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

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. This is more commonly associated with phencyclidine (PCP) or alcohol intoxication, not cocaine.

B. Cocaine is a powerful stimulant that activates the sympathetic nervous system. This results in mydriasis (dilated pupils), increased heart rate, elevated blood pressure, hypervigilance, and euphoria.

C. Depression is more likely during cocaine withdrawal, not intoxication.

D. Like depression, hypersomnia is a withdrawal symptom. Intoxication typically causes insomnia and restlessness.

A. Amnesiac Syndrome B. Alzheimer's Disease C. Delirium D. Dementia

Correct Answer is C

Explanation

A. This involves memory loss due to brain injury or alcohol abuse, not acute fluctuating confusion.

B. Alzheimer’s causes progressive, irreversible memory decline that develops gradually, not suddenly over 2 days.

C. Delirium is characterized by acute onset, fluctuating levels of orientation, confusion, speech changes, and impaired gait, often triggered by medications, infections, or metabolic issues.

D. Dementia develops slowly and progressively, not suddenly like delirium.

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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?

Nursing Test Bank

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Explanation

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