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 B
Explanation
Choice A reason: Asking if the client felt this way before hospitalization focuses on past feelings, which may not address the current emotional state or therapeutic needs. While it gathers history, it lacks empathy and does not encourage the client to elaborate on their current concerns, making it less therapeutic.
Choice B reason: Reflecting the client’s statement by asking if they feel the setting is wrong demonstrates active listening and empathy, key components of therapeutic communication. It encourages the client to express feelings, fostering trust and exploration of their concerns, aligning with psychiatric nursing principles, making this the correct choice.
Choice C reason: Suggesting the client discuss concerns later with a doctor dismisses their current emotional state, potentially undermining trust in the nurse-client relationship. It avoids immediate engagement and fails to address the client’s feelings, which is critical in psychiatric care, making this response non-therapeutic and incorrect.
Choice D reason: Labeling the client’s statement as inappropriate is judgmental and dismissive, hindering therapeutic communication. It may increase the client’s sense of alienation or shame, contrary to psychiatric nursing goals of building trust and validating feelings. This response is non-therapeutic and does not support the client’s emotional needs.
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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