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 A

Explanation

Choice A reason: Confidentiality can be breached if a patient poses a threat to others, as in Tarasoff rulings, due to safety risks from delusions driven by dopamine dysregulation. This legal and ethical exception ensures protection, aligning with psychiatric principles prioritizing harm prevention over absolute confidentiality.

Choice B reason: Absolute confidentiality is incorrect, as exceptions exist for safety. Delusions, linked to mesolimbic dopamine excess, may lead to threats requiring disclosure. Legal frameworks allow breaching confidentiality to protect others, making this response scientifically and ethically inaccurate for psychiatric practice.

Choice C reason: Law enforcement inquiries do not automatically override confidentiality. Disclosure is limited to specific legal mandates, like imminent danger from dopamine-driven delusions. Routine questions do not justify breaches, making this response incorrect for the ethical and legal standards in psychiatric care.

Choice D reason: Confidentiality breaches are not solely at the psychiatrist’s discretion. Legal and ethical guidelines, like those for threats from delusional states, dictate exceptions. This option oversimplifies complex regulations, ignoring standardized protocols for managing risks in psychiatric patients, making it incorrect.

A. Paroxetine (Paxil) B. Imipramine (Tofranil) C. Hydroxyzine (Vistaril) D. Alprazolam (Xanax)

Correct Answer is A

Explanation

Choice A reason: Paroxetine, an SSRI, is first-line for GAD, enhancing serotonin in the amygdala and prefrontal cortex, reducing excessive worry. Its efficacy and tolerability, with minimal dependence risk, align with evidence-based guidelines for long-term anxiety management, making it the preferred choice.

Choice B reason: Imipramine, a tricyclic antidepressant, affects serotonin and norepinephrine but has significant anticholinergic side effects, reducing tolerability. It is not first-line for GAD due to slower onset and side effect profile compared to SSRIs, which better target anxiety’s neurobiological basis.

Choice C reason: Hydroxyzine, an antihistamine, reduces anxiety via histamine receptor blockade, causing sedation. It is used as needed, not for chronic GAD management. SSRIs, like paroxetine, offer sustained serotonin modulation, making hydroxyzine a less effective, non-first-line option for long-term treatment.

Choice D reason: Alprazolam, a benzodiazepine, enhances GABA activity, providing rapid anxiety relief but carries high dependence risk. It is not first-line for GAD, as SSRIs offer safer, long-term serotonin-based treatment, making alprazolam unsuitable for chronic management due to addiction potential.

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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

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?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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