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

Answer and Explanation

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

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason: Clozapine, an antipsychotic, primarily causes agranulocytosis and metabolic issues, not fluid or electrolyte imbalances. Its effects on the central nervous system and bone marrow do not directly disrupt electrolyte homeostasis, making this choice incorrect for this concern.

Choice B reason: Lithium, a mood stabilizer, affects renal function, impairing sodium and water reabsorption, leading to potential hyponatremia or dehydration. This requires close monitoring of electrolytes, as imbalances can cause toxicity, making this the correct choice for heightened alertness.

Choice C reason: Fluoxetine, an SSRI, primarily affects serotonin levels, with minimal impact on fluid or electrolyte balance. Side effects like nausea do not significantly disrupt electrolytes, making this choice incorrect compared to lithium’s known renal effects.

Choice D reason: Venlafaxine, an SNRI, influences serotonin and norepinephrine but does not significantly affect fluid or electrolyte balance. Its side effects, like hypertension, are unrelated to electrolyte homeostasis, making this choice incorrect for this specific concern.

A. “You have to attend the session, or you won’t make progress.” B. “I’ll let your doctor know you’re refusing to participate.” C. “Can you share what’s making you hesitant about group therapy today?” D. “If you don’t go, you’ll miss out on important treatment.”

Correct Answer is C

Explanation

Choice A reason: Using coercive language, like stating attendance is mandatory for progress, undermines patient autonomy and may increase resistance, especially in a manic phase where defiance is common. This non-therapeutic approach hinders trust, making it incorrect for promoting engagement.

Choice B reason: Reporting refusal to the doctor without exploring the patient’s reasons dismisses their feelings and escalates authority rather than fostering collaboration. Therapeutic engagement requires understanding the patient’s perspective, making this response non-therapeutic and incorrect.

Choice C reason: Asking about the patient’s hesitation uses open-ended questioning, a therapeutic communication technique that encourages expression of feelings and builds trust. This aligns with psychiatric nursing principles to engage patients respectfully, especially during mania, making this the correct choice.

Choice D reason: Warning about missing treatment is mildly coercive and does not explore the patient’s reasons for refusal. It fails to address underlying concerns, such as anxiety or grandiosity, which are critical in mania, making this less therapeutic than exploring hesitancy.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A patient begins therapy with clozapine medication. What teaching should the nurse provide related to the drug’s strong dopaminergic effect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for patients receiving clozapine, lithium, fluoxetine, and venlafaxine. Which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance?

Correct Answer is B

Explanation

A nurse is caring for a patient with bipolar disorder who is in a manic phase and refuses to attend a scheduled group therapy session. Which response by the nurse best promotes therapeutic engagement?

Correct Answer is C

Explanation

What must the nurse obtain from the patient in order for medical information to be released to another health care facility or third party regarding a patient diagnosed with a mental illness?

Hildegard Peplau came up with the phases of the nurse-patient relationship. What does the nurse address during the orientation phase with a patient diagnosed with a psychiatric disorder?

A patient begins therapy with clozapine medication. What teaching should the nurse provide related to the drug’s strong dopaminergic effect?

Which assessment finding most clearly indicates that a patient may be experiencing a mental illness?

In which situations would a nurse have the duty to intervene and report? (Select all that apply)

A nurse is caring for a patient with a mental health disorder. Which approach best supports therapeutic care?

A nurse is caring for a group of clients in an acute mental health facility. Which of the following clients has the legal right to refuse treatment?

A fearful patient has an increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter?