A patient diagnosed with schizophrenia has received fluphenazine decanoate twice a month for 3 years. The clinic nurse's notes that the patient grimaces and is constantly smacking his lips. The patient's neck and shoulders twist in a slow, snakelike motion. Which problem would the nurse suspect?
Tourette's syndrome
Agranulocytosis
Anticholinergic effects
Tardive dyskinesia
The Correct Answer is D
A. This disorder is characterized by sudden, rapid, recurrent motor movements and vocal tics, not slow, writhing movements caused by long-term antipsychotic use.
B. This is a dangerous reduction in white blood cells, typically presenting with fever, sore throat, or infections, not abnormal involuntary movements.
C. Anticholinergic side effects include dry mouth, blurred vision, constipation, urinary retention, not the repetitive, involuntary movements seen here.
D. This condition is a late-onset side effect of long-term use of antipsychotics, especially first-generation drugs like fluphenazine. It presents as grimacing, lip smacking, and slow, writhing movements of the neck and shoulders, consistent with the patient’s symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Confidentiality does not end when a client dies; healthcare professionals are still required to protect the privacy of medical records and disclosures.
B. This reflects the "duty to warn" principle (Tarasoff ruling), which legally obligates providers to take reasonable steps to protect identifiable individuals if a client poses a threat of harm. This is a recognized exception to confidentiality.
C. Healthcare workers must comply with court orders or subpoenas requesting medical information. Refusing is not legally permissible.
D. Attorneys do not automatically have access to client information; a legal order is required. Confidentiality is not broken based on an attorney’s request alone.
Correct Answer is C
Explanation
A. Thyroid function tests are not routinely required for valproate therapy; this applies more to lithium therapy.
B. A pretreatment EEG is not necessary before starting valproate; it is used primarily for seizure evaluation.
C. Valproate can cause hepatotoxicity, so monitoring liver function tests (LFTs) before and during therapy is essential for safety.
D. High serum sodium levels are not related to valproate toxicity; this concern is associated with lithium therapy, not valproate.
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