A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?

Dry mouth

Orthostatic hypotension

Pseudoparkinsonism

Gynecomastia

Answer and Explanation

The Correct Answer is A

Choice A reason: Muscarinic receptor blockers inhibit parasympathetic activity, reducing salivary gland secretion via acetylcholine pathways. This causes dry mouth, as muscarinic receptors in salivary glands are blocked, decreasing saliva production. This anticholinergic effect is common in drugs like benztropine, requiring assessment to manage discomfort and prevent oral health issues.

Choice B reason: Orthostatic hypotension is linked to alpha-1 adrenergic blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic pathways, not vascular tone regulated by norepinephrine. While autonomic effects occur, hypotension is not a primary consequence, making this side effect unrelated to muscarinic receptor antagonism.

Choice C reason: Pseudoparkinsonism results from dopamine receptor blockade, common in antipsychotics, not muscarinic blockers. Muscarinic receptors regulate parasympathetic functions like salivation, not motor control. Blocking muscarinic receptors may alleviate parkinsonism by balancing cholinergic-dopaminergic activity, making this an incorrect side effect for assessment.

Choice D reason: Gynecomastia is associated with hormonal imbalances or dopamine blockade, not muscarinic receptors. Muscarinic blockers affect cholinergic systems, not prolactin or estrogen pathways. This side effect is unrelated to muscarinic antagonism, which primarily causes anticholinergic effects like dry mouth, not endocrine changes.

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Correct Answer is D

Explanation

Choice A reason: Buspirone enhances serotonin activity, taking weeks to reduce anxiety. Panic attacks, driven by acute norepinephrine surges in the amygdala, require rapid intervention. Buspirone’s delayed onset makes it ineffective for acute symptom relief, unlike fast-acting options targeting immediate neurochemical imbalances.

Choice B reason: Venlafaxine, an SNRI, increases serotonin and norepinephrine over weeks, unsuitable for acute panic attacks. Panic involves rapid sympathetic activation, requiring immediate GABA enhancement or similar fast-acting mechanisms, not gradual reuptake inhibition, making venlafaxine incorrect for rapid relief.

Choice C reason: Imipramine, a tricyclic, modulates serotonin and norepinephrine but takes weeks to act. Acute panic, driven by locus coeruleus norepinephrine spikes, needs immediate relief. Imipramine’s slow onset and side effects make it inappropriate for rapid intervention in acute anxiety episodes.

Choice D reason: Alprazolam, a benzodiazepine, enhances GABA-A receptor activity, rapidly inhibiting excessive neural firing in the amygdala during panic attacks. This provides quick relief from acute anxiety symptoms, like tachycardia, within minutes, making it the correct choice for immediate neurobiological stabilization in panic episodes.

A. Intervening when a self-mutilating patient attempts to harm self B. Exploring alternative options with a patient regarding medications C. Suggesting that two patients who are fighting be restricted to the unit D. Staying with a patient who is demonstrating a high level of anxiety

Correct Answer is B

Explanation

Choice A reason: Intervening in self-harm prioritizes beneficence, ensuring safety, over autonomy. Self-mutilation, often linked to dysregulated serotonin or impulsivity, requires immediate action to prevent harm, overriding patient choice. Autonomy is secondary when safety is at risk, making this an incorrect application of the principle.

Choice B reason: Exploring medication options respects autonomy by involving patients in decisions, aligning with their values. This considers individual neurobiological responses (e.g., serotonin reuptake variations) and preferences, empowering informed choice. Autonomy emphasizes patient control over treatment, making this the correct approach for ethical psychiatric care.

Choice C reason: Restricting patients for fighting prioritizes safety and unit order, not autonomy. Conflict may stem from emotional dysregulation or neurotransmitter imbalances, but restricting movement limits patient choice. This action reflects beneficence or justice, not autonomy, making it an incorrect choice for this ethical principle.

Choice D reason: Staying with an anxious patient supports emotional regulation, possibly linked to GABA deficits, but emphasizes beneficence over autonomy. While supportive, it does not involve patient decision-making. Autonomy requires empowering patient choice, not just presence, making this an incorrect application of the ethical principle.

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A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is experiencing a panic attack. What medication will provide the quickest relief from acute severe anxiety symptoms?

Correct Answer is D

Explanation

How does a psychiatric nurse best implement the ethical principle of autonomy?

Correct Answer is B

Explanation

Your patient sometimes forgets to eat. In which part of the nursing care plan would the nurse expect to find this statement: “Offer snacks and finger foods frequently”?

A nurse uses Maslow’s hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority?

Which statement most clearly reflects the stigma of mental illness?

The spouse of a patient who experiences delusions asks the nurse, “Are there any circumstances under which the treatment team is justified in violating the patient’s right to confidentiality?” What is the nurse’s best response?

A client experiences panic attacks when confronted with riding in elevators. The nurse is teaching the client to use relaxation techniques while gradually exposing the client to getting on an elevator. Which technique is the nurse using?

A patient with paranoia states, “The state is monitoring us through the listening devices hidden in this room. Be careful what you say.” Which response by the nurse would be most therapeutic?

Which of the following side effects is associated with the blockade of attachment of norepinephrine to alpha-1 receptors?

On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to do what?