’s feelings with another individual risks breaching confidentiality unless authorized by the patient or legally required. This violates ethical standards in mental health care, which prioritize privacy, making this approach non-therapeutic and incorrect for supporting patient care.
Choice D reason: Sharing personal mental health information blurs professional boundaries, potentially shifting focus from the patient’s needs to the nurse’s experiences. This undermines therapeutic communication and objectivity, risking patient trust and care quality, making this approach inappropriate and incorrect.
Correct Answer is C
Explanation
Choice A reason: Autonomy involves respecting a patient’s right to make decisions. While relevant in mental health, the scenario focuses on differing treatments for similar conditions, not patient choice, making autonomy less directly applicable than the principle of fair treatment across patients.
Choice B reason: Beneficence emphasizes promoting patient well-being. Both restraints and supervision aim to prevent harm, fulfilling beneficence, but the concern is about unequal treatment, not the intent to benefit, making this principle less relevant than justice.
Choice C reason: Justice involves fair and equitable treatment for all patients. Using restraints for one self-mutilating patient and supervision for another raises concerns about consistency and fairness in care, directly aligning with the ethical principle of justice, making this the correct choice.
Choice D reason: Nonmaleficence focuses on avoiding harm. Both interventions aim to prevent self-mutilation, fulfilling this principle, but the ethical issue is about equitable application, not harm avoidance, making justice the more relevant principle in this scenario.
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