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: Zolpidem, a nonbenzodiazepine sedative, affects the central nervous system, causing sedation and impaired coordination, particularly in the elderly. Age-related declines in metabolism and balance increase fall risk, a critical nursing consideration. Monitoring mobility and ensuring safety measures are essential to prevent injuries, making this the correct choice.
Choice B reason: While zolpidem may cause daytime drowsiness, this is not the primary nursing consideration compared to fall risk in the elderly. Drowsiness is a general side effect, but the elderly’s heightened vulnerability to falls due to sedation and impaired coordination takes precedence, making this choice less critical.
Choice C reason: Zolpidem has a lower dependence risk than benzodiazepines, and dependence is not inevitable. This assumption overstates the risk and is not the primary nursing consideration. Fall prevention, especially in vulnerable populations like the elderly, is more urgent due to immediate safety concerns, making this choice incorrect.
Choice D reason: Zolpidem induces sedation rapidly, typically within 15–30 minutes, not requiring 4 weeks. This choice is factually incorrect, as prolonged use is not necessary for efficacy. The primary concern is immediate side effects like falls, not a delayed onset, making this an invalid nursing consideration.
Correct Answer is A
Explanation
Choice A reason: A 16-year-old voluntarily admitted for mental health treatment has the legal right to refuse treatment, as voluntary admission implies consent and autonomy. Minors may have limited rights, but voluntary status allows refusal unless overridden by guardianship or legal statutes, making this the correct choice.
Choice B reason: A 20-year-old with court-ordered treatment lacks the legal right to refuse, as a court mandate overrides autonomy due to assessed risk or incapacity. Legal frameworks prioritize compliance in such cases to ensure safety and treatment efficacy, making this choice incorrect.
Choice C reason: A 35-year-old involuntarily admitted client cannot refuse treatment, as involuntary admission indicates a legal determination of danger or incapacity. Mental health laws prioritize intervention over autonomy in these cases to protect the client or others, making this choice incorrect.
Choice D reason: An adult refusing life-threatening treatment may face legal restrictions, as mental health laws can override refusal if the client poses a danger or lacks capacity. This scenario does not clearly grant a legal right to refuse, unlike voluntary admission, making this choice incorrect.
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