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 A

Explanation

A. Repeated vomiting in bulimia nervosa can cause swelling of the parotid glands, which is a common physical sign of the disorder.

B. Unlike anorexia nervosa, patients with bulimia are often normal weight or slightly overweight, not severely underweight.

C. Edema is not a typical finding in bulimia unless there is severe electrolyte imbalance, which is less common.

D. Lanugo (fine hair covering the body) is usually associated with anorexia nervosa, not bulimia nervosa.

A. Respect nurse-patient relationship confidentiality. B. File a written report with the agency's ethics committee. C. Anonymously report the abuse by phone to the local child protection agency. D. Reply, I'm glad you feel comfortable talking to me about it."

Correct Answer is C

Explanation

A. Respecting confidentiality is important, but the nurse has a legal and ethical duty to report child abuse, even if the patient discloses it in confidence.

B. Filing a report with the ethics committee does not fulfill the mandatory reporting requirement for child abuse.

C. The nurse must report suspected or disclosed child abuse to the appropriate child protection agency, even if the patient is now in rehabilitation. Anonymity may be used if allowed, but reporting is legally required.

D. Reassuring the patient about comfort in sharing does not address the immediate need to protect the child and fulfill mandatory reporting obligations.

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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

Naxlex Comprehensive Predictor Exams

What physical assessment finding is noticeable in a patient who has a history of bulimia?

Correct Answer is A

Explanation

A patient in alcohol rehabilitation reveals to the nurse. "I feel terrible guilt for sexually abusing my 6-year-old before I was admitted." Select the nurse's most important action.

Correct Answer is C

Explanation

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Select an example of a tort.

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