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 C
Explanation
A. While communication may improve indirectly, the primary goal of stimulant therapy for ADHD is to reduce hyperactivity and impulsivity, not directly increase verbal expressiveness.
B. This may be a secondary benefit, but the main desired outcome is improved behavioral control during social interactions, particularly in play.
C. Stimulant medications like amphetamine salts help the child control impulsive behavior, reduce hyperactivity, and improve attention, allowing participation in cooperative play and structured activities.
D. Self-regulation skills develop with behavioral interventions and therapy, not directly from medication alone.
Correct Answer is D
Explanation
A. Chronic deterioration refers to a gradual, long-term decline in functioning, not the sudden emergence of new or worsening psychotic symptoms.
B. While relapse can sometimes be related to nonadherence, there is no direct evidence here that the patient has stopped taking medication, so this cannot be assumed.
C. Psychoeducation may be helpful, but the immediate concern is the reemergence of psychotic symptoms, not just a lack of understanding about the illness.
D. The patient is displaying insomnia, tension, difficulty concentrating, and paranoid delusions, which are early warning signs of a psychotic relapse in schizophrenia. Prompt intervention is necessary to prevent full exacerbation.
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